History, Myths, Indications & Contraindications, and Methods of painless labor as a means of natural way of childbirth with a lot of benefits for mothers & babies.
Rupal Hospital for Women in Surat is a one stop place for all Gynaec and Obstetrics problems and our expertise lies in providing affordable Laparoscopic surgeries and difficult cases of infertility. Rupal hospital is renowned for its comprehensive services under one roof for all your Obstetric need like Painless Normal Deliveries and Caesarean Deliveries and Post natal care and advice. We have one of the best facilities of painless delivery using epidural analgesia in Surat. For the backup, we have the most sophisticated sonography machines at our disposal.
You can contact Top Gynaecologist & Obstetrician Doctors in Surat at http://www.rupalhospital.com/obstetrics_maternity.html or at http://www.rupalhospital.com
Intrapartum Care was developed for doctors and advanced midwives who care for women who deliver in district hospitals. It contains theory chapters and skills workshops adapted from the labour chapters of Maternal Care. Monitoring the mother, fetus, and progress of labour, the second and third stages of labour, managing pain, the puerperium and family planning
History, Myths, Indications & Contraindications, and Methods of painless labor as a means of natural way of childbirth with a lot of benefits for mothers & babies.
Rupal Hospital for Women in Surat is a one stop place for all Gynaec and Obstetrics problems and our expertise lies in providing affordable Laparoscopic surgeries and difficult cases of infertility. Rupal hospital is renowned for its comprehensive services under one roof for all your Obstetric need like Painless Normal Deliveries and Caesarean Deliveries and Post natal care and advice. We have one of the best facilities of painless delivery using epidural analgesia in Surat. For the backup, we have the most sophisticated sonography machines at our disposal.
You can contact Top Gynaecologist & Obstetrician Doctors in Surat at http://www.rupalhospital.com/obstetrics_maternity.html or at http://www.rupalhospital.com
Intrapartum Care was developed for doctors and advanced midwives who care for women who deliver in district hospitals. It contains theory chapters and skills workshops adapted from the labour chapters of Maternal Care. Monitoring the mother, fetus, and progress of labour, the second and third stages of labour, managing pain, the puerperium and family planning
This topic should be known by medical practitioners as well all the pregnant mothers to a certain extend to request for pain relieving modalities.......
In attempting to provide optimal labor analgesia, it is important to weigh the risks against benefits of any particular technique.
This must take in to consideration factors such as the timing of intervention and the place of practice.
Cost, accessibility, and human resources are other considerations.
It inadvisable to use an expensive or complicated technique in rural areas where there is limited medical access.
A properly performed ILA is a very cost effective technique for a pain relief in labour that can be recommneded as an alternative to CSE or epidural analgesia in areas where access to medical care is limited
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 topic should be known by medical practitioners as well all the pregnant mothers to a certain extend to request for pain relieving modalities.......
In attempting to provide optimal labor analgesia, it is important to weigh the risks against benefits of any particular technique.
This must take in to consideration factors such as the timing of intervention and the place of practice.
Cost, accessibility, and human resources are other considerations.
It inadvisable to use an expensive or complicated technique in rural areas where there is limited medical access.
A properly performed ILA is a very cost effective technique for a pain relief in labour that can be recommneded as an alternative to CSE or epidural analgesia in areas where access to medical care is limited
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 is a short presentation on eclampsia, i have made it for my class presentation, it includes definition, pathophysiology,clinical features and management.. i hope u vil like it
Peran Fentanyl pada balance anestesia -> telah banyak diteliti hasilnya adanya potensiasi fentanyl dengan obat anestesia baik inhalasi maupun intravena. Berikut ini kami mencoba menelaah beberapa penelitian dari luar maupun penelitian yang kami lakukan sendiri.
Awake Fiberoptic Intubation with Sedation in Cardiac (High-Risk) Patients – O...info622939
Embark on a compelling exploration of anesthesia innovation with our presentation on 'Awake Fiberoptic Intubation with Sedation in Cardiac (High-Risk) Patients – Our Experience.' Delve into the intricacies of this specialized technique, tailored for high-risk cardiac patients, as we share our unique insights and experiences.
Caudal Anaesthesia for CTEV with Post-Op Analgesia in Paediatric Patient- A C...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The Anesthesiologist, especially young, faces a major challenge when faced with very ill/ severly moribund, elderly, cachwexic patients with history of fall and lower extremity fractures for elective or ortho surgical procedure. Prof. mridul m. panditrao, explains various problems faced especially with GA, and the best alternatives. Two different approaches of Combined spinal epidual are discussed, with use of adjuvants and also his own randomizede trial and experience.
