Which anesthetic agent is used during labor?

Question

Hello doctor,

I was wondering if an anesthesiologist would mind getting interviewed. I am writing a research paper, and could not contact any anesthesiologist around me. Below are the questions I need an answer.

1. How many years have you been a part of this profession?

2. About how many times a month do you administer anesthesia to a pregnant mother in labor?

3. Regarding the previous question, what kind of anesthetic is used? (GA, LA, or RA).

4. Have you heard of transmitting the anesthetic agent through the placenta, from mother to child?

5. Is there any information you could provide for the above?

6. About how many times a month do you administer anesthesia to infants for surgery-related procedures?

7. Regarding the previous question, what kind of anesthetic is used? (GA, LA, or RA)

8. What kind of chemical compound is used in the hospital’s anesthetic?

9. Does this hospital use an anesthetic “Cocktail” (mixing drugs with anesthesia)?

10. What information can you provide about the issue of neurological degeneration in infants who have been exposed to anesthesia either during surgery or birthing?

11. What kind of introduction do you give your patients about the anesthesia they are about to receive?

12. Have you ever had a follow-up with any infant patients later in life? (adolescent age).

13. Is there any more information that you believe could help me better understand this topic?

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I am glad to answer your queries. Responses are by the question numbers:

1. I have been working as an anesthesiologist for the past eight years.

2. I would administer anesthesia for around 15 to 20 cesarean sections per month.

3. In my practice, RA (regional anesthesia) is the choice of anesthesia for the pregnant mother undergoing C-section. When RA is contra-indicated we do administer GA (general anesthesia); in this scenario, we avoid opioid drugs, since they cross the placental barrier and affect the baby; I use induction drugs like Propofol, muscle relaxation with Succinylcholine and Vecuronium, and maintenance with nitrous oxide and oxygen. Once the baby is delivered, I give the opioids for pain relief.

4. Yes, I am aware but I just follow my hospital/team protocols.

5. Opioid drugs like Fentanyl, Pentazocine, etc. can affect the fetus or neonate. I am unaware of the effects of other anesthetic drugs on the fetus or neonate.

6. I do not practice pediatric anesthesia.

7. Not applicable.

8. Thiopentone -Barbiturate; Fentanyl, Pentazocine, Opioids; Vecuronium-Muscle relaxant, Midazolam-Benzodiazepine, Propofol- unclassified.

9. We do use cocktail mixtures.

10. Ketamine can cause severe neurological complications in the fetus or neonate. Others I am not sure.

11.I have a pre-anesthetic clinic, in which I assess and choose the appropriate anesthesia. I explain in detail about the anesthetic procedure, and complications if any. Finally, I answer the client’s queries and explain pre-anesthetic instructions.

12. No I have not.

I hope that you get your answer.

Please let me know if you need any help.

Thank you.