Regional Anesthesia and Analgesia for Cesarean Delivery

Abstract Regional anesthesia for cesarean delivery (CD) plays a pivotal role in improving outcomes for CD by both avoiding general anesthesia and improving perioperative pain control, which results in less chronic pain, less opioid use, improved maternal-fetal bonding, and decreased postpartum depression. While multiple neuraxial techniques can be utilized successfully for anesthesia, side effects can occur and if not recognized quickly can predispose patients to serious complications. Postoperative pain management poses unique considerations as both the patient and the newborn can be affected by postoperative pain. Management options available include neuraxial, regional, and intravenous management, utilized either separately or in combination. A personalized anesthetic plan should be utilized for each patient to identify patients at risk of suboptimal pain control such as the parturient on medication-assisted treatment for opioid use disorder. Familiarity with the various anesthetic options for both CD and postoperative analgesia will likely lead toward safer outcomes and improved patient satisfaction.