*Obstetric Analgesia and Anesthesia

Question 1

Common narcotics/sedatives useful in the 1st Stage of Labor

Answer 1

Fentanyl, Nubain, Stadol, Morphine IM

Question 2

Pudendal Nerve Block:

location of nerve

where is it given

indications

Answer 2

posterior to ischial spine at its juncture with sacrospinous ligament

Block is injected bilaterally.

For operative vaginal delivery with forceps or vacuum

Question 3

Local Anesthesia:

indications

Answer 3

pts. without anesthesia who will require episiotomy, or to repair vaginal, perineal, or periurethral lacerations

Question 4

Epidural:

indications

location

complication

Answer 4

For pts. who wish to have anesthesia throughout the active phase and delivery of infant

epidural catheter is placed in L3-L4 interspace and given in bolus first then continuous infusion

! maternal hypotension 2⁰ to decreased systemic vascular resistance –> decreased placental perfusion/fetal bradycardia
! maternal respiratory depression
! spinal headache

Question 5

Spinal Anesthesia:

indications

complication

Answer 5

similar anesthesia region as an epidural, but is more rapid, given in a one-time dose directly into spinal canal

common for C-section

! maternal hypotension 2⁰ to decreased systemic vascular resistance –> decreased placental perfusion/fetal bradycardia
! maternal respiratory depression
! spinal headache

Question 6

General Anesthesia:

complication

Answer 6

! maternal aspiration

! hypoxia for mother and fetus