pain relief in labour Flashcards
waterbirth
decr need for regional anaesthesia. keep water temp
when can pethidine not be used
if expected to deliver in 2-3 hours as neonatal respiratory depression may occur.
gas and air
NO- entonox- mix of O2 and NO
CI entonox
pneumothorax
when is spinal block used
rotational delivery, C section
what space is spinal anaesthesia
subarachnoid space- anaesthetise spinal roots.
complications spinal
headache, total spinal block, urinary retention
what is epidural
anaesthetise pain fibres T11-S5
when can epidural be used
latent phase 1sr stage, continue until placenta devlivered. ephedrine and vol preload
monitoring epidural
bp every 5 mins for 15. monitor FHR for 30 mins before and after top ups. top ups every 2 hours
when may epidural be useful
OP, breech, multiple, pre term, preeclampsia, forceps, incoordinated uterine contractions
problems epidural
dural puncture, vessel puncture, hypoventilation, total spinal, epidural haematoma, abscess, postural hypotension, urinary retention, paralysis
what is a pudendal block
S2,3,4/ lidocaine just beloe ischial spines. in instrumental delivery
what can be used for quicker pain relief
combined spinal epidural. opiate intrathecally
