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Introduction to obstetric analgesia and anaesthesia

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Epidural, spinal, and combined spinal–epidural techniques are used increasingly during labour for analgesia and to provide anaesthesia for caesarean or instrumental deliveries. This tutorial will focus on the understanding and use of different analgesia options available to women during labour and delivery, and will highlight potential complications arising from these. It will provide you with a working knowledge, allowing you to advise women on analgesia options for labour and delivery and to implement immediate management of potential complications. It will also teach you to liaise effectively with anaesthetists.

Learning objectives

When you have completed this tutorial you will:

  • be aware of the types and methods of action of analgesic drugs available for use in labour and delivery, and their indications and contraindications
  • be aware of the types and methods of action of regional anaesthetics and pudendal nerve block as well as their indications and contraindications in labour and delivery
  • be able to advise women on pain relief for labour and delivery
  • be able to recognise and help manage complications of anaesthetics and analgesics including cardiac arrest, respiratory arrest, aspiration and drug reactions
  • have an understanding of the process and the potential difficulties of an obstetric general anaesthetic
  • be able to liaise effectively with anaesthetists.

Last updated: 22/01/10 (the images showing the structure of the spine, epidural and positions for epidural were replaced with new, higher quality versions)

27/11/09 (the tutorial was reviewed by Eva Wilson and Elizabeth Walker, who updated the following sections: non-pharmacological analgesia, PCA remifentanil, epidural drugs, and toxic effects of epidural).

15/01/09 (research papers added in the'Preliminary reading', 'Epidural analgesia' and 'Management' sections).

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