Obstetric Anesthesia and Patient Satisfaction

1. Obstetric Anesthesia and patient Satisfaction

2. What is Obstetric Anesthesia? • Obstetric (OB) anesthesia is defined as peripartum analgesia and anesthesia services performed during labor and delivery, including vaginal delivery, cesarean section, tubal ligation, and removal of retained placenta.   • OB anesthesia allows women to enjoy labor by offering safe deliveries and individualized relief from pain.   • There are a wealth of opportunities to provide and improve patient satisfaction via OB anesthesia services.

3. Planning for OB Anesthesia and patient satisfaction •  Preparing and evaluating an OB patient for anesthesia care requires conducting a focused history and physical examination. • Maternal health and anesthetic history, OB history including any past and present pregnancy-related complications, and examination of the airway, heart, and lungs, with measurement of vitals including a baseline blood pressure. •  The spine and back should also be examined if planning a neuraxial block, as is often done for these patients, with special attention to spinal deformities, history of procedures in the back, or active skin lesions. •  Patients should be consented for a variety of anesthetic plans, including neuraxial anesthesia and the possible need for general anesthesia in an emergent situation.   • When these discussions take place in advance, patients who are already dealing with the stress of laboring can take full advantage of the time to ask questions and express their desires and preferences in a calm and controlled manner.

4. Patients with risk factors • Preanestheticevaluation often requires a multidisciplinary approach between the obstetrician, anesthesiologist, and other specialties such as cardiology or pulmonology. •  Notable lab work includes obtaining a platelet count and a type and screen if anticipating bleeding or if maternal history necessitates this. •  Aspiration precautions must be taken seriously, as OB patients are routinely considered full stomachs, including adhering to NPO guidelines and the timely administration of aspiration prophylaxis.

5. Satisfying the patients’ needs • For some, being available for consultation but not actually performing any procedures is ideal.   • For many, providing patients in labor the option of an epidural whenever they desire is critical.   • For those patients, placing an epidural in a timely fashion upon their request and providing patient-controlled epidural analgesia (PCEA) affords them the opportunity to be in control of their own pain management.   • The PCEA empowers the patient to be able to adjust labor analgesia to her needs during the vulnerable process of giving birth without being completely dependent on healthcare providers for more pain medication. • If a cesarean section becomes necessary, being able to use an existing epidural eliminates the need for an additional procedure •  If there is no epidural in place already, a spinal block can be performed, providing a quick method of achieving reliable surgical anesthesia that lasts for the duration of the surgery and wears off over time without significant sedation or postoperative side effects.  

6. Concluding Remarks • Anesthesiologists are uniquely positioned in OB to enhance patient satisfaction through the safe and effective delivery of anesthesia and analgesia for labor and delivery. • Patients often call the anesthesiologist their "best friend" because they truly appreciate a compassionate professional who can help reduce their pain during such an intense and important time.

7. To learn more about our comprehensive anesthesia services, visit us at www.xenonhealth.com