The document discusses various methods of labour analgesia from both non-pharmacological and pharmacological perspectives. Non-pharmacological methods include psycho-prophylaxis, Lamaze technique, hypnosis and sterile water injections. Pharmacological methods include inhaled agents like Entonox, intravenous opioids like fentanyl and neuraxial blocks using local anaesthetics and opioids. Neuraxial blocks provide the most effective pain relief with minimal effects on the fetus but require technical skill for administration. The document evaluates benefits and risks of different analgesic methods for both mother and fetus.
OBSTETRICIAN’s PERSPECTIVE OF LABOUR ANALGESIA.pptxAmmu Sujatha
This document discusses various methods of labour analgesia from both non-pharmacological and pharmacological perspectives. It provides a brief history of labour analgesia and explains the physiology of labour pain. It then summarizes different non-pharmacological techniques including psycho-prophylaxis, Lamaze technique, and TENS. For pharmacological methods, it outlines inhaled options like Entonox as well as systemic opioids commonly used. It also discusses the advantages and techniques for various neuraxial blocks like spinal and epidural analgesia.
This document discusses obstetric analgesia options for labor pain. It describes:
1. Labor pain is intense and often worse than deep lacerations for many women. Regional techniques like epidural analgesia are recommended for pain relief during labor.
2. Epidural analgesia is the most common technique and involves threading a catheter into the epidural space to administer local anesthetics. Proper monitoring and maintenance is required to ensure adequate pain relief without motor block or hypotension.
3. Other options discussed include systemic opioids, inhaled gases, non-pharmacologic methods, and spinal or combined spinal-epidural techniques. The goal is providing effective pain management while avoiding negative effects on the
This document discusses pain management options for labor and delivery. It describes:
1. Labor pain is intense and often described as worse than other severe pains. Regional analgesia like epidurals are now considered the standard of care due to their safety and efficacy.
2. Non-pharmacologic methods for pain relief include childbirth education, hydrotherapy, positioning changes, and acupuncture, but they have limited effectiveness for severe labor pain.
3. Systemic opioids, inhaled gases, and some sedatives provide some analgesia but also cross the placenta and have potential neonatal effects.
4. Epidural and spinal analgesia/anesthesia allow effective pain relief with minimal fetal exposure but
Advances in the field of labour analgesia have tread a long journey from the days of ether and chloroform in 1847 to the present day practice of comprehensive programme of labour pain management using evidence-based medicine. Newer advances include introduction of newer techniques like combined spinal epidurals, low-dose epidurals facilitating ambulation, pharmacological advances like introduction of remifentanil for patient-controlled intravenous analgesia, introduction of newer local anaesthetics and adjuvants like ropivacaine, levobupivacaine, sufentanil, clonidine and neostigmine, use of inhalational agents like sevoflourane for patient-controlled inhalational analgesia using special vaporizers, all have revolutionized the practice of pain management in labouring parturients.
This document provides an overview of obstetric anaesthesia and analgesia. It describes the pain pathways of labour and delivery, including that the first stage is visceral pain conducted by C fibers, while the second stage is somatic pain conducted by A-delta fibers. It discusses various techniques for labour analgesia including non-pharmacological methods, pharmacological methods like nitrous oxide and narcotics, and regional techniques like epidural, spinal, combined spinal-epidural and continuous spinal analgesia. The advantages, disadvantages and complications of different analgesic methods are outlined.
This document discusses pain pathways and methods of pain management during labor and caesarean section. It describes how the uterus and cervix receive nerve supply during different stages of labor. The ideal analgesic for labor should provide rapid and effective pain relief with no side effects to the mother or fetus. Methods of labor analgesia discussed include non-pharmacological techniques, parenteral drugs like pethidine, inhalation of nitrous oxide, and regional techniques like epidural analgesia. Epidural analgesia is described as the most effective form of pain relief but it requires careful administration and monitoring to avoid problems.
Obstetric analgesia aims to reduce labor pain while minimizing effects on the fetus and labor progress. Options include non-pharmacological methods like breathing techniques, and pharmacological methods like systemic opioids (e.g. fentanyl, morphine), nitrous oxide inhalation, and regional techniques like epidurals. Systemic opioids provide some relief but readily cross the placenta and can depress the fetus. Nitrous oxide provides faster acting analgesia with fewer side effects than opioids as it is quickly eliminated through exhalation. Regional techniques like epidurals dramatically reduce pain while allowing participation in birth with minimal motor block or fetal effects.
The document discusses various methods for managing pain relief during labor and delivery. It describes both non-pharmacological methods like hydrotherapy, TENS, acupuncture, massage and pharmacological methods like systemic opioids, pethidine, fentanyl, butorphanol and tramadol. It also discusses various nerve blocks for pain relief like pudendal, paracervical and neuraxial blocks like spinal and epidural analgesia. The goal is to provide effective pain management options to help make the delivery experience as comfortable as possible for the mother.
