Labor Physiology/Anesthesia

Question 1

What causes pain during first stage labor?

Answer 1

Passive cervical stretch and lower uterine segment

Question 2

What causes pain in second stage labor?

Answer 2

Stretch of perineum as fetal head passes

Question 3

Which nerves mediate pain in first stage labor?

Answer 3

Sympathetic T10-L1

Question 4

Which nerves mediate pain in second stage labor?

Answer 4

Pudendal (S2-S4)

Question 5

Effect of maternal temp when using epidural analgesia?

Answer 5

Increased temp/Fever

Question 6

Which regional technique for labor increases local anesthetic levels systemically the most?

Answer 6

Paracervical block

Question 7

How is 2-chloroprocaine metabolized?

Answer 7

Plasma cholinesterase

Question 8

By what % does FVC change with pregnant patients with spinal?

Answer 8

5%

Question 9

By what % does PEFR change in pregnant spinal patients?

Answer 9

10%

Question 10

By how much does VC decrease in obese patients?

Answer 10

25%

Question 11

What is the effect on epidural morphine if 2-chloroprocaine is used?

Answer 11

Decreased efficacy

Question 12

Why is inhalational induction faster in pregnant patients?

Answer 12

Higher MV and decreased FRC

Question 13

True of false: Desflurance lowers uterine tone more than sevoflurane?

Answer 13

True

Question 14

At what MAC level is uterus no longer responsive to oxtytocin?

Answer 14

> 2 MAC

Question 15

Ketamine effects on uterine tone?

Answer 15

Increases

Question 16

Nitroglycerine dose for uterine relaxation?

Answer 16

50 mcg q1min for max dose of 250 mcg