Labor analgesia

The moment when the baby is born is the happiest moment in mothers' lives. It is not enough to just say thank you for mom's hard work. At that time, mommy had a painful experience, and even many mothers were afraid of childbirth after hearing some gossip on the Internet.

What is labor analgesia?

The occurrence of labor pain is a complex physiological and psychological process. 98% of parturients have experienced pain during childbirth, but their feelings about the pain caused by childbirth are quite different.

Effect of labor pain on mother and fetus;

1, leading to emotional stress, uterine vasoconstriction, elevated blood pressure, increased cardiac load and prolonged labor, leading to fetal distress.

2. Hyperventilation caused by pain leads to increased oxygen consumption of mother and fetus, respiratory acidosis and hypoxemia.

3, energy consumption, maternal fatigue, uterine inertia, prolonged labor.

4, psychological injury, prone to postpartum depression.

What is the feeling of labor analgesia?

Childbirth is a necessary process for every mature woman. Because of the fear of pain during childbirth, more and more women choose cesarean section. However, in addition to the risk of anesthesia, there may be some corresponding complications during or after cesarean section, including severe bleeding, endometriosis, infection and so on. This is contrary to the normal physiological process. Modern clinical application of labor analgesia can relieve pain, reduce the fear caused by it, and make the delivery complete smoothly and return to nature.

Labor analgesia ≠ completely painless

Actually, it's not completely without feeling. Some pregnant women still feel contractions, but the pain will be significantly reduced. From the pain of 10 to below 3-4, some mothers can achieve complete painless. However, in fact, mild pain and uterine contraction are also conducive to maternal cooperation and delivery, while excessive analgesia is not conducive to maternal activities in the field.

A few parturients may have no effect or unilateral numbness. At this time, the catheter position should be adjusted in time, and it is rarely necessary to puncture again.

The highest principle of labor analgesia is to maintain the safety of mother and fetus. Moreover, spinal anesthesia drugs are mainly confined to the roots of lumbar dorsal nerves, and the concentration and dosage of drugs used are very safe. Few drugs can be absorbed into the blood through the placenta and reach the baby. Many clinical trials have proved that labor analgesia generally does not have any adverse effects on the baby.

In fact, excessive maternal pain stress may lead to a decrease in blood flow through the placenta, which will lead to a significant decrease in the oxygen obtained by the fetus, which is more likely to cause hypoxia and even acidosis in the baby. Relieving the pain during childbirth not only has no effect on the fetus, but also is more conducive to the cooperation of the parturient and reduces the rate of cesarean section and lateral incision.

How long does labor analgesia last?

About 20 minutes after the injection of analgesic delivery needle, Ma Bao didn't feel intense uterine contraction pain. The analgesic pump continued to give drugs until the end of delivery.

Labor analgesia can last until the baby is born. According to the length of routine labor in Ma Bao, anesthesiologists adjust drug injection to meet the needs of the longest labor, so as to ensure Ma Bao's complete and effective analgesia for a long time.

Analgesic delivery originated from abroad, with a history of nearly a hundred years, and its technology is quite mature, but it started late in China. By using appropriate anesthetic drugs, the pain during delivery can be alleviated or even disappeared, so that Ma Bao can accumulate enough strength to successfully complete delivery when the cervix is opened, thus reducing the fear of delivery and postpartum fatigue. The anesthetic used for labor analgesia is the same as that used for cesarean section, but the dosage is only110 of that of cesarean section. Therefore, Ma Bao can stay awake, minimize the pain, keep the uterine contractility and keep the movement of lower limbs unaffected.

How often does labor analgesia hurt?

Epidural analgesia can relieve the pain of most parturients, reduce the level of catecholamine and improve the perfusion of uterus and placenta. For parturients with indications of cesarean section, epidural anesthesia can be changed at any time to shorten the preoperative preparation time.

1. High safety: epidural anesthesia is used for labor analgesia. The doctor placed a drug tube in the epidural space of the expectant mother's waist. The concentration of anesthetic in this tube is about 1/5 of cesarean section, which means light anesthetic, which is very safe.

2. Convenient activities: When the uterus is opened for 2-3 minutes, the expectant mother can turn over freely by giving medicine through the placed medicine tube.

