An Overview of Obstetric Anaesthesia and Treatment

About the Study

Obstetric anaesthesia, often known as ob-gyn anaesthesia or ob-gyn anaesthesiology, is a sub-specialty of anaesthesiology that offers pain relief (analgesia) for labor and anaesthesia (suppression of consciousness) for caesarean births ('C-sections'). Cardiovascular anesthesiology, pediatric anesthesiology, pain medicine, critical care, neuroanesthesia, regional anaesthesia, transplant anaesthesia, and trauma anaesthesia are some of the other subspecialties in anesthesiology.

Obstetric anesthesiologists usually interact with ob-gyn specialists and treat pain throughout both complicated and uncomplicated pregnancies. The scope of an obstetric anesthesiologist's work may be limited to treating pain during vaginal births and delivering anaesthesia for caesarean sections, but it is growing to include anaesthesia for both maternal and fetal operations.

Cervical cerclage, External Cephalic Version (ECV), postpartum Bilateral Tubal Ligation (BTL), and dilation and evacuation are all procedures that only mothers undergo (D and E). Two fetus-specific treatments include fetoscopic laser photocoagulation and Ex-utero Intrapartum Therapy (EXIT). Anesthesiologists on most labor and delivery units, on the other hand, spend the bulk of their time managing labor analgesia and anaesthesia for caesarean sections.

To properly care for the patient, the anesthesiologist uses many patient monitors intraoperatively. Pulse oximetry, capnography, ECG, non-invasive blood pressure band monitoring, and temperature are only a few examples. Arterial blood gas monitoring may be useful in some instances.

Various techniques, including pharmacological and non-pharmacological approaches, are used to provide anaesthesia for labor and vaginal delivery. Lamaze breathing, acupuncture, acupressure, LeBoyer method, transcutaneous nerve stimulation, massage, hydrotherapy, vertical positioning, presence of a support person, intradermal water injections, and relaxation techniques are only a few examples of non-pharmacological therapies. Women's use of epidurals may be reduced if they are immersed in water during the early stage of labor.

According to a meta-analysis, the presence of a support person may have benefits such as reduced usage of pharmacologic analgesia, shorter labor, and a lower incidence of cesarian section. Hypnosis is a field that has to be examined into further.

The following pharmacological substances and methods are used by obstetric anesthesiologists:

• Opioids such as meperidine, morphine, and fentanyl are administered Intravenously (IV).

• Volatile anaesthetics such as isoflurane, sevoflurane, and desflurane, as well as nitrous oxide, are used as inhalation agents.

• The most extensively utilized anaesthetic and analgesia procedures in the United States today are neuraxial (regional) anaesthetic and analgesia techniques (e.g. epidural, spinal, combined spinal-epidural). These procedures are the most effective type of labor pain reduction (vaginal births), with high mother satisfaction rates. Paracervical and pudendal nerve blocks, which target distinct nerve distributions, are other nerve blocks during labor.

The most prevalent kind of anaesthesia for caesarean sections (C-sections) is neuraxial (regional) anaesthesia, which has a superior safety profile for both the mother and the infant. General anaesthesia is used instead of neuraxial anaesthesia in emergencies or when neuraxial anaesthesia is not possible. Thiopental, propanol, etomidate, and ketamine are some of the drugs used to produce general anaesthesia. Inhalation agents are utilized to maintain unconsciousness, and muscle relaxing drugs are employed as needed. Because of concerns about deleterious effects on the newborn, opioids are used less frequently prior to birth. However, in some cases, it is necessary to reduce hypertensive reactions to induction and incision, and ultra-short acting opioids (remifentanil and alfentanil) appear to be both effective and safe.