OBSTETRICIAN’s PERSPECTIVE OF LABOUR ANALGESIA.pptxAmmu Sujatha
This document discusses various methods of labour analgesia from both non-pharmacological and pharmacological perspectives. It provides a brief history of labour analgesia and explains the physiology of labour pain. It then summarizes different non-pharmacological techniques including psycho-prophylaxis, Lamaze technique, and TENS. For pharmacological methods, it outlines inhaled options like Entonox as well as systemic opioids commonly used. It also discusses the advantages and techniques for various neuraxial blocks like spinal and epidural analgesia.
This document discusses obstetric analgesia options for labor pain. It describes:
1. Labor pain is intense and often worse than deep lacerations for many women. Regional techniques like epidural analgesia are recommended for pain relief during labor.
2. Epidural analgesia is the most common technique and involves threading a catheter into the epidural space to administer local anesthetics. Proper monitoring and maintenance is required to ensure adequate pain relief without motor block or hypotension.
3. Other options discussed include systemic opioids, inhaled gases, non-pharmacologic methods, and spinal or combined spinal-epidural techniques. The goal is providing effective pain management while avoiding negative effects on the
This document discusses pain management options for labor and delivery. It describes:
1. Labor pain is intense and often described as worse than other severe pains. Regional analgesia like epidurals are now considered the standard of care due to their safety and efficacy.
2. Non-pharmacologic methods for pain relief include childbirth education, hydrotherapy, positioning changes, and acupuncture, but they have limited effectiveness for severe labor pain.
3. Systemic opioids, inhaled gases, and some sedatives provide some analgesia but also cross the placenta and have potential neonatal effects.
4. Epidural and spinal analgesia/anesthesia allow effective pain relief with minimal fetal exposure but
Advances in the field of labour analgesia have tread a long journey from the days of ether and chloroform in 1847 to the present day practice of comprehensive programme of labour pain management using evidence-based medicine. Newer advances include introduction of newer techniques like combined spinal epidurals, low-dose epidurals facilitating ambulation, pharmacological advances like introduction of remifentanil for patient-controlled intravenous analgesia, introduction of newer local anaesthetics and adjuvants like ropivacaine, levobupivacaine, sufentanil, clonidine and neostigmine, use of inhalational agents like sevoflourane for patient-controlled inhalational analgesia using special vaporizers, all have revolutionized the practice of pain management in labouring parturients.
This document provides an overview of obstetric anaesthesia and analgesia. It describes the pain pathways of labour and delivery, including that the first stage is visceral pain conducted by C fibers, while the second stage is somatic pain conducted by A-delta fibers. It discusses various techniques for labour analgesia including non-pharmacological methods, pharmacological methods like nitrous oxide and narcotics, and regional techniques like epidural, spinal, combined spinal-epidural and continuous spinal analgesia. The advantages, disadvantages and complications of different analgesic methods are outlined.
This document discusses pain pathways and methods of pain management during labor and caesarean section. It describes how the uterus and cervix receive nerve supply during different stages of labor. The ideal analgesic for labor should provide rapid and effective pain relief with no side effects to the mother or fetus. Methods of labor analgesia discussed include non-pharmacological techniques, parenteral drugs like pethidine, inhalation of nitrous oxide, and regional techniques like epidural analgesia. Epidural analgesia is described as the most effective form of pain relief but it requires careful administration and monitoring to avoid problems.
Obstetric analgesia aims to reduce labor pain while minimizing effects on the fetus and labor progress. Options include non-pharmacological methods like breathing techniques, and pharmacological methods like systemic opioids (e.g. fentanyl, morphine), nitrous oxide inhalation, and regional techniques like epidurals. Systemic opioids provide some relief but readily cross the placenta and can depress the fetus. Nitrous oxide provides faster acting analgesia with fewer side effects than opioids as it is quickly eliminated through exhalation. Regional techniques like epidurals dramatically reduce pain while allowing participation in birth with minimal motor block or fetal effects.
The document discusses various methods for managing pain relief during labor and delivery. It describes both non-pharmacological methods like hydrotherapy, TENS, acupuncture, massage and pharmacological methods like systemic opioids, pethidine, fentanyl, butorphanol and tramadol. It also discusses various nerve blocks for pain relief like pudendal, paracervical and neuraxial blocks like spinal and epidural analgesia. The goal is to provide effective pain management options to help make the delivery experience as comfortable as possible for the mother.
