Pain Management Options During Labor
Posted by Healthfitline
On
Wednesday, March 13, 2013
Some women are able to go through the whole process of labor and delivery without any pain relievers or by doing simple breathing and relaxation exercises. Others may request for pain relievers in between the delivery process, after realizing labor isn't what they thought it would be. Whatever the reason, there is always some medications that can be used in relieving pain during labor and delivery. The type of pain relievers given will be determined by many factors and every pregnant woman should be able to discuss all about this before the due date.
Pain medications works by increasing comfort of the mother, without interfering with the baby, mother's pushing ability and uterine contractions. Most of these pain relievers medications are considered safe for both the mother and the fetus. Rarely, do they lead to serious complications.
The following are the different ways and medications that can be used to relief pain during labor and delivery;
1. Narcotic Analgesics
Narcotic medications works by providing an analgesic effects on the mother but they do not totally eliminate the pain. They work by depressing the central nervous system, making the mother less sensitive to pain. However, all narcotics should be given with caution, especially medication like demerol since it can crosses the placenta barrier and may cause fetal respiratory distress. Demerol should be given more than 3 hours before delivery to make sure the peak effectiveness of the drug on fetus have passed by the time of delivery.
1. Narcotic Analgesics
Narcotic medications works by providing an analgesic effects on the mother but they do not totally eliminate the pain. They work by depressing the central nervous system, making the mother less sensitive to pain. However, all narcotics should be given with caution, especially medication like demerol since it can crosses the placenta barrier and may cause fetal respiratory distress. Demerol should be given more than 3 hours before delivery to make sure the peak effectiveness of the drug on fetus have passed by the time of delivery.
Narcotics analgesics are either administered through an IV line, muscles or into the spinal cord (intrathecal administration). Intrathecal narcotics are usually not very effective in relieving pain and may require pudendal block as a supplement during late labor.
2. Regional Anesthesia - Pain reliever medication is injected into the spinal cord to block the pain from reaching to other parts of the body. Depending on the region where the anesthesia is injected, you may or may not be able to feel the uterine contractions but you will remain awake during the whole process of labor and delivery.
The three types of regional anesthesia are the; Epidural Anesthesia (Peridural block), Spinal (Subarachnoid) Anesthesia and Combined Spinal Epidural Technique.
2. Regional Anesthesia - Pain reliever medication is injected into the spinal cord to block the pain from reaching to other parts of the body. Depending on the region where the anesthesia is injected, you may or may not be able to feel the uterine contractions but you will remain awake during the whole process of labor and delivery.
The three types of regional anesthesia are the; Epidural Anesthesia (Peridural block), Spinal (Subarachnoid) Anesthesia and Combined Spinal Epidural Technique.
- Epidural Anesthesia - the spinal cord is protected by several layers (pia, arachnoid and dura mater). Within these layers there are spaces in between. Epidural is the space found just outside the dura mater. In epidural anesthesia, the medication (anesthesia) is delivered by use of a small catheter into the epidural space.
- Spinal Anesthesia is rarely used nowadays and it is only used during emergency cases, since it is faster to administer than the epidural. However, it is more likely to cause hypotension and spinal headache (a late complication of spinal anesthesia).
- Combined Spinal Epidural Technique - spinal anesthesia offers immediate relief to pain while epidural may takes around 20 to 30 minutes to be effective. However, with spinal anesthesia, woman are not allowed to ambulate (walk) afterwards. This is the reason why a combined spinal epidural techniques is used. When a Combined Spinal Epidural Technique is used, the woman is relieved of pain almost immediately and she is able to ambulate soon after delivery. Possible complications associated with combined spinal epidural technique are: urinary retention, hypotension, itching, nausea and vomiting.
3. Local Anesthesia
The two types of local anesthesia are: Local Infiltration and Pudendal Nerve Block.
- Local Infiltration - Medications such as, lidocaine is injected along the nerve of the perineum to numb the area and allow for suturing (stitching) of the injured area of the vagina. The effects of medication usually last for at least one hour, giving the doctor adequate time to finish the stitching.
- Pudendal Block Nerve - This is the injection of anesthesia through the vagina to block the pudendal nerve (nerve in the pelvic region) from transmitting pain. Pudendal Block Nerve usually produces faster results and its effects last longer than a local infiltration.
4. General Anesthesia
General anesthesia is rarely used nowadays because of the possible complications that are associated with it. It is usually done during emergencies cases, such as abruption placenta or times when an immediate cesarean section is required. The woman is completely put to sleep until the time the baby is born.
Possible complications associated with general anesthesia include; hypoxia (decreased level of oxygen in the tissue), vomitus inhalation, gastric reflux and aspiration.
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