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Management of discomfort

Management of discomfort. Lectures 5 Petrenko N.V., MD, PhD. SOME SPINAL ANESTHESIC AGENTS. Lidocaine Bupivicaine. Mechanism of actions…. Some inhaled anesthesia agents…. Halothane  (Fluothane): Isoflurane  (Forane): Enflurane  (Ethrane): Desflurane  (Suprane):

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Management of discomfort

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  1. Management of discomfort Lectures 5 Petrenko N.V., MD, PhD

  2. SOME SPINAL ANESTHESIC AGENTS. • Lidocaine • Bupivicaine

  3. Mechanism of actions….

  4. Some inhaled anesthesia agents… Halothane (Fluothane): Isoflurane (Forane): Enflurane (Ethrane): Desflurane (Suprane): Nitrous oxide (nitrous oxide):

  5. Opioid Antagonist :NALOXONEDuring Labor Mireille Flore .N.

  6. Mechanism of Action: Reaching Receptors Epidurally administered drugs must travel through: dura matter arachnoid matter CSF pia matter white matter gray matter dorsal horn Competing pathways Uptake into epidural epidural fat Uptake into systemic circulation

  7. Dosage And Administration

  8. Fentanyl and Meperidine(Demerol

  9. Pain Pathways – 1st stage

  10. Pain Pathways – 2nd stage

  11. Epidural

  12. Dosing

  13. PHASES OF LABOUR FRIEDMAN’S CURVE 10- DECELRATION PHASE 8- Cervical dilatation 6- ACCELRATION PHASE 4- LATENT PHASE 2- ACTIVE PHASE | | 6 | 8 | 10 | 2 | 4 Duration of labour

  14. MANAGEMENT OF LABOUR 4-Analgesia • Epidural • Nitrous oxide • Narcotics ↑ pain & anxiety ↑ Catecholamines Dystocia Uterine Contraction strength Uterine blood flow

  15. 5-Contiuous assessment of progress of labour THE PARTOGRAM

  16. PHILPOTT’S CERVICOGRAPH • Cervicograph should not be used until active labour has been established 3-4 cm dilatation 10- 8- Action line Cervical dilatation 6- Alert line 4- 2- | | 6 | 8 | 10 | 2 | 4 Time (hr)

  17. TREATMENT OF DYSTOCIA 1-Oxytocin 2-Active management of labour 3-Instrumental deliveries 4-CS ADVERSE EFFECTS OF OXYTOCIN

  18. ACTIVE MANAGEMENT OF LABOUR

  19. Non pharmacologic managementof discomfort Pain relief during labor

  20. Spinal anesthesia

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