The document discusses pain relief options for labor, including non-pharmacological and pharmacological methods. It describes the etiology and physiology of labor pain, noting that pain in the first stage is visceral while the second stage is somatic. Non-pharmacological options discussed are continuous labor support, relaxation, hydrotherapy, TENS, hypnosis and acupuncture. Pharmacological options include opiates, nitrous oxide, and regional analgesia techniques like epidural and spinal blocks. Epidural analgesia is described as the most effective method of pain relief, but it can prolong labor and restrict movement. Complications of epidurals are also outlined.
This document discusses various techniques for providing analgesia during labor and childbirth. It begins with a brief history of labor analgesia and then describes both non-pharmacological methods like hypnosis and TENS, as well as pharmacological methods including inhalation analgesia, systemic opioids like fentanyl and remifentanil, and regional techniques like epidurals. It provides details on the mechanisms of action, dosages, benefits and risks of different analgesic options. The goal is to relieve pain during labor while maintaining safety for both the mother and fetus.
This document provides information on obstetric analgesia techniques for labor pain. It discusses:
- The physiology of labor pain and its effects on the mother and fetus. Labor pain stimulates the release of hormones that can affect uterine contraction and fetal oxygen levels.
- Various pharmacological and non-pharmacological techniques for pain management, including systemic opioids, inhalational gases, regional nerve blocks, and spinal analgesia using local anesthetics and opioids.
- The advantages and disadvantages of different techniques. Neuraxial blocks like epidurals provide the most effective pain relief with few side effects on the mother or fetus, while minimizing depressant effects seen with systemic opioids.
PHYSIOLOGY OF LABOUR PAIN AND LABOUR ANALGESIA [Autosaved] [Autosaved].pptxKeerthy Unnikrishnan
This document discusses physiology of labour pain and various analgesia techniques. It describes the components and pathways of visceral and somatic labour pain. Non-pharmacological techniques like water immersion, hypnosis, acupuncture, TENS and Lamaze are summarized. Pharmacological analgesics including opioids like fentanyl, remifentanil and non-opioids like nalbuphine are outlined. Regional analgesia techniques such as epidural analgesia are also mentioned. Newer advances in analgesia including patient controlled analgesia are briefly covered.
The document discusses pain management options during labor and delivery, including both pharmacological and non-pharmacological approaches. It defines labor pain, describes the nature and stages of labor pain, and discusses endorphins and their role in pain relief. Both non-pharmacological methods like hydrotherapy, TENS, acupuncture, and hypnosis as well as pharmacological options like narcotics, epidural analgesia, spinal analgesia, nitrous oxide, and general anesthesia are explained in terms of their use, effects, advantages, disadvantages, complications, and contraindications. Regional techniques like epidural analgesia are emphasized as the most common and effective method for relieving labor pain.
This topic includes Introduction for analgesia and anesthesia used in obstetrics, maternal risk factors for anesthesia, anatomical and physiological considerations, analgesia during labour and delivery, sedatives and analgesia, opioid analgesics, combination of narcotics and antiemetics, inhalation methods, commonly used local anesthesia in obstetrics, spinal anesthesia, infiltration anesthesia, patient controlled anesthesia, psychoprophylaxis, general anesthesia for cesarean section, complication of general anesthesia and its management.
This document discusses various methods of pain relief during labor and delivery. It describes the nerve supply of the genital tract and various anesthetic options including opioid analgesics like pethidine and meperidine, benzodiazepines, inhalation methods using nitrous oxide and oxygen, and regional anesthetic techniques like continuous lumbar epidural blocks, paracervical nerve blocks, and pudendal nerve blocks. Risk factors for complications and considerations for each method are also outlined.
Labour analgesia has advanced significantly in recent decades. Regional techniques like epidural analgesia are now considered the gold standard due to their superior pain relief compared to systemic opioids. Epidural analgesia involves the placement of a catheter in the epidural space in the lower back to administer local anesthetics that attenuate pain from uterine contractions without negatively impacting the birth process. It allows women to be comfortable yet actively participate in labour.
This document discusses various methods of labor analgesia. It begins by outlining the objectives and introducing the stages of labor and physiology of pain. It then summarizes non-pharmacological methods like psychoprophylaxis and TENS. Various pharmacological methods are discussed including inhalational analgesia, systemic opioids, and regional techniques like epidural analgesia, combined spinal epidural, and walking epidural. Epidural analgesia is described as the gold standard, and optimal epidural regimens, administration techniques, and monitoring are outlined.
Mc Gill pain scale, history , pathophysiology of labour pain , ideal labour analgesia, non pharmacological methods , birth philosophies , pharmacological methods ,systemic and inhalational agents , regional analgesia
The document discusses pain pathways and effects during labor, various analgesic options for labor pain including systemic opioids, regional techniques like epidural and spinal blocks, and considerations for both maternal and fetal safety. It provides details on specific drugs and techniques, outlining advantages and disadvantages. Regional analgesia like epidural is presented as the most effective option, allowing an alert participating mother while avoiding fetal depression from systemic drugs. Factors influencing placental drug transfer and techniques for local infiltration are also summarized.
