ABSTRACT
The rising popularity of regional anesthesia in the last several decades has greatly
changed the experience of labor. Although the use of regional anesthesia has aided
in decreasing maternal morbidity and mortality, a new dimension of neurologic issues,
particularly headache and peripheral neuropathy, is apparent. Obstetric anesthesiologists
frequently encounter patients with preexisting neurologic disease. Although very few
of these disorders contraindicate the use of neuraxial technique, there are limited
published data on specific neurologic and neuromuscular disorders in pregnancy. Neurologists
are often consulted by anesthesiologists and obstetricians to evaluate pregnant patients
for the feasibility of labor analgesia and when postpartum neurologic complications
arise. Early consultation with an obstetric anesthesiologist, discussion with a neurologist,
and communication with the obstetrician allows for the education and discussion of
the risks and benefits of both the mode of delivery and anesthetic options. This multidisciplinary
approach is crucial in forming reasonable expectations for the patient. The aim of
this discussion is to provide an obstetric anesthesiologist's perspective on regional
anesthesia and its implications in obstetrics, and to enhance communication between
our specialties.
KEYWORDS
Regional anesthesia - postpartum - headache - peripheral neuropathy - obstetric
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Laura Y ChangM.D.
Obstetrical Anesthesiology Fellow, Brigham and Women's Hospital, Harvard Medical School
75 Francis Street, Boston, MA 02115
eMail: Lychang@partners.org