5. Background It is only in the last 100 years that effective methods of pain relief have become available. Queen Victoria was given chloroform by John Snow for the birth of her eight child and this did much to popularize the use of pain relief in labour
6. Nowadays most women who deliver in modern obstetric units request some kind of pharmaco- logical pain relief. Epidural analgesia is the gold standard in obstetric analgesia. If an epidural is contraindicated or a woman dose not wish to have epidural, other methods can be used.
10. Pain pathway in LabourThe afferent nerve of the uterus and cervix is via A delta and C fibers, that accompany the thoraco lumbar and sacral dorsal sympathetic chains. - Pain in first stage mediated through (T10 - L1 ). - In the second stage mediated through (S2 – S4 ).
13. History of Epidural (Current therapy in pain, Howard Smith, 2009) First description of Ep. Analgesia dates back to Leonard J. Corning, a neurologist who in 1895 inadvertently injected cocaine in the Epidural space. Since 1900, Epidural analgesia was being used to treat the pain of child birth.
14. In 1931 a continuous technique was described by Italian surgeon, A.M. Dogliotti. He was the first to describe the loss of resistance technique. Philip Bromage published the first text book on Epidural anesthesia in 1978. Bromage introduced the administration of epidural opioids for post operative analgesia in 1980. 1988: Introduction of PCA with Epidural by many anesthetists, allover the world.
15. Absolute Contraindications of Epidural Patient refusal. Blood Coagulopathy Infection at the site of injection Sever hypovolemia Fixed cardiac out put - Sever aortic stenosis - Sever mitral stenosis - Hypertrophic obstructive cardiomyopathy Contraindicated In pregnancy
16. Relative Contraindications of Epidural Systemic sepsis. Uncooperative patient. Preexisting neurological deficits, e.g. demyelinating disease, peripheral neuropathy Sever spinal deformity. Avoid in pregnancy
28. CSE has lower failure rate 10% , comparing to 14% in Epidural only. Miller’s Anaesthesia
29.
30. Remifentanil IV PCA Remifentanil is a novel , ultra short acting synthetic opioid. It is a selective mu opioid agonist. Rapid onset; peak effect of blood/brain equilibration time (1.2 – 1.4 min) . It has ester linkage rendering it susceptible to rapid metabolism by non specific blood and tissue esterases. A short duration of action independent of duration of infusion ( context sensitive half time 3.7 minutes).
31.
32. Blair et al, 2001 Has investigated the efficacy and safety of Remifentanil on 21 women. ASA I or II. Patient in active labour, cervix dilated at minimum 3 cm. Excluded preeclampsia, multiple pregnancy and allergy to any medications used, or failure to obtain informed consent. Bolus dose 0.25 – 1.0 Micgr/kg, with or without background infusion(0.025- 0.05) Micgr/kg/min
33. Blair et al, 2001 (cont.) Monitors mother and fetus. VAS was used to assess pain score. Conclusion Remifentanil PCA with bolus dose 0.25 – 0.5 Micgr/kg , and lockout time 2 min appears safe and effective to control labour pain. The technique appears to be most beneficial with multiparous women ( 73%).
34. Volikas et al, 2005 Studied maternal and neonatal side effects of remifentanil in labour. 50 women enrolled in the study ( 24 multiparous and 26 primiparous). Bolus dose 0.5 Micgr/kg, lockout time 2 min. VAS was used to asses pain, nausea, and itching. There was no evidence of cardiovascular instability or respiratory depression. Pain score decreased significantly.
35. Conclusion At the bolus dose the PCA remifentanil has an acceptable level of maternal side effects and minimal effect on the neonates. Remifentanil crosses the placenta and appears to be either rapidly metabolized or redistributed in the neonate.
1. Humanitarian reason, to reduce patient suffering.2. Economic benefits, quick recovery and rapid discharge. Less morbidity.3. Medical reasons, next slide.
Labour pain may produce sustained maternal hyperventilation and elevated oxygen demand, resulting in intermittent hypoxemia, hypocapnea and dramatically increased catecholamine production. This in turn can lead to hypo- perfusion, fetal hypoxia and acidosis. Pain relief, especially epidural analgesia avoids or attenuates many of adverse maternal and fetal responses to labour.4. Quick recovery and fast discharge with minimum complication.
There are many options available to relieve the pain of child birth.
Due to Neuro-axial failure, there are many obstetrical anaesthetist suggesting that CSE provides more effective analgesia
A pilot study of comparing the efficacy of two regimens of remifentanil PCA.