In 1847, the Scottish obstetrician James Simpson administeredether to a woman during labor to treat the pain of childbirth.He was impressed with the degree of analgesia associated withthe use of the drug. Nevertheless, he expressed concern aboutthe possible adverse effects of anesthesia: "It will be necessaryto ascertain anesthesia's precise effect, both upon the actionof the uterus and on the assistant abdominal muscles; its influence,if any, upon the child; whether it has a tendency to hemorrhageor other complications."1
One and a half centuries later, the maternal and fetal effectsof analgesia during labor . . . [Full Text of this Article]
Regional Analgesia for Vaginal Delivery
Technique of Regional Analgesia
Effect of Epidural Analgesia on the Method of Delivery
Observational Studies
Randomized Trials
Studies of Sentinel Events
Timing of Epidural Analgesia during Labor
Effect of Combined SpinalEpidural Analgesia on the Rate of Cesarean Delivery
Effect of Epidural Analgesia on Maternal Temperature and the Newborn
Other Reported Complications of Regional Analgesia
Fasting during Labor and Delivery
Pain Relief during and after Cesarean Delivery
General Anesthesia
Postcesarean Analgesia
Conclusions
Source Information
From the Department of Anesthesiology, Perioperative and Pain Medicine (H.K.E., W.R.C.) and the Department of Obstetrics and Gynecology (E.S.L.), Brigham and Women's Hospital and Harvard Medical School, Boston; and the Department of Anesthesiology and Intensive Care Medicine, Eberhard-Karls University, Tübingen, Germany (H.K.E.).
Address reprint requests to Dr. Camann at the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115, or at wcamann@partners.org.
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