Professional Documents
Culture Documents
Anesthesia
By Abdulaziz Al Gain
History
The first anesthetic used in obstetrics was chloroform
and ether in 1848
Education
Systemic Analgesics
All narcotics used for pain relief in labor can have
adverse effects on the mother and the fetus or neonate.
Site of administration
Maternal metabolism
Molecule size
Decrease reflexes
Metabolized to normeperidine
Morphine
IV 20min onset time
10-15mg IM
Fentanyl (Sublimaze)
Synthetic opoid 1000 times more potent than
meperidine
Rapid onset
Brief duration
Dose 50-100micrograms IV
Fentanyl cont
Not used in labor
Lidocaine (Xylocaine)
Mepivicaine (Carbocaine)
Prilocaine (Citanest)
Etidocaine (Duranest)
Local anesthetics
Ionization, PH, Protein binding, lipid solubility all effect
the duration to onset and duration of action, and the
quickness of onset
Used in SVDs
15mg/hr Bupivicaine
200mg/hr Chlorprocaine
Coagulation abnormalities
Uncooperative pt
Uncorrected hypovolemia
Vaginal laceration