title: Analgesia and anesthesia during labor and birth: implications for mother and fetus.
abstract: Labor and birth, although viewed as a normal physiological process, can produce significant pain, requiring appropriate pain management. Systemic analgesia and regional analgesia/anesthesia have become less common, whereas the use of newer neuraxial techniques, with minimal motor blockade, have become more popular. Low- and ultra-low-dose epidural analgesia, spinal analgesia, and combination spinal-epidural analgesia have replaced the once traditional epidural for labor. The shift from regional anesthesia during labor, in which the woman became a passive participant during the labor and birth, to a collaborative approach for pain management, in which the woman becomes an active participant, has resulted in a new philosophy of labor analgesia. This article provides a review of the current systemic analgesics and regional and neuraxial analgesia/anesthesia techniques for pain management in labor and birth. Also addressed are implications for perinatal nurses who participate in pain management choices during labor and birth.
authors.affiliation: Presbyterian Healthcare, Charlotte, NC 28226, USA. judithHpoole@cs.com
authors.forename: Judith H
authors.initials: JH
authors.lastname: Poole
mesh_terms: D016362:Analgesia, Obstetrical / Q000451:nursing* / Q000523:psychology; D016058:Analgesia, Patient-Controlled / Q000451:nursing* / Q000523:psychology; D000773:Anesthesia, Obstetrical / Q000451:nursing* / Q000523:psychology; D003657:Decision Making; D005260:Female; D006801:Humans; D007743:Labor, Obstetric / Q000187:drug effects* / Q000523:psychology; D009035:Mothers / Q000523:psychology*; D024802:Nurse's Role; D015404:Nursing Methodology Research; D007744:Obstetric Labor Complications / Q000517:prevention & control; D009773:Obstetric Nursing / Q000592:standards*; D010147:Pain Measurement / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome; D014481:United States