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Pathways of labor pain. Pain stimuli from the cervix and uterus travel through the paracervical region and the pelvic and hypogastric plexus to enter the lumbar sympathetic chain. Through the white rami communicantes of the T10, T11, T12, and L1 spinal nerves, they enter the dorsal horn of the spinal cord. Blockade at different levels along this path can alleviate the visceral component of labor pain. (Adapted from Eltzschig HK, Lieberman ES, and Camann WR: Medical progress: Regional anesthesia and analgesia for labor and delivery. N Engl J Med 348:319, with permission. Copyright © 2003 Massachusetts Medical Society. All rights reserved.) Source: Chapter 19. Obstetrical Anesthesia, Williams Obstetrics, 23e Citation: Cunningham F, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics, 23e; 2010 Available at: Accessed: October 23, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved
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