Tomorrow is my last day of obstetric anesthesiology and also my last day as a second year anesthesiology resident (CA-1). Over the last two months, I’ve done a ton of epidurals, spinals, and combined spinal-epidural anesthetics to help provide labor analgesia and surgical anesthesia for my patients. There’s nothing more gratifying than seeing a parturient in immense pain… pain which I will never know as a male… experience significant relief after a neuraxial anesthetic.
While much of the first month was spent studying for my Basic board exam, the latter part of the rotation was filled with reading obstetric anesthesiology – the physiologic and pharmacodynamic changes associated with pregnancy, the maternal-fetal considerations with neuraxial anesthesia, and above all else, playing with the incredibly cute babies!
One of the best parts about being at the head of the bed in a C-sections is being the first to congratulate the mothers! Sometimes they’re tearful. Other times they’re nauseated. But they’re always happy. And I get to practice taking mother-baby photos. 😉
Overall, this was a wonderful rotation which helped me appreciate the nuances of neuraxial anesthesia, and just how much of it depends on the “feel” of the epidural needle. I really know when I’ve engaged the supraspinous/interspinous ligaments, ligamentum flavum, and most importantly, feel a true loss of resistance indicative of the epidural space. Hopefully this knowledge will stay with me till October when I come back to the obstetric service as a CA-2. 🙂
…here’s hoping I don’t have an inadvertent dural puncture on my last day tomorrow! 😯
