AWHONN Clinical Practice Guideline: Analgesia and Anesthesia in the Intrapartum Period

Purpose Statement

The purpose of this Guideline is to provide evidence-based clinical practice recommendations for nursing assessment and management of women in the intrapartum period choosing various types of analgesia/anesthesia for pain management. Guidelines for assessment and management of the woman and her fetus, including an assessment of pain relief, side effects, and potential adverse effects of medications, are described. Interventions directed at minimizing side effects and adverse reactions associated with analgesia and anesthesia and facilitating labor progress are also included.

This Guideline provides evidence-based approaches to accomplish the following:

  • Identify safety principles for maternal analgesia/anesthesia in the intrapartum period.
  • Describe the nursing role during the administration of pharmacologic interventions during labor, including analgesics, regional analgesia/anesthesia, remifentanil, and inhaled nitrous oxide.
  • Promote safe staffing patterns for the woman choosing analgesia/anesthesia in labor.
  • Use evidence to recommend routine nursing assessments and interventions for maternal and fetal response to analgesics/anesthetics in labor.
  • Evaluate specific needs of special populations receiving pharmacologic interventions during labor.

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