Obstetrical Anesthesia

The birth of a child is one of the most exciting experiences of one’s life. The physicians and staff of Anesthesia Medical Group are committed to making the delivery of your newborn as safe and comfortable as possible. Administering more than 12,000 labor anesthetics per year, AMG is very skilled in providing several types of analgesia and anesthesia. Because every pregnancy is unique, we work with each patient individually to determine the safest and most effective form of anesthesia for delivery. Many forms of anesthesia are available to help control the pains of labor. We hope the following information will help you make an informed decision regarding your anesthetic options

Types of Pain Control

• Natural childbirth: Some women are able to achieve adequate pain control through non-medical techniques such as controlled breathing, meditation, focused relaxation and massage.
• IV (Intravenous) Medication: The obstetrician can order pain medication that can be administered through the patient’s IV. These medications can effectively reduce the pains of labor, but rarely stop the pain entirely. Some women have adequate pain control for delivery with only IV medications. These medications must be given carefully as they can sedate the patient and the newborn.
• Local Anesthesia:The obstetrician can inject local anesthetics directly into the vaginal area to relieve the pain associated with delivery. Local anesthetics will not provide adequate pain relief in the earlier stages of labor.
• Regional Blocks: More commonly known as epidurals or spinals, this technique provides good pain relief for the entire labor and delivery. Epidurals are more commonly used for labor and vaginal deliveries. Having an epidural catheter allows medication to be given for pain relief for as long as necessary. They can also be used to provide excellent anesthesia should a C-section become necessary. Spinals are typically used for elective C-sections.

Administering an Epidural

A patient usually receives her epidural in the labor room early in her labor. The OB nurse under the supervision of the obstetrician, works with each patient to determine the best time to request an epidural. The epidural will be placed and managed by the anesthesia department. The patient is asked to lie on her side or sit up on the edge of the bed. Her back is then washed with a sterile solution and covered with a sterile drape with an opening over her lower back. A small area of skin will be anesthetized with local anesthetic. An epidural needle will be placed through this area to the epidural space and a catheter (a tiny plastic tube) will be inserted. The needle will then be completely removed leaving the catheter in place. The catheter will then be secured to the patient’s back with tape. The epidural is now ready for the anesthetic medication to be administered. The epidural is typically attached to a pump that continuously administers a small amount of anesthetic that will maintain the pain relief.

Comfort Level

Every patient has a different pain tolerance. The goal of the anesthesia staff is to maximize each patient’s pain relief while providing a safe delivery. An optimized epidural will allow the patient to still feel her contractions but remain pain free. This allows the patient enough muscle function to push when the time comes. Even though the placement and management of an epidural is not an exact science, most epidurals work very well and provide superior pain control.

Risks of Regional Anesthesia

All medical procedures carry a certain amount of risk. All of the physicians at AMG are board certified anesthesiologists. They and AMG’s CRNAs (certified registered nurse anesthetists) are experts in placing and managing epidurals and spinals. Even though special precautions are taken to minimize the risk associated with performing regional blocks, a minimal amount of risk still remains. Complications do not occur often and rarely lead to significant problems for the mother and baby. Your anesthesia care provider will discuss these risks with you and any other questions you might have at any time.

Anesthesia for C-sections

The anesthetic for a C-section can be achieved through several means. A scheduled C-section is usually done with a spinal (or subarachnoid block). This anesthetic is similar to an epidural. A spinal is different from an epidural in that a spinal is a single injection in your lower back without the use of a catheter and the medicine is administered in a different place in your back. If a laboring patient with an epidural requires a C-section, the epidural can be used to provide an excellent anesthetic. A general anesthetic (going to sleep) can be used if conditions warrant.

Questions

The physicians of AMG are glad to answer any questions you might have concerning your anesthetic needs for your delivery. A consultation can be arranged if necessary. If you would like to talk with someone about your anesthesia, please call our office at 327-7870. Our office staff will help you get in touch with the appropriate pre-op clinic or anesthesiologist. We look forward to helping you with a safe and comfortable delivery.

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