is the same, the response to this process is different. Many women identify the pain of childbirth as one of the most painful experiences imaginable, whereas others view the experience as tolerable. These viewpoints emphasize the importance of the emotional experience to the definition of pain. This definition also explains why Lamaze has been shown to decrease the pain of labor. It does not alter the process; rather, it alters the person's interpretation of the experience. 1 This point is further reemphasized by the current study. There were 2 study populations, one from a hospital in Miami and the other from a hospital in Jerusalem. Whereas there was no effect of the mutation of the allele on the duration of analgesia, there was a notable effect from the culture and the expectation of labor. It is this emotional response to the pain of labor that makes studies in obstetric anesthesia so difficult and yet so fascinating. An investigator must consider the population being studied and factor in the culture of labor and the accompanying pain when assessing any factor that influences the duration or severity of pain. Comment by Robert Gaiser, MD, MEd Disclosure: The author declares no conflict of interest.REFERENCE 1. Monfared H, Sferra JJ, Mekhail N. The medical management of chronic pain.before neuraxial procedures seems to diminish, if not eliminate, this risk. In the current case, neuraxial anesthesia was avoided given the presence of hypovolemia and hypertropic cardiomyopathy and the emergent nature of cesarean delivery. This case report illustrates the importance of a thorough prenatal assessment, multidisciplinary discussions, and careful risk-versus-benefit analysis in the successful anesthetic management of parturients with multiple complex comorbidities.
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