Anesthesia involves the pacification of pain, general or local temporary loss of sensitivity and soothing effect.
In each individual case, the decision is made by the doctor leading the delivery, based on the characteristics of their course and the occurrence of indications for this or that type of anesthesia.
Modern medicine offers various methods by which it is possible either to prevent the onset of a pain syndrome associated with childbirth and some necessary obstetric manipulation, or to minimize the manifestation of pain.
Anesthesia is not recommended for everyone. But if a woman is excited so that it breaks the process of delivery; if you need to slow down the rapid process of delivery; if forceps are required; when the pain is greater than the mother's endurance; if labor is long and difficult and the future mother is exhausted, anesthesia is used. Thinking about easing your own pain, be aware that all substances injected by a pregnant woman in order to obtain anesthesia or analgesia penetrate the fetus in one way or another.
Easier discomfort during labor can be intramuscular or intravenous injections of analgesics. Since these drugs can cause drowsiness and childbirth, and the baby, their administration is usually used for anesthesia in the early stages of childbirth or for rest and preparation for childbirth.
Percutaneous electroneurostimulation (TENS).
With this simple, non-invasive technique, electrostimulation is performed through electrodes attached to the waist on both sides of the spine. The use of TENS gives moderate anesthesia and is most suitable for alleviating back pain in the first stage of labor and in patients with short delivery. No side effects were noted for the mother and the newborn.
Inhalation anesthesia is inhaled by the woman in labor during an anesthetic contraction, usually a mixture of nitrous oxide and oxygen. This technique provides good analgesia in 50% of parturient women.
Complications: toxic reactions when a local anesthetic enters a blood vessel: infection; hematoma.
Pudendal (local infiltration) anesthesia locks the genital nerve with a local anesthetic by pricking through the perineum or through the vaginal wall. Pain from fights this anesthesia does not remove. It is used in the second stage of labor with a rather rare operation of applying obstetrical forceps or by cutting the perineum and plastic operations on it. In these cases, a good analgesic effect was noted. Local anesthesia is ineffective throughout childbirth.
Regional anesthesia (epidural, or spinal) is used by an anesthesiologist for anesthesia of labor.
Most often epidural anesthesia is used in difficult childbirth, when the doctor sees that the woman is suffering a lot of pain, and we need to give her the opportunity to relax. Drugs are administered in the lumbar region in the immediate vicinity of the nerves, in order to block pain in the lower part of the body. In this case, the consciousness remains and the pain decreases significantly or completely disappears during childbirth.
Epidural anesthesia is used for the anesthetization of labor both normal and complicated by various pathologies. Women with late toxicosis of pregnant women, diseases of internal organs in such anesthesia because of their diseases will not be denied. Epidural anesthesia begins, as a rule, with the establishment of regular labor in the mother of the mother, and they stop in the second stage of labor, if there is no need to turn off attempts. This type of anesthesia is used and, if necessary, cesarean section.
Someone is afraid of her, and someone dreams of giving birth with such anesthesia. The most common fears sound approximately the same: "I heard that there is an injection in the spine, after which you do not feel anything at all. But at the same time, if the anesthetist & bdquo; the hand will tremble and it will not go there, you can remain paralyzed for life. "
The advantages of this method of anesthesia include: high efficiency (complete anesthesia is achieved in 92-95% of observations); the consciousness of the mother is preserved, the blood supply of the uterus improves, and labor activity is not inhibited.
Epidural anesthesia is an effective and safe method of anesthesia, therefore in the last 25 years many women began to plan its use in their births. However, possible complications should be considered. The most common complication is the penetration of an anesthetic into the deeper layers of the spinal cord. Because of this, a spinal block arises, which can be accompanied by impaired breathing and a sharp decrease in blood pressure.
For the mother:
- many months of headaches, back pain;
- lower blood pressure;
- forces a woman to lie down and thereby removes the effect of gravity, which helps the child advance;
- Oxytocin may be required (especially in the first birth);
- higher risk of requiring forceps and vacuum extraction (this increases the possibility of injury, incontinence of urine and urine);
- there is a higher probability of requiring a cesarean section (especially in the first birth);
- can cause a postnatal urinary retention;
- can cause the temperature to rise to 38 А C. C because of a violation of thermoregulation through the central nervous system;
- can make attempts difficult;
- can cause itching of the face, neck, chest;
- an infection can be introduced;
- hematoma can occur due to damage to the vessels of the epidural space, etc.
For the child:
- may cause respiratory disturbances in the child (and require mechanical ventilation, intubation, hospitalization);
- often causes disorientation, motor disability, difficulty sucking, children after epidural anesthesia have 5 times more often diagnosed with "maternal encephalopathy";
- violates the establishment of a connection between mother and child that leads to postpartum depression;
- The children of mothers who have fever are more likely to get antibiotics, etc.
There are the following contraindications to this type of anesthesia: a scar on the uterus (due to previous surgical interventions on uterus - caesarean section or other); neurological diseases; infection of the skin at the puncture site; previous operations on the spine and spinal cord; treatment with anticoagulants, blood clotting disorders. A competent and highly qualified doctor, realizing the seriousness of this procedure, will explain to the woman everything "for" and "against" and without special need will not do epidural anesthesia simply because he was asked. The refusal of the patient is a sufficient excuse not to do anesthesia. Most anesthesiologists discuss with women the efficacy and benefits of this method, both for the mother and the baby, and the risk of possible complications. The ideal time to discuss the methods of anesthesia is before delivery. If anesthesia requires a successful course of labor, it must be done.
Continuous epidural anesthesia in obstetric practice can only an anesthesiologist, who is fluent in this technique. Do not forget to remind the doctor, do you have any allergic reactions.
General anesthesia is used in emergency situations during childbirth for anesthesia while sewing up soft tissue ruptures of the perineum, vagina, cervix, which occur during the birth of the child. It consists in the development of the patient's state of sleep, analgesia, muscle relaxation and can only be used by an anesthesiologist. Under anesthesia, it is impossible to give birth in a natural way. Consciousness turns off, muscles are relaxed almost completely. General anesthesia is performed only for obstetric operations. If self-delivery is impossible or dangerous, you need to do a caesarean section, - anesthesia is performed.
Complications: the means for anesthesia circulate for a while in the mother's blood and enter the milk. Children do not immediately bring their mother to the first feeding - because of the danger of toxic effects.
Various drugs are used to anesthetize labor in modern anesthesia. However, it would be nice to know that all means for anesthesia mainly affect the central nervous system. Some drugs work narcotics. The degree of depression in the fetus depends on the concentration of anesthetic in the mother's blood. Inhibition of breathing, violation of acid-base balance, lowering of blood pressure, hypothermia, signs of neurologic depression were observed in children, whose mothers were given different painkillers. Think about whether you need your child to suffer from the effects of chemicals on vital functions.
One of the most commonly used analgesics - promedol - belongs to the drug group. It does have an analgesic, soothing effect, but depresses the respiratory center if it is injected less than 2 hours before the birth of the child. The child will be born sluggish, sleepy. After birth, breathing is restored, but the children do not immediately take the chest. Perhaps, it is better to suffer than to begin the life of your child with such a "gift"? Anesthesiologists usually ask if there is an allergy in patients. It is necessary to warn the doctor if the woman in labor is there. Allergy can be obtained from the administration of certain pain medications. The state of a newborn child is assessed on a 10-point Apgar scale. With the help of anesthesia, it is easy to give birth only to "troechnik".