This document discusses pain management techniques for labor and delivery. It begins by outlining the pain pathways involved in each stage of labor. It then discusses the effects of pain and stress on the mother and fetus. Various analgesic techniques are discussed, including systemic opioids, nitrous oxide, local anesthetics, and regional techniques like epidural and combined spinal-epidural blocks. Risks, benefits, and considerations for both maternal and fetal safety are provided for each technique. The document concludes by emphasizing individualizing the analgesic approach based on the patient's goals and labor stage while optimizing outcomes and safety.
The document discusses various methods of providing anesthesia and analgesia during labor. It begins by defining anesthesia and analgesia. It then discusses the physiology of pain during the first and second stages of labor. It outlines maternal risk factors for anesthesia and debates whether labor pain requires analgesia. The majority of the document then examines both non-pharmacological and pharmacological methods for pain management, including sedatives, regional techniques like epidural and spinal anesthesia, and inhalation methods. It provides details on procedures, dosages, onset times and complications for each method.
Stages of labour & labour analgesiaImran Sheikh
This document discusses stages of labor and labor analgesia. It defines labor and outlines the normal parameters of labor including 4 stages - 1st, 2nd, 3rd, and 4th. It describes the stages in detail including cervical dilation, descent of the baby, and delivery of the placenta. It discusses pain mechanisms in each stage. It then summarizes various techniques for labor analgesia including non-pharmacological methods like hypnosis, acupuncture, and TENS as well as pharmacological methods like systemic opioids, inhalational gases, and regional techniques like epidural analgesia.
This document summarizes guidelines for managing acute perioperative pain in infants and children. It discusses pain assessment tools, non-pharmacological approaches like regional anesthesia, and pharmacological options including acetaminophen, NSAIDs, gabapentin, ketamine, dexmedetomidine, and opioids. It emphasizes the need for multimodal analgesia, risk-based dosing due to developmental differences, and close monitoring for sedation and respiratory depression when using opioids in this vulnerable population.
The document discusses the history and debate around pain relief during childbirth. Originally, some clergy argued that pain relief interfered with God's will. However, Queen Victoria's painless birth using anesthesia influenced public acceptance. The document then describes various pharmacological (parental drugs, inhalational agents, regional blocks) and non-pharmacological (hypnosis, water birth, massage, music) methods for pain relief during labor and their benefits, risks, and mechanisms of action. Regional blocks like epidurals provide effective relief but require medical expertise and monitoring. Non-drug methods like hypnosis, water birth and massage can also help reduce a woman's pain and stress during labor.
Tohouri Grace IM-638 Analgesics in Ob-gyn.pptxUgo161BB
This document discusses various methods of providing analgesia and anesthesia during labor and delivery. It outlines both non-pharmacological and pharmacological options. Regional techniques like epidural and spinal blocks are preferred due to their effectiveness in relieving pain while allowing the patient to remain awake and aware. Factors like the patient's condition, type of procedure, and risk of complications are considered when determining the appropriate method. Potential risks of each option are also reviewed.
Labor Analgesia- A Maternal Blessing.pptxNabidulIslam1
the basic physiology of Labour pain and all the modern techniques of Labour Analgesia compiled in Short Presentation. The main emphasis is one the Epidural Labour Analgesia, its indications, contraindications, techniques, advantages and positive outcomes.
The document discusses pain relief options for labor, including non-pharmacological and pharmacological methods. It describes the etiology and physiology of labor pain, noting that pain in the first stage is visceral while the second stage is somatic. Non-pharmacological options discussed are continuous labor support, relaxation, hydrotherapy, TENS, hypnosis and acupuncture. Pharmacological options include opiates, nitrous oxide, and regional analgesia techniques like epidural and spinal blocks. Epidural analgesia is described as the most effective method of pain relief, but it can prolong labor and restrict movement. Complications of epidurals are also outlined.
This document discusses various techniques for providing analgesia during labor and childbirth. It begins with a brief history of labor analgesia and then describes both non-pharmacological methods like hypnosis and TENS, as well as pharmacological methods including inhalation analgesia, systemic opioids like fentanyl and remifentanil, and regional techniques like epidurals. It provides details on the mechanisms of action, dosages, benefits and risks of different analgesic options. The goal is to relieve pain during labor while maintaining safety for both the mother and fetus.
This document provides information on obstetric analgesia techniques for labor pain. It discusses:
- The physiology of labor pain and its effects on the mother and fetus. Labor pain stimulates the release of hormones that can affect uterine contraction and fetal oxygen levels.
- Various pharmacological and non-pharmacological techniques for pain management, including systemic opioids, inhalational gases, regional nerve blocks, and spinal analgesia using local anesthetics and opioids.
