← AANA Practice Manual
Guideline
Analgesia + Anesthesia for the Obstetric Patient (Guideline)
Last AANA revision: 2024
Our paraphrased summary. The text below is our own condensed phrasing for board review, derived from the AANA Practice Manual document of the same name. The AANA document is the authoritative source — read it on aana.com for legally-binding language.
OB-specific recommendations covering labor analgesia, cesarean anesthesia, emergency C/S, and high-risk obstetric scenarios (preeclampsia, placental disorders, postpartum hemorrhage).
Key points
- 1.Pre-anesthesia evaluation + airway exam early in labor (Mallampati IV → 11% complication rate)
- 2.Aspirate every epidural top-up; test dose 1.5% lidocaine + epinephrine 15 mcg
- 3.Cesarean GA only when neuraxial unavailable / contraindicated — high failed-intubation rate
- 4.Phenylephrine first-line for spinal hypotension (better fetal pH than ephedrine)
- 5.Active management 3rd stage: oxytocin slow IV/IM after delivery
- 6.PPH protocol: oxytocin → methylergonovine → carboprost → misoprostol → TXA → surgical/IR
This is an exam-prep summary, not a substitute for the full AANA document. Read the source at aana.com for authoritative wording. Education only.