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Obstetric Anesthesia: Changes and Choices


  • William F. McCool CNM, PhD,

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    • 1William F. McCool, CNM, PhD, FACNM, is the Director of the Midwifery Graduate Program in the School of Nursing at the University of Pennsylvania in Philadelphia, PA.

  • Jana Packman RN, CRNA,

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    • 2Jana Packman, RN, MSN, CRNA, is a recent graduate of the Pennsylvania Hospital School of Nurse Anesthesia.

  • Arthur Zwerling MS, MSN, CRNA

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    • 3Arthur Zwerling, MS, MSN, CRNA, FAAPM, is the program director of the University of Pennsylvania School of Nurse Anesthesia.

Midwifery Graduate Program, University of Pennsylvania School of Nursing, 420 Guardian Drive, Philadelphia, PA 19104. E-mail:


This article is a review of analgesics and anesthetics offered to laboring women, including intravenous drugs, epidural and spinal agents, and inhalational anesthetics. An overview of the uses, risks, and benefits is provided for each anesthetic alternative. To provide the most effective care to women in labor, clinicians have a responsibility to have current knowledge of the best evidence for safety and efficacy of these pharmacologic agents and techniques and be able to effectively communicate this information to clients.