- The advantages and disadvantages of different techniques. Neuraxial blocks like epidurals provide the most effective pain relief with few side effects on the mother or fetus, while minimizing depressant effects seen with systemic opioids.
PHYSIOLOGY OF LABOUR PAIN AND LABOUR ANALGESIA [Autosaved] [Autosaved].pptxKeerthy Unnikrishnan
This document discusses physiology of labour pain and various analgesia techniques. It describes the components and pathways of visceral and somatic labour pain. Non-pharmacological techniques like water immersion, hypnosis, acupuncture, TENS and Lamaze are summarized. Pharmacological analgesics including opioids like fentanyl, remifentanil and non-opioids like nalbuphine are outlined. Regional analgesia techniques such as epidural analgesia are also mentioned. Newer advances in analgesia including patient controlled analgesia are briefly covered.
The document discusses pain management options during labor and delivery, including both pharmacological and non-pharmacological approaches. It defines labor pain, describes the nature and stages of labor pain, and discusses endorphins and their role in pain relief. Both non-pharmacological methods like hydrotherapy, TENS, acupuncture, and hypnosis as well as pharmacological options like narcotics, epidural analgesia, spinal analgesia, nitrous oxide, and general anesthesia are explained in terms of their use, effects, advantages, disadvantages, complications, and contraindications. Regional techniques like epidural analgesia are emphasized as the most common and effective method for relieving labor pain.
This topic includes Introduction for analgesia and anesthesia used in obstetrics, maternal risk factors for anesthesia, anatomical and physiological considerations, analgesia during labour and delivery, sedatives and analgesia, opioid analgesics, combination of narcotics and antiemetics, inhalation methods, commonly used local anesthesia in obstetrics, spinal anesthesia, infiltration anesthesia, patient controlled anesthesia, psychoprophylaxis, general anesthesia for cesarean section, complication of general anesthesia and its management.
This document discusses various methods of pain relief during labor and delivery. It describes the nerve supply of the genital tract and various anesthetic options including opioid analgesics like pethidine and meperidine, benzodiazepines, inhalation methods using nitrous oxide and oxygen, and regional anesthetic techniques like continuous lumbar epidural blocks, paracervical nerve blocks, and pudendal nerve blocks. Risk factors for complications and considerations for each method are also outlined.
Labour analgesia has advanced significantly in recent decades. Regional techniques like epidural analgesia are now considered the gold standard due to their superior pain relief compared to systemic opioids. Epidural analgesia involves the placement of a catheter in the epidural space in the lower back to administer local anesthetics that attenuate pain from uterine contractions without negatively impacting the birth process. It allows women to be comfortable yet actively participate in labour.
This document discusses various methods of labor analgesia. It begins by outlining the objectives and introducing the stages of labor and physiology of pain. It then summarizes non-pharmacological methods like psychoprophylaxis and TENS. Various pharmacological methods are discussed including inhalational analgesia, systemic opioids, and regional techniques like epidural analgesia, combined spinal epidural, and walking epidural. Epidural analgesia is described as the gold standard, and optimal epidural regimens, administration techniques, and monitoring are outlined.
Mc Gill pain scale, history , pathophysiology of labour pain , ideal labour analgesia, non pharmacological methods , birth philosophies , pharmacological methods ,systemic and inhalational agents , regional analgesia
The document discusses pain pathways and effects during labor, various analgesic options for labor pain including systemic opioids, regional techniques like epidural and spinal blocks, and considerations for both maternal and fetal safety. It provides details on specific drugs and techniques, outlining advantages and disadvantages. Regional analgesia like epidural is presented as the most effective option, allowing an alert participating mother while avoiding fetal depression from systemic drugs. Factors influencing placental drug transfer and techniques for local infiltration are also summarized.
This document discusses pain management techniques for labor and delivery. It begins by outlining the pain pathways involved in each stage of labor. It then discusses the effects of pain and stress on the mother and fetus. Various analgesic techniques are discussed, including systemic opioids, nitrous oxide, local anesthetics, and regional techniques like epidural and combined spinal-epidural blocks. Risks, benefits, and considerations for both maternal and fetal safety are provided for each technique. The document concludes by emphasizing individualizing the analgesic approach based on the patient's goals and labor stage while optimizing outcomes and safety.
The document discusses various methods of providing anesthesia and analgesia during labor. It begins by defining anesthesia and analgesia. It then discusses the physiology of pain during the first and second stages of labor. It outlines maternal risk factors for anesthesia and debates whether labor pain requires analgesia. The majority of the document then examines both non-pharmacological and pharmacological methods for pain management, including sedatives, regional techniques like epidural and spinal anesthesia, and inhalation methods. It provides details on procedures, dosages, onset times and complications for each method.
