L8: Analgesia & Anasethia in Obstetrics Flashcards
Def of Analgesia
Relief of pain èout loss of consciousness.
Def of Local & regional anesthesia
Blocking nerves or nerve roots carrying pain signals from localized areas of body.
Def of General anesthesia
Loss of consciousness.
Safety of Anasthesia in Obstetrics
- Anesthetic complications are significant cause of maternal morbidity & mortality & accounts for approximately 4% of maternal deaths.
Changes in preganncy that affect Anasthesia
Neuropathways of Labor Pain
Severity of Labor Pains
Value of Pain Relief in Obstetrics
methods of giving information to mother about pain and Analgesia
Methods of pain control in labor
- Support during labor
- Non pharmacological methods
- Pharmacological methods
Methods of pain control in labor
- Support During Labor
By partner, midwife or doula.
Methods of pain control in labor
- Non-Pharmacological Methods
Non-Pharmacological methods of pain control in labor
- Techniques that decrease pain stimuli
Non-Pharmacological methods of pain control in labor
- Techniques that activate peripheral sensory receptors
Non-Pharmacological methods of pain control in labor
- Techniques that enhance descending inhibitory pathways
Pharmacological methods of pain control in labor
- Systemic agents (narcotics & sedatives)
- Local & regional anesthesia
- General anesthesia
Pharmacological methods of pain control in labor
- Systemic agents (narcotics & sedatives)
Systemic agents (narcotics & sedatives)
- Examples
Meperidine (pethidine), Morphine & Fentanyl.
Systemic agents (narcotics & sedatives)
- Risks
Systemic agents (narcotics & sedatives)
- Antagonist
Naloxone (0.1 mg/kg IM or IV for neonate)
Local & regional anesthesia
Local & regional anesthesia
- Local infiltration of perineum
For episiotomy
Local & regional anesthesia
- Paracervical Block
Rarely used due to associated fetal bradycardia
Local & regional anesthesia
- Pudendal Nerve Block
- Provides perineal anesthesia by anesthetizing pudendal n.
- Works well for vaginal delivery & episiotomy repair but doesn’t provide adequate anesthesia for forceps delivery
Local & regional anesthesia
- Spinal Anasthesia
Uses of Spinal Anasthesia
Useful when maternal participation is no longer needed
- as assisted vaginal delivery, CS & extraction of retained placenta
Advantages of Spinal Anasthesia
rapid onset & easier to administer than epidural anesthesia.
Complications of Spinal Anasthesia
General Anasthesia
Uses of General Anasthesia
Types of General Anasthesia
- Inhalation anesthetics
- IV anesthetics
Types of General Anasthesia
- Inhalation anaethesia
Types of General Anasthesia
- IV Anesthesia
Thiopental & Ketamine.
Aspiration Pneumonitis in Obstetrics
- Incidence
Commonest cause of anesthetic death in obstetrics.
Aspiration Pneumonitis in Obstetrics
- Etiology
Inhalation of acidic gastric contents (PH < 2.5) → severe chemical pneumonitis.
Aspiration Pneumonitis in Obstetrics
- Signs
- Tachypenia, hypotension
- Cyanosis, bronchospasm
- Ronchi, rales & atelectasis.
Aspiration Pneumonitis in Obstetrics
- Prophylaxis
Aspiration Pneumonitis in Obstetrics
- TTT
