Epidurals redefined in analgesia and anesthesia: a distinction with a difference.

Advances in our understanding of pain have created a new and meaningful distinction between epidural analgesia and anesthesia. The principles underlying this important difference are reviewed from a childbirth perspective and promote a reconsideration of the role of pain relief in labor versus the need for anesthesia at delivery. An epidural analgesic technique is presented with fresh implications for several old intrapartum practices. The analgesia/ anesthesia distinction in epidural therapy offers new opportunities and flexibility for safety and fulfillment in childbirth.