Stages of labour & labour analgesiaImran Sheikh
This document discusses stages of labor and labor analgesia. It defines labor and outlines the normal parameters of labor including 4 stages - 1st, 2nd, 3rd, and 4th. It describes the stages in detail including cervical dilation, descent of the baby, and delivery of the placenta. It discusses pain mechanisms in each stage. It then summarizes various techniques for labor analgesia including non-pharmacological methods like hypnosis, acupuncture, and TENS as well as pharmacological methods like systemic opioids, inhalational gases, and regional techniques like epidural analgesia.
This document summarizes guidelines for managing acute perioperative pain in infants and children. It discusses pain assessment tools, non-pharmacological approaches like regional anesthesia, and pharmacological options including acetaminophen, NSAIDs, gabapentin, ketamine, dexmedetomidine, and opioids. It emphasizes the need for multimodal analgesia, risk-based dosing due to developmental differences, and close monitoring for sedation and respiratory depression when using opioids in this vulnerable population.
The document discusses the history and debate around pain relief during childbirth. Originally, some clergy argued that pain relief interfered with God's will. However, Queen Victoria's painless birth using anesthesia influenced public acceptance. The document then describes various pharmacological (parental drugs, inhalational agents, regional blocks) and non-pharmacological (hypnosis, water birth, massage, music) methods for pain relief during labor and their benefits, risks, and mechanisms of action. Regional blocks like epidurals provide effective relief but require medical expertise and monitoring. Non-drug methods like hypnosis, water birth and massage can also help reduce a woman's pain and stress during labor.
Tohouri Grace IM-638 Analgesics in Ob-gyn.pptxUgo161BB
This document discusses various methods of providing analgesia and anesthesia during labor and delivery. It outlines both non-pharmacological and pharmacological options. Regional techniques like epidural and spinal blocks are preferred due to their effectiveness in relieving pain while allowing the patient to remain awake and aware. Factors like the patient's condition, type of procedure, and risk of complications are considered when determining the appropriate method. Potential risks of each option are also reviewed.
Labor Analgesia- A Maternal Blessing.pptxNabidulIslam1
the basic physiology of Labour pain and all the modern techniques of Labour Analgesia compiled in Short Presentation. The main emphasis is one the Epidural Labour Analgesia, its indications, contraindications, techniques, advantages and positive outcomes.
Similar to OBSTETRICIAN’s PERSPECTIVE OF LABOUR ANALGESIA (1).pptx (20)
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
2. SCOPE OF ANAESTHESIA IN OBSTETRICS
• Integral part of care of the pregnant women .
• Antenatal assessment and peripartum care.
• Education- midwives,antenatal and enhanced recovery pathway, crisis resource management.
• High risk obstetric patient-assessment and stabilisation.
• Co-ordinate theatre ,aid communication.
• Care of critically ill pregnant or postpartum women.
• Cardiorespiratory emergencies.
• Endocrine and neurological emergencies in pregnancies.
• Anaesthesia for caesarean section and non-obstetric surgery.
• Analgesia for labour – which we are high lighting today.
3. HISTORY
➢ GARDEN OF EDEN
• ORIGINAL SIN.
• GOD PUNISHED EVE: “IN SORROW THOU SHALT BRING FORTH CHILDREN.”
GENESIS 3:16
• FORMED THE BASIS OF 1800 YEARS OF OPPOSITION TO PAIN RELIEF IN
LABOUR.
➢ 1591
• LADY EUFRAME MACALYANE OF EDINBURGH, SCOTLAND: WAS BURNED
AT THE STAKE BECAUSE ASKING FOR LABOR ANALGESIA.
5. LABOUR
• ‘LABOUR can be defined as spontaneous painful uterine contractions associated with the
effacement and dilatation of the cervix and the descent of the fetal presenting part’.
• STAGES OF LABOUR.
STAGE 1:
From onset of regular uterine contractions to full dilation of cervix.
STAGE 2 :
From full cervical dilationto delivery of the fetus.
STAGE 3:
From delivery of the fetus to delivery of the placenta.
STAGE 4
Stage of physical recovery.
Birth of placenta to 4 hrs observation.
6. SIGNIFICANCE OF LABOUR ANALGESIA
• Labor pain is one of the most intense pains that awoman can experience, and it is typically worse
than a pain associated with a deep laceration.
7.
8. AS NOTED BY THE ASAAND THE ACOG
• ͞There is no other circumstance where it is
considered acceptable for a person to
experience severe pain, amenable to safe
intervention.
• Maternal request is a sufficient medical
indication for pain relief during labor.
9. PHYSIOLOGY OF LABOR PAIN
Mechanism of labour pain.
