妇产科学教学课件：Chapter 16 Labor Analgesia.ppt

4 Methods of labor analgesia ---intravenous analgesia Indications anxious parturient uterine contraction out of tune rigid uterus cervical hypertensive parturient Principle for drug choosing no damage on parturient and fetus not affect labor progress not result in unconscious convenient adiministration 4 Methods of labor analgesia ---pudendal block Second stage analgesia Chapter 16 Labor Analgesia Outline 1 Labor pain 2 Effects of labor analgesia on fetus 3 Effects of labor analgesia on parturient 4 Methods of labor analgesia 1 Labor pain---progress of labor progressive cervix dilatation, repetitive uterine contractions First stage onset of labor---maximal cervical dilation Second stage full cervical dilation---delivery of the infant Third stage delivery of the infant---delivery of the placenta 1 Labor pain --Mechanism and pain pathway 1st stage T10-L1 2nd stage S2-S4 3rd stage mild pain 1 Labor pain---effect on parturient Anxiety and fear Decreased uterine blood flow increased maternal catecholamine secretion hyperventilation hypocapnia Fetal heart rate variability 1 Labor pain---key point Labor pain is very intense Distribution 1st stage T10-L1; 2nd stage S2-S4 Serious consequence on parturient and fetus 2 Effects of analgesics on fetus --- placenta transfer of analgesics Placenta barrier Molecular weight small large Lipid solubility high small Ionization low high Protein binding low high 2 Effects of analgesics on fetus --- placenta transfer of analgesics Drugs Lipid solubility Ionization Protein binding Placenta transfer Opioid