Pain relief in obstetrics
Every woman experiences the birth of her child differently, and the intensity of the labour pains she feels varies from person to person. Although many pregnant women give birth without any additional aids, there are often situations in which pain relief measures are necessary. A wide range of methods is available for this purpose, so that pain relief can be tailored to your individual needs. In addition to alternative methods, there is a selection of pharmacological options available, which we will discuss in more detail below. Some of these methods are administered by midwives, whilst others are carried out by our experienced anaesthetists.
Self-administered pain relief
Ultiva-PCA
With Ultiva-PCA, a patient-controlled, intravenous method of administering pain relief is now also available in obstetrics. With this method, the woman in labour can administer an ultra-short-acting, very potent painkiller (remifentanil) to herself via a vein in her arm using a PCA (patient-controlled analgesia) pump. The dose of the medication is adjusted according to the intensity of contractions and the individual’s perception of pain.
Regional anaesthesia
By regional anaesthesia, we mean the relief or elimination of pain in larger areas of the body whilst the patient remains conscious. In obstetrics, both epidural anaesthesia and spinal anaesthesia are used for this purpose. Under local anaesthesia, epidural anaesthesia (Fig. 1) involves inserting a very thin plastic tube between two vertebrae in the lower part of the spine, close to the dura mater. Local anaesthetics and painkillers can then be administered through this tube as required. These agents bathe the nerves leading from the uterus to the spinal cord, thereby numbing the pain of labour contractions during childbirth. Epidural anaesthesia has long been established as a gentle and effective form of pain relief in obstetrics.
In spinal anaesthesia (Fig. 2) – as with epidural anaesthesia – a very fine needle is advanced between the vertebrae under local anaesthesia until it reaches and pierces the dura mater. This allows the anaesthetic to be injected directly into the fluid surrounding the spinal cord. Both procedures can be used for both natural childbirth and caesarean sections.
General anaesthesia
General anaesthesia is now very rarely used in obstetrics. It is only used in certain rare circumstances, such as during caesarean sections or in obstetric emergencies.
Anaesthesia Consultation
During a face-to-face consultation, your anaesthetist will endeavour to address all your questions. For legal reasons, it is necessary for you to give your written consent to the procedures. Please do not hesitate to contact us in good time so that we can answer your questions and clarify any uncertainties during the anaesthesia consultation. It is important that you are well-informed before the birth of your child and can look forward to the event without any fears or anxieties. To book an appointment for the anaesthesia consultation: T +41 44 209 22 71.