PAIN RELIEF ON LABOR AND DELIVERY: LOCAL ANESTHESIA, SEDATION, AND GENERAL ANESTHESIA, Michael Silverstein, MD (Digital)

By on August 1, 2017

The five most commonly used methods of pain relief used in labor and delivery are epidural, spinal, local anesthesia, IV sedation, and general anesthesia. Being informed about different forms of anesthesia will help prevent expectant mothers from being caught off guard in the event that it may be necessary. Read on to learn more about local anesthesia, sedation, and general anesthesia.

About Local Anesthesia, Sedation and General Anesthesia

Local anesthesia is anesthesia of a small part of the body such as a tooth or an area of skin. It is used on the labor floor to repair an episiotomy or perineal laceration if either no epidural was used or if the epidural is not dense enough to provide relief.

Local anesthesia is injected adjacent to the area where sutures need to be placed. A very skinny needle is used. Most are short-acting and have no long-term sequelae.

Sedation is provided via the IV by the OB Anesthesiologist, often in the operating room in cases such as a retained placenta, or excessive bleeding after a delivery. It is often short-acting and has no long-term sequelae.

General anesthesia is reserved for very few cases, such as cesarean if spinal anesthesia is not allowed (such as dangerously low platelets or rare bleeding disorders) or emergent cesareans where there is insufficient time for either spinal anesthesia or to boost an epidural. General anesthesia causes a total loss of both sensation and consciousness. Because a mother’s conscious participation is highly important for an efficient birth, this form of anesthesia is rarely used in childbirth.

How is General Anesthesia Given?

A muscle relaxant will be given intravenously, which quickly makes the patient feel relaxed and semi-conscious. Then, the patient will inhale a gas that causes total loss of consciousness. A tube will be inserted into the trachea to help keep the airway open and allow administration of the anesthetic.

Are There Risks Involved?

Research indicates that general anesthesia used for childbirth has at least double the maternal death rate than regional anesthesia. Since it is frequently used in emergency situations, it is unclear whether that increase is because of the general anesthesia or the situation that necessitates its use. There is also the concern of a decrease in uterine blood flow and the potential for neonatal depression.

Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!

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