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Answer
It is interesting that labor analgesia is one of the few areas of anesthesiology in
which we usually want our patients to be awake. Most other types of anesthesia include
sleep or drowsiness as an important goal. As a result, many of the commonly utilized
anesthetic agents do cause drowsiness as their primary effect or as a side effect. In
addition, many of the drugs used to treat other problems you might have (such as nausea
or itching) can cause sedation as a side effect.
There are too many anesthetic agents in common usage to list here. However, some
general guidelines may be helpful. Local anesthetics usually do not cause sedation
and this is why they have become an important part of labor analgesia. Many agents
such as narcotics cause sedation in a dose-dependent fashion, meaning the more
medicine you get the more sleepy you get. This means that when these drugs are
given we usually give them in smaller dosages. Lastly, some agents such as
benzodiazepines (Valium is one of the drugs in this category) cause sedation as one
of their primary effects. Obviously you may want to avoid these types of drugs.
Your anesthesiologist is familiar with these drugs, their effects and their side
effects. They are aware of the effect of different dosages, different combinations,
etc. Discuss your concerns and your desire to be awake with your doctors and
nurses. This will be important when they are deciding which drugs to choose for
your labor analgesia.
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