L8: Analgesia & Anasethia in Obstetrics

Question 1

Def of Analgesia

Answer 1

Relief of pain èout loss of consciousness.

Question 2

Def of Local & regional anesthesia

Answer 2

Blocking nerves or nerve roots carrying pain signals from localized areas of body.

Question 3

Def of General anesthesia

Answer 3

Loss of consciousness.

Question 4

Safety of Anasthesia in Obstetrics

Answer 4

• Anesthetic complications are significant cause of maternal morbidity & mortality & accounts for approximately 4% of maternal deaths.

Question 5

Changes in preganncy that affect Anasthesia

Answer 5

Question 6

Neuropathways of Labor Pain

Answer 6

Question 7

Severity of Labor Pains

Answer 7

Question 8

Value of Pain Relief in Obstetrics

Answer 8

Question 9

methods of giving information to mother about pain and Analgesia

Answer 9

Question 10

Methods of pain control in labor

Answer 10

• Support during labor
• Non pharmacological methods
• Pharmacological methods

Question 11

Methods of pain control in labor

• Support During Labor

Answer 11

By partner, midwife or doula.

Question 12

Methods of pain control in labor

• Non-Pharmacological Methods

Answer 12

Question 13

Non-Pharmacological methods of pain control in labor

• Techniques that decrease pain stimuli

Answer 13

Question 14

Non-Pharmacological methods of pain control in labor

• Techniques that activate peripheral sensory receptors

Answer 14

Question 15

Non-Pharmacological methods of pain control in labor

• Techniques that enhance descending inhibitory pathways

Answer 15

Question 16

Pharmacological methods of pain control in labor

Answer 16

• Systemic agents (narcotics & sedatives)
• Local & regional anesthesia
• General anesthesia

Question 17

Pharmacological methods of pain control in labor

• Systemic agents (narcotics & sedatives)

Answer 17

Question 18

Systemic agents (narcotics & sedatives)

• Examples

Answer 18

Meperidine (pethidine), Morphine & Fentanyl.

Question 19

Systemic agents (narcotics & sedatives)

• Risks

Answer 19

Question 20

Systemic agents (narcotics & sedatives)

• Antagonist

Answer 20

Naloxone (0.1 mg/kg IM or IV for neonate)

Question 21

Local & regional anesthesia

Answer 21

Question 22

Local & regional anesthesia

• Local infiltration of perineum

Answer 22

For episiotomy

Question 23

Local & regional anesthesia

• Paracervical Block

Answer 23

Rarely used due to associated fetal bradycardia

Question 24

Local & regional anesthesia

• Pudendal Nerve Block

Answer 24

• Provides perineal anesthesia by anesthetizing pudendal n.
• Works well for vaginal delivery & episiotomy repair but doesn’t provide adequate anesthesia for forceps delivery

Question 25

Local & regional anesthesia - Spinal Anasthesia

Answer 25

Question 26

Uses of Spinal Anasthesia

Answer 26

Useful when maternal participation is no longer needed - as assisted vaginal delivery, CS & extraction of retained placenta

Question 27

Advantages of Spinal Anasthesia

Answer 27

rapid onset & easier to administer than epidural anesthesia.

Question 28

Complications of Spinal Anasthesia

Answer 28

Question 29

General Anasthesia

Question 30

Uses of General Anasthesia

Answer 30

Question 31

Types of General Anasthesia

Answer 31

- Inhalation anesthetics - IV anesthetics

Question 32

Types of General Anasthesia - Inhalation anaethesia

Answer 32

Question 33

Types of General Anasthesia - IV Anesthesia

Answer 33

Thiopental & Ketamine.

Question 34

**Aspiration Pneumonitis in Obstetrics** - Incidence

Answer 34

Commonest cause of anesthetic death in obstetrics.

Question 35

**Aspiration Pneumonitis in Obstetrics** - Etiology

Answer 35

Inhalation of acidic gastric contents (PH < 2.5) → severe chemical pneumonitis.

Question 36

**Aspiration Pneumonitis in Obstetrics** - Signs

Answer 36

- Tachypenia, hypotension - Cyanosis, bronchospasm - Ronchi, rales & atelectasis.

Question 37

**Aspiration Pneumonitis in Obstetrics** - Prophylaxis

Answer 37

Question 38

**Aspiration Pneumonitis in Obstetrics** - TTT

Answer 38