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If we could induce local anaesthesia without the absence of consciousness, which occurs in general anaesthesia, many would see it as a still greater improvement. Regional anesthetic techniques, were introduced to obstetrics in 1900, when Oskar Kreis described the use of spinal anesthesia.
Influence of epidural analgesia on maternal plasma concentrations of catecholamines during labor.

Epidural Analgesia Provides excellent pain relief reducing maternal catecholamines Ability to extend the duration of block to match the duration of labor Blunts hemodynamic effects of uterine contractions: beneficial for patients with preeclampsia.
Comparison of Sitting and Lateral Positions for Performing Spinal or Epidural ProcedureS SittingLying (left lateral) Advantages Midline easier to identify in obese women Obese patients may find this position more comfortable Can be left unattended without risk of fainting. Maintenance of epidural analgesia can be achieved by: regular top-ups an epidural infusion patient-controlled epidural analgesia (PCEA).

John Snow born 15 March 1813 in York, England.Queen Victoria was given chloroform by John Snow for the birth of her eighth child and this did much to popularize the use of pain relief in labor.

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