1.Uterine contraction result in myometrial ischemia
Releases bradykinin, histamine, serotonine
pain
2.Stretching and distention of lower uterine segment & cervix
Stimulates mechanoreceptors
pain
10. Conduction of pain
• Dilation of the cervix anddistention of
the lower uterine segment.
• localized poorly, dull aching,Slow
conducting, visceral C fibers, enter
spinal cord at T10 to L1
1st stageof labor
Mostly visceral
2nd
Stages of
Labour
Mostly somatic
• Distention of the pelvicfloor, vagina and
perineum
• Sharp, severe and well
localized
• Rapidly conducting A- delta fibers, enter
spinalcord at S2 to S4
13. NON -PHARMACOLOGICAL PHARMACOLOGICAL
Psycho prophylaxis
Lamaze technique
Hypnosis
TENS
Acupuncture
Hydrotherapy
Aromatherapy
Heat and cold
Vertical position
sterile water injection
Other means
Inhalational Systemic Regional
Entonox
Sevoflurane
Desflurane
Isoflurane
Opioids
Sedatives
Ketamine
Tramadol
Epidural-
lumbar,Caudal .
Combined spinal
epidural
Subarachnoid block
Lumbar Sympathetic
block.
Paracervical block
Pudendal block
METHODS OF LABOUR ANALGESIA
14. NON PHARMACOLOGICAL
• PSYCHO PROPHYLAXIS [DICK READ]:CHILD BIRTH
PREPARATION.
• This method focuses on teaching the mother conditioned reflexes to overcome the
pain and fear of childbirth.
• It uses an education program, human support during labor, breathing techniques,
relaxation techniques of voluntary muscles, a strong focus of attention, and specific
activities to concentrate on , during contractions to block pain.
15. LAMAZE TECHNIQUE
• The stated goal of lamaze is to increase a mother's confidence ; help pregnant
women in ways that both facilitate labor and promote comfort, including relaxation
techniques, movement and massage.
• Take an organizing breath—a big sigh as soon as the contraction begins,followed by
rapid and shallow breathing. Focusyour attention.
16. TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION
• Anelectro-analgesia method.
• Reducepain by nociceptive inhibition at apresynapticlevel in the dorsal horn by limiting central transmission.
• GATE CONTROL THEORY OFPAIN is used todefine how tensaffects thepain perception.
• Placement of electrode pads over the lower back region in thedistribution of T10-L1 may provide
some analgesia for parturients in early labor.
17. ACUPUNCTURE
• Generally two local points and two distal points on thearms or on the legs are
selected.
• Begin acupuncture 4 weeks before the expected time of delivery.
• Needles are placed once a week using the specific points.
• May cause preterm labour.
18. STERILE WATER INJECTIONS
Intradermal water blocks consist of 4 intradermal injections of 0.05- to 0.1-ml sterile
water (using a 1-ml syringe with a 25-gauge needle) to form 4 small blebs, 1over each
posterior superior iliac spine and 2 others placed 3 cm below and 1 cm medial to each
of the firstsite.the sites are known
as “dimple of venus”.It can be repeated.
20. PHARMACOLOGICAL
• INHALED LABOUR ANALGESIA
• Sub-anaesthetic concentrations of inhalational anaesthetic agents.
• Mother remains awake with protective laryngeal reflexes.
• Can be self administered, but requires presence of a health care provider to ensure an
adequate level of consciousness.
A. Entanox
The most commonly used agent for inhaled
analgesia , which is a mixture of 50% nitrousoxide
and 50% oxygen premixed in cylinder.
21. • The mixture is stable under most conditions, but at very low temperatures, the constituent gas
separates.
• SAFEST AGENT WITH NO REPORTED ORGAN TOXICITY, DOES NOT DEPRESS UTERINE
ACTIVITY OR PROLONG LABOUR OR HAS ANY DETRIMENTAL EFFECT ON NEONATAL
OUTCOME.
• DISADVANTAGES :
1. Drowsiness, disorientation and nausea may occur including brief episodes of loss of
consciousness.
2. Does not provide complete analgesia.
22. VOLATILE HALOGENATEDAGENTS
The usual range of concentrations of volatile inhalational
• Agents administered with oxygen :
- Desflurane 0.2% .
- Enflurane 0.25-1.25%.
- Isoflurane 0.2-0.25%.
- Sevoflurane 0.8% ( SEVOX )- sevoflurane is a volatile inhalational agent
commonly used during general anaesthesia. Because of its short onset and
offset of action, it appears to be the best- suited inhalational agent for
labour analgesia.It is used in the concentration of 0.8% with oxygen in
specialized equipments.
• Patient controlled inhalational anaesthesia uses sevox .
23. Inhalational
agents
Decreased uterine.
contractility (except N2O)
•Risk of unconsciousness
and aspiration.
•Difficulties with
scavenging in labor rooms.
