Pain relief in labour Flashcards
What are some non-pharmacological pain relief options in pregnancy
- Understanding what to expect
- Having good support
- Being in a relaxed environment
- Changing position to stay comfortable
- Controlled breathing
- Water births may help some women
- TENS machines may be useful in the early stages of labour
Simple analgesia option in pregnancy
Paracetamol ± Codeine
What is the medical name for gas and air
Entonox
What is entonox?
50% nitrous oxide
50% oxygen
Use of entonox
Used during contractions for short term pain relief. The woman takes deep breaths using a mouthpiece at the start of a contraction, then stops using it as the contraction eases.
Side effects of entonox
Lightheadedness
Nausea
Sleepiness
What opioid medications are used in pain relief in pregnancy
Pethidine
Diamorphine (Heroin)
Uses of diamorphine in pregnancy
Used for pain relief, anxiety and distress
Side effects of diamorphine
Drowsiness
Nausea
Respiratory depression in neonate (Makes first feed harder)
What drug is used in pati8ent controlled analgesia?
Ramifentanyl
How is ramifentanyl administered?
patient pressing a button at the start of a contraction to administer a bolus of this short-acting opiate medication.
What is involved in an epidural
inserting a small tube (catheter) into theepidural spacein the lower back. This isoutsidethedura mater, separate from thespinal cordandCSF.Local anaestheticmedications are infused through the catheter into theepidural space, where they diffuse to the surrounding tissues and through to the spinal cord, where they have an analgesic effect.
Anaesthetics used in epidural
Levobupivacaine
Bupivacaine
Mixed with fentanyl
Adverse effects of epidural
- Headache after insertion
- Hypotension
- Motor weakness in the legs
- Nerve damage
- Prolonged second stage
- Increased probability of instrumental delivery
