**6.1 Anesthesia**

There are many options for anesthesia. These are; local, regional and general anesthesia.

## *6.1.1 Local anesthesia*

Usually, local anesthetics and opioids are frequently used. These medicines pass through the placenta and thus, before delivery, the medicine/drugs should be given in small doses to avoid toxicity in the neonate. The common toxicities related to local anaesthia are; central nervous system [CNS] depression and bradycardia [13].

It must be noted that opioids used alone do not provide adequate analgesia and so are most often used with anesthetics.

In the option for anesthesia, most of the local anesthetic methods used include; pudendal blocks and perineal infiltration as well as para-cervical blocks.

a.**Pudendal block:** Pudendal blocks are used rarely. Instead of this, epidural injections are more preferred. In this, a local anesthetic is injected through the vaginal wall so as to bathe the pudendal nerve as it crosses the ischial spine. In this way, the block anesthetizes the lower vagina, perineum and posterior

#### *Vaginal Delivery DOI: http://dx.doi.org/10.5772/intechopen.96097*

vulva. However, the anterior vulva, innervated by lumbar dermatomes, is thus not anesthetized [13]. Usually, pudendal block is considered a safe and simple method for spontaneous vaginal deliveries if the delivery is uncomplicated. It is even more so especially if the mother wishes to bear down and push or when the labor is advanced such that there is no time for epidural injection. It should be noted that pudendal block may have some complications which include intravascular injection of anesthetics, hematoma and infections.

