Anesthesia in Labor and Delivery

There are five types of anesthesia used in labor and delivery: local anesthesia, pudendal block, lumbar epidural block, subarachnoid (spinal) block, and general anesthesia.

Local Anesthesia:
  • It is used for blocking pain during episiotomy
  • It is administered just before the birth of the baby
  • The anesthetic has no effect on fetus

Pudendal Block:
  • It is administered just before the birth of the baby
  • The anesthetic is injected into the pudental nerve through a transvaginal route
  • It has effect last about 30 minutes
  • It blocks the perineal area for episiotomy
  • There is no effect on contraction or the fetus


Lumbar Epidural Block:
  • The anesthetic relieves pain from contractions and numbs the vagina and perineum
  • The anesthetic is injected in epidural space at L3 to L4 and may cause hypotension, so assess the maternal blood pressure
  • The anesthetic is administered after labor is established or just before a scheduled casarean birth
  • Keep mother in side-lying position or place a rolled blanket beneath the right hip to displace the uterus from the vena cava
  • Administer IV fluids if prescribed
  • Increase fluids if hypotension occurs

Subarachnoid (spinal) Block:
  • The anesthetic is injected into the spinal subarachnoid space at L3 to L5 and administered just before the birth
  • It relieves uterine and perineal pain and numbs the vagina, perineum, and lower extremities
  • The anesthetic can cause maternal hypotension and postpartum headache
  • Keep mother lie flat for 8 to 12 hours following spinal injection
  • Administer IV fluids as prescribed

General Anesthesia:
  • General anesthesia may be used for some surgical interventions
  • It might cause a danger of respiratory depression and vomiting
  • The mother is not awake

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