3. Long-lasting drug effect: After about 10 minutes, the parturient will not feel the severe pain of uterine contraction, but the pain she can feel is just like the slight abdominal pain during menstruation. The drug was administered continuously through the analgesic pump until the end of delivery.

4. Suitable for the crowd: Most parturients are suitable for labor analgesia, but if they are complicated with diseases such as coagulation dysfunction, drug allergy, and history of waist injury, the parturient should consult a doctor, and the doctor will decide whether labor analgesia can be performed.

5. No need to enter the operating room: the whole process of labor analgesia is completed by the cooperation of anesthesiologists, anesthesiologists and obstetricians. Normal painless delivery can be carried out in the delivery room without entering the operating room.

How to relieve labor analgesia

Labor pain is the most severe pain that most women encounter in their lives. About 80% primiparas think that the pain of uterine contraction during childbirth is unbearable. Severe pain will make women feel nervous, anxious and irritable, eat less and produce a series of fetal reactions, and because of fear of severe pain, the rate of cesarean section will increase. Therefore, relieving the severe pain during childbirth is of great benefit to both the mother and the newborn.

At present, there are two main methods to relieve labor analgesia: drug and non-drug. The former is to achieve analgesic effect through anesthetics or analgesics, while the latter is to relieve labor pain through prenatal training and guided breathing during contraction.

Recently, a study published in a magazine explored the role of intravenous dexamethasone in assisting labor analgesia.

The researchers randomly assigned the subjects to intravenous dexamethasone 8mg+50ml saline group or 50ml saline placebo group about 45 minutes before operation.

All patients received epidural analgesia according to the hospital plan. After the initial drug injection, 5ml/ h of 0. 1% levobupivacaine and 2μg/ ml of fentanyl were given continuously. If necessary, the same drug combination can be maintained at 5ml with an interval of 65438 02 minutes.

Main Results The average hourly consumption of levobupivacaine fentanyl composition provided by nerve axons was measured. Secondary outcomes and observation indicators were pain score, maternal satisfaction, sensory and motor block, hemodynamic indexes, fetal heart rate, duration of the second stage of labor, delivery mode, Apgar score 1-5 and adverse reactions.

How to distinguish labor analgesia

Non-drug analgesia is the most important method in normal delivery. You should select an application first. There are many non-drug analgesia methods to choose from, such as bathing, massage, contact nursing with caregivers, and other concentration methods, such as relieving respiratory pain (Ramaz), pronunciation training and relaxation (opening the glottis, relaxing and singing), which can effectively divert the attention of lying-in women and relieve pain. Allow and support the free posture and activities of the parturient during delivery. The most important thing is not to be in the supine position, but to be able to move freely and maintain an upright posture, such as sitting, standing and walking.

Influencing factors of labor pain

The degree of labor pain varies from person to person and is influenced by environmental, physiological and psychological factors. The results of different studies are somewhat different. The degree of labor pain is also related to parity, fetal position, labor process, intervention during labor and previous dysmenorrhea history. If the pain of the multipara is less than that of the primipara, the cervix of the natural parturient is soft and the labor pain is lighter. The pain of uterine contraction caused by oxytocin is more serious when induced labor. Menopausal women are less sensitive to pain than primiparas. When abnormal manifestations such as pelvic stenosis, giant fetus or occipital posterior position lead to dystocia, the degree of labor pain is more serious. Psychological factors such as fear, anxiety and anxiety will increase the sensitivity of lying-in women to pain and affect their behavior. In other words, the more nervous, the more intense the pain, and severe pain will increase tension and anxiety. Dick Reid, a British obstetrician, put forward the "natural childbirth method" in 1933, opposing the use of drugs. He pointed out that labor pain is a syndrome of fear, tension and pain, which can be controlled by oneself. He emphasizes education, exercise and relaxation, and alleviates the fear of lying-in women by explaining their work. From the beginning of prenatal care, we should be psychologically prepared and have some positive information, learn how to train muscles to relax, and strengthen delivery care, so that the parturient can relax mentally and muscles during delivery, thus achieving the purpose of relieving pain. Many subsequent studies also supported his theory.