Obstetric Anaesthesia

Question 1

Some examples of simple analgesia used during labour?

Answer 1

Paracetamol

Codeine

Question 2

Examples of opioids used in obstetric anaesthesia?

Answer 2

Single shot (IM)
- morphine
- diamorphine
- pethidine (avoid in epileptics)
PCA via IV cannula
- fentanyl
- alfentanil
- remfentanil

Question 3

What does entonox compromise?

Answer 3

50% NO2 and 50% O2

Minimal side effects

Question 4

What are some examples of regional anaesthesia?

Answer 4

Epidural
Spinal
Combined Spinal Epidural

Question 5

What are examples of neuroaxial drugs? What is the definition of neuroaxial drugs?

Answer 5

Neuroaxial - drugs that are delivered in close proximity to the spinal cord i.e intrathecally into the CSF or epidurally into the fatty tissues surrounding the dura, by injection or infusion

Bupivacaine
Fentanyl
Diamorphine

Question 6

what is the hierachy of analgesia/anaesthesia for labour/C-section? From 1st line to last?

Answer 6

Simple analgesia i.e paracetamol/codeine
Entonox
Opioids i.e single shot/PCA
Regional anaesthesia +/- neuroaxial techniques
General anaesthesia

Question 7

Indications for epidural

Answer 7

Maternal request
Pregnancy-induced HTN/Pre-eclampsia toxaemia
Cardiac/other medical disease
Augmented labour
Multiple births
Instrumental/operative delivery likely

Question 8

Contraindications to regional anaesthesia?

Answer 8

Absolute

• Maternal refusal
• Local infection
• Allergy LA

Relative

• Coagulopathy
• Systemic infection
• Hypovolaemia
• Abnormal anatomy
• Fixed cardiac output