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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