Obstetric anesthesiologists employ the following pharmacological agents and techniques:

• Parenteral (IV) agents: opioids such as meperidine, morphine (rarely used today), and fentanyl.
• Inhalation agents: volatile anesthestics such as isoflurane, sevoflurane, and desflurane[23] or nitrous oxide.
• Neuraxial (regional) anesthetic and analgesia techniques: (e.g. epidural, spinal, combined spinal-epidural) are used most widely in the United States today. These regional techniques are considered the most effective form of labor pain relief (vaginal deliveries) with high rates of maternal satisfaction. Other nerve blocks for labor include paracervical and pudendal blocks which target different nerve distributions.

Anesthesia for cesarean sections (C-sections) most commonly uses neuraxial (regional) anesthesia due to its better safety profile for both mother and baby. However, for emergencies or cases where neuraxial anasthesia cannot be used, general anesthesia is used instead. Drugs used to induce general anesthesia include thiopental, propofol, etomidate, and ketamine. Unconsciousness is maintained using inhalation agents, and muscle relaxing agents are used as needed. Opioids are less commonly used prior to delivery due to fear of adverse effects on the neonate. However under certain circumstances it is important to attenuate the hypertensive responses to induction and incision and ultra-short acting opioids (remifentanil and alfentanil) appear to be efficacious and safe.

In the United States, obstetric anesthesiology is a sub-specialty of anesthesiology (i.e., an anesthesiologist trains for an additional year as a fellow to qualify as an obstetric anesthesiologist)

After earning a four-year undergraduate bachelor's degree, students enroll in a four-year graduate education leading to a degree in medicine (the Doctor of Medicine degree (M.D.)) or in osteopathic medicine (the Doctor of Osteopathic Medicine degree (D.O.)).  After receiving a medical degree, students must complete a four-year residency training at an approved anesthesiology program  and pass certification exams to become a board-certified, general anesthesiologist.[29] Obstetric anesthesiologists then complete an additional year of study (fellowship) to gain specialized experience. Currently, obstetric anesthesia is not associated with an additional certification period over being board-certified in anesthesiology.

Current Issue: Volume 3: Issue 2

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Regards,
Elisha Marie,
Editorial Manager,
Anesthesiology Case Reports