AANA Updates Analgesia and Anesthesia Guidelines for Obstetric Patients

AANA Updates Analgesia and Anesthesia Guidelines for Obstetric Patients

To help ensure that all obstetric patients receive high-quality, safe analgesia and anesthesia care during labor and delivery, the American Association of Nurse Anesthesiology (AANA) has published its updated Analgesia and Anesthesia for the Obstetric Patient  practice guidelines. This comprehensive revision provides evidence-based practice recommendations and closes equity gaps in obstetric pain management and anesthesia care.

According to the Commonwealth Fund, U.S. women have the highest rate of maternal deaths among high-income countries, with Black women being nearly three times more likely to die from pregnancy-related complications than white women.

“Many of the complications related to maternal care are preventable,” says Beth Ann Clayton, DNP, CRNA, FAANA, FAAN, lead revision subject matter expert. “We know that there is a significant equity gap in maternal care between races and that one of the best ways to close that gap is to have standardized, evidence-based care. AANA’s new guidelines offer obstetric anesthesia providers current practice recommendations to support optimal maternal care and improve the delivery of care, patient safety, and patient outcomes.”

Research confirms racial and ethnic disparities in pain control for maternal care. Therefore, standardization of care supported by these guidelines is important in addressing these disparities. The updated guidelines cover topics such as physiologic changes during pregnancy, pre-anesthesia assessment and evaluation, patient education, preparing a plan of care, analgesia and anesthesia options during labor, delivery, and postpartum care, as well as complications and emergency care. In addition, recommendations highlight care for high-risk patients, including those with hypertensive disorders such as preeclampsia and obstetric complications and emergencies such as obstetric hemorrhage and amniotic fluid embolism. 

“These guidelines and their protocols promote equity of care. For example, when a patient has preeclampsia, direct steps for hypertension management can be taken,” Clayton says. “In an emergency, if clinicians do not have a protocol available, they may miss a step. These guidelines are in place to increase communication between the anesthesia, obstetric, and pediatric professionals regarding labor status and patient-specific considerations to create an optimal environment for safe maternal and neonatal care. The document also highlights how CRNAs help drive change to reduce maternal-related deaths and implement prevention strategies to reduce racial and ethnic disparities in pregnancy-related mortality.

CRNAs are highly educated, trained, and qualified anesthesia experts. They provide 50 million anesthetics annually in the U.S., working in every setting where anesthesia is delivered. CRNAs are the primary providers of anesthesia care in rural locations, enabling facilities in these medically underserved areas to offer obstetrical, surgical, pain management, and trauma stabilization services.