labour analgesia

Question 1

drug free techniques of managing pain in labour

Answer 1

birthing ball 
birthing pool 
hypobirth 
thames machines
aromatherapy

Question 2

simple drug therapies

Answer 2

entonox

diamorphine

Question 3

entonox

Answer 3

gas and air

breath in during contraction to help with pain - deep breaths when contractions start

Question 4

entonox advantages

Answer 4

widely used
safe
patient in control 
works quickly (~30s) 
wears of quickly
can be used alongside other pain relief

Question 5

entonox disadvantages

Answer 5

dizzy 
dry mouth 
sick
helps u cope but doesnt take all pain away 
takes practice to time it

Question 6

diamorphine

Answer 6

injection at top of leg

works 30 min s

Question 7

diamorphine advantages

Answer 7

lasts 4hrs

relaxes pt and helps them cope

Question 8

diamorphine disadvantages

Answer 8

sick
sleepy
slow breathing
similar effects on baby (they can have injection after birth to reverse effects)

Question 9

advanced techniwues

Answer 9

remifentanil PCA

epidural

Question 10

remifentanil PCA

Answer 10

patient controlled analgesia pump

drip back of hand, administered when patient pushes button

machine allows max 1 dose every 2 mins

Question 11

remifentanil PCA advantages

Answer 11

pt in control
works and wears off quickly
strong effect on relieving pain

Question 12

remifentanil PCA disadvantages

Answer 12

can slow down breathing
extra O2 and monitoring
drowsy, sick, itchy
can start if had diamorphine in last 4hrs

Question 13

epidural

Answer 13

local anaesthetic to numb nerves supplying womb

small amounts medicine administered through epidural periodically, patient also has a button they can press to administer

machine programmed to limit amount can give themselves

Question 14

epidural advantages

Answer 14

most work really well
unlikely to affect baby
pt in control
can be used for theatre CS

Question 15

epidural disadvantages

Answer 15

can slow pushing phase delivery
risk forceps/suction cup 
drops in BP 
itching, fever
sore area on back 
1in100 headahce

Question 16

rare side effect epidural

Answer 16

temp nerve damage 
nerve damage >6mo 
epidural abscess
meningitis
epidural haematoma
accidental unconsciousness