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Semin Neurol 2011; 31(4): 374-384
DOI: 10.1055/s-0031-1293536
© Thieme Medical Publishers

Neurologic Issues and Obstetric Anesthesia

Laura Y. Chang1 , Jean Marie Carabuena1 , William Camann1
  • 1Department of Obstetrical Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Publication History

Publication Date:
23 November 2011 (online)

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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