Anesthetic management of labor pain: what does an obstetrician need to know?

Abstract

Obstetrical anesthesia is considered by many to be a high-risk subspecialty of anesthesia practice that is laden with clinical challenges and medico-legal liability. Anesthesia-related complications are the sixth leading cause of pregnancy-related maternal mortality in the United States. Difficult or failed intubation following induction of general anesthesia for cesarean delivery remains the major contributory factor to anesthesia-related maternal complications. Communication skills and exchange of information (between anesthesiologists, obstetricians, and nurses) in an ever changing environment of labor and delivery are essential for a perfect outcome, which is always expected when providing safe passage for both the mother and her fetus from antepartum to postpartum period. The safe provision of labor anesthesia and/or analgesia requires appropriate staff, facilities, and equipment for proper patient safety. This article is intended for obstetricians and reviews the current guidelines for the administration of obstetrical anesthesia and analgesia.