Anesthesia for labor and vaginal delivery includes various modalities including pharmacological and non-pharmacological techniques. Non-pharmacological Non-pharmacological techniques include Lamaze breathing, acupuncture, acupressure, LeBoyer technique, transcutaneous nerve stimulation, massage, hydrotherapy, vertical positioning, presence of a support person, intradermal water injections, and biofeedback amongst many more. Water immersion in the first stage of labor may reduce women's use of epidural. A meta analysis showed there may be benefits to the presence of a support individual (doula, family member) including lower use of pharmacologic analgesia, decreased length of labor, and lower incidence of cesarian section. Hypnosis warrants further investigation. Medications<unk> sts employ the following pharmacological agents and techniques: * Parenteral (IV) agents: opioids such as meperidine, morphine (rarely used today), and fentanyl * Inhalation agents: volatile anesthetics such as isoflurane, sevoflurane, and desflurane or nitrous oxide. * Neuraxial (regional) anesthetic and analgesia techniques: (e.g. epidural, spinal, combined spinal-epidural) are used most widely in the United States today. These regional techniques are considered the most effective form of labor pain relief (vaginal deliveries) with high rates of maternal satisfaction. Other nerve blocks for labor include paracervical and pudendal blocks which target different nerve distributions. Anesthesia for cesarean sections (C-sections) most commonly uses neuraxial (regional) anesthesia due to its better safety profile for both mother and baby. However, for emergencies or cases where neuraxial anasthesia cannot be used, general anesthesia is used instead. Drugs used to induce general anesthesia include thiopental, propofol, etomidate, and ketamine. Unconsciousness is maintained using inhalation agents, and muscle relaxing agents are used as needed. Opioids are less commonly used prior to delivery due to fear of adverse effects on the neonate. However under certain circumstances it is important to attenuate the hypertensive responses to induction and incision and ultra-short acting opioids (remifentanil and alfentanil) appear to be efficacious and safe.
Obstetric anesthesiology
Traumatology
Obstetrical nursing
Obstetrics
Cardiogeriatrics
Teratology
Foundation doctor
Anesthesiology