Labor pains are the most severe pains most women have ever experienced, and if they encounter dystocia, the pain is even more painful. Seeing this, most Jia fans are already impatient: it is painless to fight ~ go directly to heaven!
Analgesia during childbirth can effectively relieve the pain of labor and reduce other adverse effects caused by excessive ventilation in women. From the time the woman is in labour to the second stage of labour, analgesia can be implemented during childbirth. Follow Kopga to see the relevant mechanisms and classifications of childbirth analgesia
Labor pains, where does it hurt
In the first stage of labour, due to contractions caused by ischemia and hypoxia of the uterine muscles, coupled with the high tension of the muscles during cervical expansion, this feeling is transmitted to the spinal cord through the sympathetic nerve through the posterior segments of the thoracic nerves 10, 11 and 12, and the pain is derived.
In the second stage of labour, the fetal head compresses the pelvic floor, vagina, and perineum, and this pain is transmitted to the spinal cord through the sensory fibers of the sacral nerves 2, 3, and 4; in addition, the mother's emotional tension and anxiety during childbirth can also cause fear-tension-pain syndrome.
Methods of analgesia in childbirth
The ideal analgesic method is to block the sensory nerves, do not let it conduct pain, but can not affect the motor nerves, so as to ensure that the mother does not feel pain, and maintain physical strength, in the first stage of labor can be active, the second stage of labor breath-holding force, the fetus to the uterine mouth pushed. However, this effect is not 100% achieved at this time.
Take it off?! Don't worry, read it down and talk about it
01
Non-pharmacological analgesia
The pain during childbirth is directly related to the nervousness of the mother. And some expectant mothers have low tolerance (not pretentious!). Prenatal active education, psychological support for expectant mothers in many ways, and active cooperation in independent training (such as: Ramazer breathing pain reduction method), in addition, the companionship of family members is also very important
02
Systemic opioid anesthesia
Patient-controlled analgesia (PCA) can also be administered intermittently, mainly intravenously or intramuscularly. The main effect is analgesia, which makes the mother feel happy. However, the effect is limited, the pleasure generated is not permanent, and some women will also have nausea, respiratory depression, prolonged emptying of the gastrointestinal tract, fetal heart rate abnormalities, neonatal respiratory depression and other conditions.
03
Spinal canal analgesia and anesthesia
I know this! It should also be a more commonly used analgesic method, right?
Right! The mode of administration is divided into epidural administration (epidural), subarachnoid administration (lumbar anesthesia), and subarachnoid epidural combined administration. Among them, lumbar anesthesia analgesia has a short time and is suitable for caesarean section and postpartum tubal ligation. Lumbar-hard combined anesthesia is fast and small, while the analgesic effect is similar to that of epidural.
04
Local nerve block
Also known as pudendal nerve block, local anesthesia is given with a special cannula needle around bilateral sciatic spines. Paracervical nerve block, on the other hand, refers to local anesthesia injections at 3 and 9 points in the cervix. The analgesic effect is not complete, and it has been used less in clinical practice. In addition, the injection of drugs into blood vessels may also cause hypotension, arrhythmias, and cause convulsions; paracervical nerve block may also lead to fetal bradycardia.
Reference source: Department of Obstetrics and Gynecology, Xi'an Jiaotong No.1 Affiliated Hospital
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