Obstetric Analgesia

Since biblical times, the labour process has been recognised as one of the most painful human experiences. Early treatments varied widely, according to the cultural and religious beliefs and practices of the time. Over the last 100 years, pain relief options have become safer and more effective. Since pain relief in labour has always been surrounded by myths and controversies, providing effective and safe analgesia during labour has remained an ongoing challenge. The introduction of newer techniques like combined spinal epidurals and low-dose epidurals facilitate ambulation. Pharmacological advances like remifentanil for patient-controlled intravenous analgesia, newer local anaesthetics like ropivacaine and levobupivacaine all have revolutionised the practice of pain management in labouring parturient. The present-day practise comprises an evidence-based, comprehensive programme of labour pain management. A quote by Moir aptly describes this chapter: "The delivery of the infant into the arms of a conscious and pain-free mother is one of the most exciting and rewarding moments in medicine".