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Labor analgesia for the parturient with respiratory disease: what does an obstetrician need to know?
1Department of Anesthesiology, University of California, San Diego, 92103-8770, CA, USA. kkuczkowski@ucsd.edu
Background:
Significant alterations occur in the pulmonary system during pregnancy, which primarily serve to meet the increased oxygen consumption by the growing fetus. When pregnancy is complicated by a respiratory tract disorder such as asthma, cystic fibrosis or tobacco-related respiratory complications the peripartum management (both obstetric and anesthetic) may become challenging.
Technique:
Regional anesthesia remains the technique of choice for these parturients because airway manipulation and endotracheal intubation are avoided.
Conclusion:
When providing labor analgesia to parturients with asthma, cystic fibrosis, and tobacco-related respiratory disorders every effort should be made to reduce the likelihood of high (thoracic) levels of analgesia and/or anesthesia and subsequent airway compromise.
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