Pain management

Question 1

definition of analgesia

Answer 1

inability to feel pain

Question 2

definition of anethesia

Answer 2

lack of pain artificially induced by drugs

Question 3

_________blocks the sensation without blocking function

Answer 3

anesthsia

Question 4

Where in the spine is the first stage of labor pains?

Answer 4

T11 and T12 = uterine pain

Question 5

Where in the spine is the second stage of labor?

Answer 5

S2-S4 =cervical, vag, peri pain

Question 6

5 types of systemic opiods given in labor

Answer 6

1. meperdine (Demerol)
2, morphine
3. fentanyl
4. butophanol (stadol)
5. Nalbuphine (nubain)

Question 7

What are common side effects of systemic opiods?

Answer 7

• resp depression
• orthostatic hypotenson
• decreased gastrc motility
• nausea and vomiting
• depression of CNS

Question 8

what is the dose and duration of Demerol?

Answer 8

25-100mg
duration: q 2-4hrs IM
OR
q 2-3hrs IV

Question 9

onset and peak of Demerol?

Answer 9

onset- 20minutes IM or immediately IV

peak- 40-50 minutes IM or 10-15 IV

Question 10

what is the dose and duration of stadol

Answer 10

1-2mg IV or IM

duration is 2-4 hours maybe longer

Question 11

what is the onset and peak of stadol?

Answer 11

onset- IV is immediate, IM is 60 minutes

Question 12

what is the dose and duration of nubain?

Answer 12

5-10mg IV or IM

duration 3-6 hours

Question 13

what is the onset and peak of nubain?

Answer 13

onset: IV immediate, IM 15 minutes
peak: IV immediate, IM 30mintues

Question 14

dose of fentanyl

Answer 14

50-100 IV every hour

Question 15

what is the half life of fentanyl?

Answer 15

8 hours

Question 16

difference between spinal and epidural?

Answer 16

has to do wit where in the dura it is placed.

Question 17

where is the site of action in an epidural?

Answer 17

substantia gelatinosa of the spinal cord

Question 18

________anesthesia is currently the most effective form of intrapartum pain relief available

Answer 18

regional

Question 19

Why are women in pregnancy more susceptable to spinal headache?

Answer 19

bc the blood vessles are very engorged and increases the possibility of vascular trauma.

Question 20

How could reginal anesthesia lesson the chance of fetal acidosis?

Answer 20

may reduce materanl hyperventilation and catecholamine release

Question 21

With general anesthesia, safety in the newborn in related to what?

Answer 21

dose related.

Question 22

What is one major risk factor of paracervical block?

Answer 22

fetal bradycardia in 15% of the cases.

Question 23

A pudendal block blocks the _______nerve

Answer 23

pudendal

Question 24

Pudendal block anesthetizes what?

Answer 24

perineum, vulva, rectum

Question 25

What is the duration of a pudendal block?

Answer 25

90 minutes

Question 26

What are 4 CNS toxicity (non cardio) symptoms of local anesthetic?

Answer 26

1. tingling
2. mettalic taste
3. confusion
4. convulsion/coma

Question 27

What are 5 cardio toxicity symptoms of local anesthetic?

Answer 27

1. htn
2. tachycardia
   THEN
3. hypotention
4. arrhythmias
5. cardiac arrest

Question 28

What are the 4 contraindications for regional anesthesia?

Answer 28

1. actual or anticipated maternal hemmorhage
2. infection at or near site of injection
3. suspicion of neurological disease
4. anticoagulation therapy

Question 29

When following the rules of “habituation” when will the technique become ineffective?

Answer 29

15-20 minutes.

Question 30

What are three methods of back pain relief in labor?

Answer 30

2. counter pressure
3. double hip squeeze
4. knee press