Labor Pain Flashcards
1
Q
Morphine, Codeine, *Fentanyl
A
Labor Pain Pure Opioid Agonist • Fxn: Analgesia, Sedation, Respiratory Depressants - *Fentanyl = Prime analgesics used for Epidural Analgesia. - IV route always preferred MOA - Very potent stimulants of μ (Mu) receptor. ADE - N/V -Respiratory depression - sedatitive/hypnotic effect -constipation - urticaria, pruritis, bronchospasms
2
Q
Naloxone (Narcan)
A
Labor Pain
Pure Opioid Antagonist
- Rapidly reverses opioid effects by blocking opioid receptors
MOA
- Pure Blocker (Blocks Both μ (Mu) & κ (Kappa))
3
Q
Butorphanol, Nalbupine
A
Labor Pain Mixed Opioid Agonist AKA “Agonist-Anagonist” MOA - Stim κ (Kappa); Blocks μ (Mu); Used for Labor Pain bc less Repiratory Depression ADE - N/V -Respiratory depression - sedatitive/hypnotic effect -constipation - urticaria, pruritis, bronchospasms
4
Q
Labor epidurals
A
Labor Pain
Labor Epidurals = (Local anesthetic + Opioid.)
a) This approach reduces the dose of each agent needed (limiting toxicity), prolongs the analgesic effect, reduces motor block (paralysis of Leg muscles), and improves patient satisfaction, as compared with the use of local anesthetic alone.
b) Less systemic Effect = Less sedation & Respiratory Depression
c) *Goal = sensory block much greater than motor block
d) Main Meds:
• Opioids:
- Fentynyl
- Sufentanil
• Local Analgesics:
- Bupivacaine
- Naropin
MOA (L/A)
a) Block Na-Channel = Blocks Conduction
b) Binds to Intracellular bind sites on Voltage-Gated-Na-Channel → Closes Channel → ↓s conduction of APs
Routes of ADM (LA+opioid)
a) Epidural
b) Intrathecal (Intraspinal) into subarachnoid space
c) Combined Spinal-Epidural Analgesia
• Initial Bolus via Intrathecal
• Maintenance via Epidural infusion
ADE (epidural)
• Hypotension
• *local anesthetic toxicity
• allergic reaction
• high or total spinal anesthesia
• neurologic injury
• postdural puncture headache
5
Q
IV Fat Emulsion
A
Antidote for Local Anesthetic Toxicity (via -caine)
