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from Section 3 - Passing the Gas
Published online by Cambridge University Press: 09 June 2025
Obstetric anaesthesia is one of the high-risk areas of anaesthetic practice and is feared by many novices. Physiological differences of the pregnant patient are discussed.
The anaesthetist may have three main functions in the labour ward: provision of support and analgesia for the parturient, care of the patient in the obstetric theatre and care of the patients in the maternity high-dependency unit. Effective labour analgesia requiring the support of an anaesthetist may include the use of Entonox, IV/IM medications, and placement of an epidural or spinal. Remifentanil PCAs may be preferred in patients with contraindications to regional intervention and set-up may follow strict protocols and meticulous monitoring. A caesarean section may be an emergency depending on the threat to the health of the mother or fetus and may require urgent timely intervention. Regional anaesthesia is frequently the first choice, but some cases may require a general anaesthetic. Both types of interventions may carry risks and complications. Failed tracheal intubation in the obstetric patient should follow the OAA and DAS management guidelines.
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