An essential requisite for best results in obstetric anesthesia and analgesia is cooperation between physicians doing deliveries and physicians giving anesthesia. The general practitioner participates in the majority of deliveries in the United States; he therefore plays a significant part in determining the quality of anesthetic care. It must cause the least possible disturbance to the bodily functions of the mother and infant. Psychological preparation of the mother is important. Medication to produce analgesia should not begin until uterine contractions occur not less than four minutes apart and last at least 35 seconds, with the cervix dilated to 3 cm. Sedatives must not be confused with analgesics and narcotics, and the respiratory effects of various drugs must be watched most carefully. There is no one method of anesthesia that is best for all obstetric patients. The several methods of general anesthesia, like the methods for regional anesthesia, have specific advantages and disadvantages. Some methods are more likely than others to delay the onset of spontaneous breathing in the infant, and it is the responsibility of the obsteric team to make sure that the infant is not harmed by hypoxia.
Bonica JJ. OBSTETRIC ANALGESIA AND ANESTHESIA IN GENERAL PRACTICE. JAMA. 1957;165(17):2146–2154. doi:10.1001/jama.1957.02980350004002
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