Medical and Surgical Complications in Pregnancy
Lady with MS + MR with full term gestation, obstretician planning to conduct normal delivery, what would be anaesthesia of choice? (AIIMS Nov. 2012)
a. Pain relief is important for heart disease patients as pain can cause tachycardia, which in turn can cause cardiac failure.
b. Epidural and spinal (intrathecal) techniques are the most effective means of providing pain relief for labor, which can be the most severe pain that a woman experiences during her lifetime .
c. The epidural and spinal approaches are known as regional techniques because pain relief is limited to a specific anatomical region.
d. These modalities are also known as neuraxial techniques, since both approaches involve administration of drugs that exert their effect in the axial portion of the central nervous system.
e. In the context of obstetric pain relief, the term "regional analgesia" refers to the inhibition of labor pain, whereas the term "regional anesthesia" implies the use of a greater concentration of local anesthetic, which results in more intense ablation of all sensation and is used to facilitate instrumental or cesarean delivery.
f. However, the two terms are sometimes used interchangeably and there is considerable overlap between them. As an example, in some patients epidural analgesia may provide sufficient pain relief for instrumental delivery, obviating the need for more potent anesthesia