The guidelines provide information for women to consider before receiving anesthetics during childbirth.
"Not all women
require anesthetic care during labor and delivery,"
Dr. Joy L. Hawkins, from University of Colorado, Denver, and chair of
the ASA Task Force on Practice
Guidelines for Obstetric Anesthesia said
in a statement.
If a woman does request pain relief during labor and delivery, there
are many options available, Dr. Hawkins said, depending on the
patient''s medical status, progress of labor and the resources available
at the healthcare facility.
"The revised practice guidelines do not guarantee specific outcomes,
but provide basic
recommendations based on a synthesis of expert
research and recommendations," Dr. Hawkins continued.
Among the revised recommendations:
* Women in early labor should be offered the option of spinal or
epidural analgesia when available and it should not be withheld to meet
arbitrary standards for cervical dilation. Women should be reassured
that neuraxial analgesia does not increase the incidence of cesarean
section.
* The use of spinals or epidurals is preferred over general anesthesia for most cesarean sections.
* To minimize post dural (spinal) headache, pencil-point spinal
needles should be used instead of cutting-bevel spinal needles for
spinal anesthesia.
* Drinking clear liquids in limited quantities has been found to
bring comfort to women in labor and does not increase labor
complications. Women with uncomplicated labor may drink small amounts
of clear liquid, while those scheduled for nonemergency cesarean
section may drink small amounts of clear liquids up to 2 hours before
anesthesia administration.
* Solid foods should be avoided by patients during labor. Women
scheduled for elective cesarean section or tubal ligation should fast
for 6 to 8 hours prior to anesthesia administration.
For more information on the revised practice guidelines for obstetric anesthesia, visit www.anesthesiology.org or www.asahq.org.
Anesthesiology 2007;106:843-863.