|
|
|
Epidural
narcotic after birth: provides narcotic analgesia for approx 24 hrs after
birth. Anesthesiologists injects opioid such as morphine sulfate (Duramorph)
into epidural space STAT /p birth. SE: pruritis, N&V, urinary retention.
Resolves in 14 – 16 hrs. Drug guide: p 389
|
|
|
|
Spinal block:
local anesthetic is injected into spinal fluid in spinal canal to provide
anesthesia for C-sec, rarely for vag. ADVANTAGE: STAT onset of anesthesia,
easy to administer, smaller dose, maintenance of muscle tone (+ or -)
|
|
DISADVANTAGE:
high incidence of maternal
hypotension, → fetal hypoxia. CONTRAINDICATED in severe
hypovolemia, CNS disease; infection over puncture site, + same as epidural
|
|
|
|
Pudendal block –
transvaginal administration; provides perineal anesthesia but no relief of
contraction discomfort. Easy to administer, absence of maternal hypotension;
no need to monitor FHR. May decrease urge to push; may perforate rectum or sciatic nerve
|
|
|
|
Local
anesthesia: injecting agent into areas of perineum for episiotomy incision or
repair.
|
|
|