Pain management Flashcards
definition of analgesia
inability to feel pain
definition of anethesia
lack of pain artificially induced by drugs
_________blocks the sensation without blocking function
anesthsia
Where in the spine is the first stage of labor pains?
T11 and T12 = uterine pain
Where in the spine is the second stage of labor?
S2-S4 =cervical, vag, peri pain
5 types of systemic opiods given in labor
1. meperdine (Demerol) 2, morphine 3. fentanyl 4. butophanol (stadol) 5. Nalbuphine (nubain)
What are common side effects of systemic opiods?
- resp depression
- orthostatic hypotenson
- decreased gastrc motility
- nausea and vomiting
- depression of CNS
what is the dose and duration of Demerol?
25-100mg
duration: q 2-4hrs IM
OR
q 2-3hrs IV
onset and peak of Demerol?
onset- 20minutes IM or immediately IV
peak- 40-50 minutes IM or 10-15 IV
what is the dose and duration of stadol
1-2mg IV or IM
duration is 2-4 hours maybe longer
what is the onset and peak of stadol?
onset- IV is immediate, IM is 60 minutes
what is the dose and duration of nubain?
5-10mg IV or IM
duration 3-6 hours
what is the onset and peak of nubain?
onset: IV immediate, IM 15 minutes
peak: IV immediate, IM 30mintues
dose of fentanyl
50-100 IV every hour
what is the half life of fentanyl?
8 hours
difference between spinal and epidural?
has to do wit where in the dura it is placed.
where is the site of action in an epidural?
substantia gelatinosa of the spinal cord
________anesthesia is currently the most effective form of intrapartum pain relief available
regional
Why are women in pregnancy more susceptable to spinal headache?
bc the blood vessles are very engorged and increases the possibility of vascular trauma.
How could reginal anesthesia lesson the chance of fetal acidosis?
may reduce materanl hyperventilation and catecholamine release
With general anesthesia, safety in the newborn in related to what?
dose related.
What is one major risk factor of paracervical block?
fetal bradycardia in 15% of the cases.
A pudendal block blocks the _______nerve
pudendal
Pudendal block anesthetizes what?
perineum, vulva, rectum
What is the duration of a pudendal block?
90 minutes
What are 4 CNS toxicity (non cardio) symptoms of local anesthetic?
- tingling
- mettalic taste
- confusion
- convulsion/coma
What are 5 cardio toxicity symptoms of local anesthetic?
- htn
- tachycardia
THEN - hypotention
- arrhythmias
- cardiac arrest
What are the 4 contraindications for regional anesthesia?
- actual or anticipated maternal hemmorhage
- infection at or near site of injection
- suspicion of neurological disease
- anticoagulation therapy
When following the rules of “habituation” when will the technique become ineffective?
15-20 minutes.
What are three methods of back pain relief in labor?
- counter pressure
- double hip squeeze
- knee press
