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Review Article
Medical Progress
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Volume 348:319-332 January 23, 2003 Number 4
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Regional Anesthesia and Analgesia for Labor and Delivery
Holger K. Eltzschig, M.D., Ellice S. Lieberman, M.D., Dr.P.H., and William R. Camann, M.D.

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In 1847, the Scottish obstetrician James Simpson administered ether to a woman during labor to treat the pain of childbirth. He was impressed with the degree of analgesia associated with the use of the drug. Nevertheless, he expressed concern about the possible adverse effects of anesthesia: "It will be necessary to ascertain anesthesia's precise effect, both upon the action of the uterus and on the assistant abdominal muscles; its influence, if any, upon the child; whether it has a tendency to hemorrhage or other complications."1

One and a half centuries later, the maternal and fetal effects of 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 Spinal–Epidural 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.


Related Letters:

Regional Anesthesia and Analgesia for Labor and Delivery
Jakobi P., Solt I., Zimmer E. Z., Van de Velde M., Teunkens A., Vandermeersch E., Zwissler B., Camann W., Eltzschig H., Lieberman E.
Extract | Full Text | PDF  
N Engl J Med 2003; 348:1818-1820, May 1, 2003. Correspondence

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