MD David J. Birnbach (Director of Obstetric Anesthesiology, Associate Professor of Anesthesiology in Obstetrics and Gynecology) , MD Deborah J. Stein (Associate Director of Obstetric Anesthesiology, Assistant Professor of Anesthesiology)
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7 The substance-abusing parturient: implications for analgesia and anaesthesia management
Substance abuse remains a major problem in society, while substance abuse in pregnancy has emerged as a major health problem in the 1990s. Due to this trend, obstetricians, neonatologists and anaesthesiologists are encountering an increasing number of pregnant patients who use licit and illicit substances. The use of these substances presents a multitude of problems for the patient, her unborn child, and the physicians involved in their care. The following article reviews the various substances of abuse used by pregnant women and the implications of their use for analgesia and anaesthesia during labour and delivery. In conclusion, it is essential for physicians to identify the substance abusing parturient to optimize care of these patients and be prepared for the crises that may arise.
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