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Obstetrics anesthesia and analgesia

Obstetrics anesthesia and analgesia. Dr .Nawal Alsinani. Analgesia : Loss of perception of pain . Anesthesia : Loss of ability to perceive touch – pain and other sensation. General consideration. 1 – two person to be consider .

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Obstetrics anesthesia and analgesia

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  1. Obstetrics anesthesia and analgesia Dr .Nawal Alsinani

  2. Analgesia : Loss of perception of pain . Anesthesia : Loss of ability to perceive touch – pain and other sensation .

  3. General consideration 1 – two person to be consider . 2- respiratory center of the infant is highly vulnerable to sedative and anesthetic . 3 – duration of administration . 4 – patient preparation .

  4. Anatomy of pain 1 – pain in first stage of labour . L1 – T10 – T11 – T12 . 2 – sensory pathways : - Uterine plexus . - Inferior hypo gastric plexus . - Midle and superior hypo gastric . - Lumbar and lower thoracic symptathetic chain

  5. 2 – pain in the 2nd stage - branches of the pudendal nerve . - Conveyed along nerve roots S2-S3 –S4 - Other nerves as the ilioinguinal nerve – genitofemoral nerves .

  6. Techniques of analgesia without the use of drugs * Psychoprophylaxis * hypnosis

  7. Analgesic , amnestic and anesthetic agents * General comments and precautions : 1- prepare patient psychologically . 2- individualize the treatment of every patient . 3- know the drugs . 4- all systemic drugs cross the placenta . 5- No drugs has selective maternal effects .

  8. Pharmacologic aspects 1- route of administration : - Oral ,I.M , I.V . 2- placental transfer .

  9. Specific types of analgesic agents 1- Inhalant agents : - Nitrous Oxide ( 50% N2O + 50% O2 ) Good in 1st stage of labor . 2- Sedatives : * Produce drowsiness * Slow

  10. 3- tranquilzers and amnestics : - Relieve apprehension Eg. Valium : If given early can cause Kernicterus . 4- Narcotic Analgesics : - Used in 1st stage of labor . Eg. Morphine : If given early can cause respiratory depression.

  11. Regional Anesthesia - Lumbar Epidural Block . - Spinal Anesthesia . - Caudal Block . - Paracervical Block . - Pudendal Nerve Block .

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