Pharmacologic Pain Mgmt In Labor

Front 1

Causes of labor pain: 1st stage:

Back 1

Uterine contractions, stretching of uterus, dilating and thinning of cervical os, position of fetus

Front 2

Causes of labor pain: 2nd stage:

Back 2

Extreme stretching and pressure on perineum and muscles of vagina as fetus descent progresses.

Front 3

Causes of labor pain: 3rd stage:

Back 3

Uterine contractions as placenta expelled.

Front 4

Pharmacologic Methods of Pain Relief:

Back 4

Analgesia, anesthesia

Front 5

Opioid analgesics:

Back 5

Acts in CNS to decrease perception of pain without the loss of consciousness. Given IV at beginning of contraction.

Front 6

Adverse effects of opioid analgesics:

Back 6

Crosses the placental barrier, causes respiratory depressions, sedation, tachycardia, hypotension, decreased FHR variability, allergic reaction.

Front 7

Nursing implications when opioids are used:

Back 7

Monitor vital signs, continuous fetal monitoring, Narcan should be available to counteract the effects of respiratory depression, administer antiemetics.

Front 8

Regional anesthesia:

Back 8

Short acting opioids administered into the epidural or intrathecal space along with a local anesthetic.

Front 9

Regional anesthesia:

Back 9

Provides rapid pain relief. Hypotension is a common adverse effect. Give 500 -1000 ml bolus of fluid to prevent hypotension.

Front 10

General anesthesia:

Back 10

Used in emergency c-section, rarely used for uncomplicated vaginal birth and infrequently used for c-section delivery.