ABSTRACT
In every hospital providing labor and delivery services, anesthesia personnel must be available on a 24-hour basis, with the ability to perform a cesarean delivery within 30 minutes from decision. For severe, refractory, postoperative pain, Ketamine may be used as an analgesic adjunct to decrease opioid requirements. Lidocaine patches, gabapentin, and pregabalin may also improve postoperative pain control. Pregnancy is associated with unique physiologic changes. Increasingly, many pregnant women are seeking alternative approaches to labor pain relief such as water immersion, acupuncture, and aromatherapy. Acupuncture and acupressure are therapeutic techniques based on the concept that energy flows throughout the body and strategic placement of needles or pressure can restore its balance and provide pain relief. Parenteral opioids continue to have a role in managing labor pain globally and are the most widely used of the systemic medications for labor analgesia. Patients with gestational hypertension, preeclampsia, and eclampsia are at increased risk for hemodynamic instability during both labor and surgical anesthesia.
