Summary of Recommendations

Document Overview

Design and created by Guideline Central in participation with the American Society of Anesthesiologists.

Obstetric Anesthesia

American Society of Anesthesiologists

Publication Date: Feb 1, 2016

Page Last Updated: May 5, 2026

Document Overview

Document Title: Obstetric Anesthesia

Authoring Society: American Society of Anesthesiologists

Document Publication Date: Feb 1, 2016

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: anesthesiology.pubs.asahq.org/article.aspx?articleid=2471779

Source Citation: Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology*. Anesthesiology 2016;124(2):270-300.

Document Scope, Criteria, and Use Cases

Document Objectives: Enhance the quality of anesthetic care for obstetric patients, improve patient safety by reducing the incidence and severity of anesthesia-related complications, and increase patient satisfaction.

Scope: Management, Prevention

Diseases/Conditions (MeSH)

D013513 - Obstetric Surgical Procedures

D000773 - Anesthesia, Obstetrical

D016362 - Analgesia, Obstetrical

D009774 - Obstetrics

D013513 - Obstetric Surgical Procedures

D000773 - Anesthesia, Obstetrical

D016362 - Analgesia, Obstetrical

D009774 - Obstetrics

Keywords: Obstetric Anesthesia, Peripartum, intrapartum anesthesia

Target Patient Population: Patients with uncomplicated pregnancies or with common obstetric problems

Target Provider Population: anesthesiologists

Inclusion Criteria: Female, Adult

Health Care Settings: Hospital, Operating and Recovery Room, Outpatient

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resource: Data Supplement

Number of Source Documents: 228

Literature Search Start Date: Saturday, January 1, 2005

Literature Search End Date: Friday, July 31, 2015

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: No

Obstetric Anesthesia

Summary of Recommendations

Perianesthetic Evaluation and Preparation

History and Physical Examination

Intrapartum Platelet Count

Blood Type and Screen

Perianesthetic Recording of Fetal Heart Rate Patterns

Aspiration Prevention

Clear Liquids

Solids

Antacids, H₂-receptor Antagonists, and Metoclopramide

Anesthetic Care for Labor and Delivery

Timing of Neuraxial Analgesia and Outcome of Labor

Neuraxial Analgesia and Trial of Labor after Prior Cesarean Delivery

Analgesia/Anesthetic Techniques

Early Insertion of a Neuraxial (i.e., Spinal or Epidural) Catheter for Complicated Parturients

Continuous Infusion Epidural Analgesia

Analgesic Concentrations

Single-injection Spinal Opioids with or without Local Anesthetics

Pencil-point Spinal Needles

Combined Spinal–Epidural Analgesia

Patient-controlled Epidural Analgesia

Removal of Retained Placenta

Anesthetic Techniques

Nitroglycerin for Uterine Relaxation

Anesthetic Care for Cesarean Delivery

Equipment, Facilities, and Support Personnel

General, Epidural, Spinal, or Combined Spinal–Epidural Anesthesia

IV Fluid Preloading or Coloading

Ephedrine or Phenylephrine

Neuraxial Opioids for Postoperative Analgesia

Postpartum Tubal Ligation

Management of Obstetric and Anesthetic Emergencies

Resources for Management of Hemorrhagic Emergencies

Equipment for Management of Airway Emergencie

Cardiopulmonary Resuscitation

Document Overview

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology

Obstetric Anesthesia

Summary of Recommendations

Perianesthetic Evaluation and Preparation

History and Physical Examination

Intrapartum Platelet Count

Blood Type and Screen

Perianesthetic Recording of Fetal Heart Rate Patterns

Aspiration Prevention

Clear Liquids

Solids

Antacids, H2-receptor Antagonists, and Metoclopramide

Anesthetic Care for Labor and Delivery

Timing of Neuraxial Analgesia and Outcome of Labor

Neuraxial Analgesia and Trial of Labor after Prior Cesarean Delivery

Analgesia/Anesthetic Techniques

Early Insertion of a Neuraxial (i.e., Spinal or Epidural) Catheter for Complicated Parturients

Continuous Infusion Epidural Analgesia

Analgesic Concentrations

Single-injection Spinal Opioids with or without Local Anesthetics

Pencil-point Spinal Needles

Combined Spinal–Epidural Analgesia

Patient-controlled Epidural Analgesia

Removal of Retained Placenta

Anesthetic Techniques

Nitroglycerin for Uterine Relaxation

Anesthetic Care for Cesarean Delivery

Equipment, Facilities, and Support Personnel

General, Epidural, Spinal, or Combined Spinal–Epidural Anesthesia

IV Fluid Preloading or Coloading

Ephedrine or Phenylephrine

Neuraxial Opioids for Postoperative Analgesia

Postpartum Tubal Ligation

Management of Obstetric and Anesthetic Emergencies

Resources for Management of Hemorrhagic Emergencies

Equipment for Management of Airway Emergencie

Cardiopulmonary Resuscitation

Document Overview

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology

Antacids, H₂-receptor Antagonists, and Metoclopramide