•Unpleasant smell and high
cost.
Easy to administer(no
needles or PDPH).
•Satisfactory analgesia.
•Minimal neonatal
depression.
ADVANTAGE
DISADVANTAGE
24. SYSTEMIC ANALGESICS
Most common method used for labour analgesia.
Drug Usual dose Onset Duration(
hr)
Comments
Meperidine
or pethidine
(most commonly
used opioid)
25-50mg IV
50-100mg
IM
5-10min IV
40-45min IM
2-3 Nausea,vomiting
Immediate and
longterm fetal
effects
Morphine 2-5mg IV
5-10mg IM
3-5min IV
20-40min IM
3-4 More neonatal
respiratory depression
Diamorphine 5-7.5mg
IV/IM
5-10min IM 90 min Morphine prodrug
more euphoria,
less nausea than
with morphine.
Fentanyl
(short half
life,rapidly
acting so suitable
for prolong use
in labour.)
25-50 µg IV
100 µg IM
2-3min IV
10min IM
30-60min Usually administered
as an infusion or by
PCA .Accumulates
during an infusion
less neonatal depression
than with meperidine.
25. Drug Dose Onset Duratio
n (hr)
Comments
Nalbuphine 10-20mg
IV/IM
2-3min IV
15min IM/SC
3-6 Opoid agonist/antagonist
Ceiling effect on
respiratory depression
Lower neonatal
neurobehavioral scores
More sedation.
Butorphanol 1-2mg IV/IM 5-10min IV 10-
30min IM
3-4 Opoid agonist/antagonist
Ceiling effect on
respiratory depression
Meptazinol 100mg IM 15min IM 2-3 Partial opoid agonist Less
sedation and respiratory
depression than with other
opoids.
Pentazocine 20-40mg
IV/IM
2-3 min IV
5-20min IM/SQ
2-3 Opoid agonist/ antagonist
Psychomimetic effects
Tramadol 50-100 mg
IV/IM
10 min IM 2-3 Less efficacy than with
meperidine
More side effects than
meperidine
26. Potential Fetal/Neonatal effects
Low 1 and 5min
Apgar scores
Respiratory
acidosis.
Naloxone/ve
ntilatory
support may
be needed.
Neurobehaviora
l depression
dose
dependent.
Occasionall
y,
prolonged
observation
in NICU
needed
28. ADVANTAGES
Most effective & Least
depressant
Great versatility in
strength
& Duration
Reduces maternal
Catecholamines
Improved Uteroplacental
perfusion
Low dose LA
;no effect on
uterine activity
Low dose
opiod;no effect
on fetus
29. • Uterine
perfusion
maintained
• Does not affect
Apgar scores,
acid-base status.
• Neurobehavioral
effects absent
• LA toxicity -
extremely rare
Specifi
c fetal
benefit
• Blunts Haemodynamic
response in :
Hypertensive disorders
Cardiac disease
Asthma
Diabetics
• Avoids depressant
effects of opioids in :
Prolonged labor
Prematurity
Multiple gestation
Breach delivery
Specifi
c
matern
al
benefit
30. EPIDURALANALGESIA
Mainstay for many years.
Near complete analgesia by cephalad and caudal spread of Local anaesthetic T10-L1 ,S2-S4.
Most commonly: mid-lumbar midline placement
• T10-L1 segments need to be blocked to relieve pain of uterine contractions and cervical
dilatation.
• S2-S4 segments need to be blocked to relieve pain of vaginal and perineal distension
31. COMMONLY ACCEPTED CRITERIA FOR
PLACEMENT
1.No fetal distress
2.Good regular contractions 3-4 min apart &lasting about 1 min.
3.Adequate cervical dilatation i.e. 3-4cm
4.Engagement of the fetal head.
5.Early epidural analgesia (e.g., Before 5 cm cervical dilation) may interfere
with uterine contractions and slow the progress of labor.
• If a patient in early labor requests epidural analgesia,first administer either a spinal
or epidural opioid alone or an epidural opioid combined with a very dilute
solution of local anaesthetic.
32. PARACERVICAL BLOCK
• GOOD FOR 2ND STAGE OF LABOR NOT FOR FIRST. 5-10 ml of local anaesthetic injected
through a needle introduced into left or right lateral vaginal fornix, near the cervix, at 4 o’clock
and8 o’clock position.
33. PUDENTAL NERVE BLOCK
• Lithotomy position
- Goal : to block the pudendal nerve distal to its formation by
anterior divisions of S2-S4 .
- Needle introduced through vaginal mucosa and sacrospinous
ligament, just medial and posterior to ischial spine. Pudendal
artery lies in close proximity to pudendal nerve, must aspirate
before and during injection of local anaesthetic
- Timing : immediately before delivery
- Repeated on both sides