SubSpecialties  |   December 2014
All That Is Old Is New: Obstetric Anesthesia
Author Affiliations
  • Robert Gaiser, M.D., M.S.Ed.
    Society for Obstetric Anesthesia and Perinatology
    President
Article Information
Obstetric Anesthesia / SubSpecialties
SubSpecialties   |   December 2014
All That Is Old Is New: Obstetric Anesthesia
ASA Monitor 12 2014, Vol.78, 50-52.
ASA Monitor 12 2014, Vol.78, 50-52.
Obstetric anesthesia continues to evolve, providing improved care for both the mother and the neonate. While the means for providing anesthesia and analgesia have changed, the goals for obstetric anesthesia have remained the same, i.e., comfortable delivery for the mother with no interference of the labor process, resulting in a healthy newborn. The means of achieving the goals have changed with research and new developments. The interesting aspect to these changes is that several techniques which were used 20 or more years ago are currently being revisited.
When I was completing my fellowship in obstetric anesthesia in 1992, I was trained in the use of inhalation analgesia. Since women were transferred from the labor room to the delivery room (operating room), a parturient would occasionally receive inhaled analgesia during the delivery process if she did not have neuraxial analgesia. It was not used frequently because of the concern of aspiration and of induction of general anesthesia. Induction of general anesthesia was a concern for the parturient given the increase in minute ventilation and decrease in functional residual capacity. As separate labor rooms and delivery rooms merged into a single LDR room (labor/delivery/recovery) and as the use of epidural analgesia increased, the use of inhaled analgesia decreased. It would occasionally be used when a patient undergoing a cesarean delivery required supplemental analgesia; in this case, nitrous oxide would be used. However, there recently has been an increasing interest in the use of nitrous oxide for labor analgesia.
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