Pain Relief In Labour

              Though labour is a normal physiological process, it is associated with some amount of pain. Pain is a very subjective phenomena and dependent on the individual. It depends on many factors like the person’s physical build, her emotional status, her mental outlook, associated and coincidental problems etc. Since there are so many factors that influences pain perception, pain relief can be achieved by changing some or all these factors.                Labour analgesia was first practiced way back in 1847 when chloroform was used by a Scottish physician called James Simpson. The only problem was that the woman woke up 3 days after the delivery and refused to believe that she had delivered.Later on prominent people like Queen Victoria also did experience “Painless Labour”.                During that time it was believed that to opt for painless labour was immoral. The justification was that labour pain was punishment to the woman for Eve’s indiscretion in Eden. But this is a thing of the past and more and more people are going in for pain relief during labour by either medications or other forms of therapy.                There is madication for painless labour like epidural and spinal anaesthesia: This type of medication is by far the most popular or commonly followed method. Both are nearly similar but Epidural is preferred for a variety of technical reasons. In Epidural anesthesia / analgesia, a local anaesthetic agent is injected inside the vertebral column in the region of the lower back. This reduces the backache and abdominal pain during labour. The doctor may inject the local anaesthetic by a special needle (single shot EA) or more preferably, pass a thin plastic tube into the vertebral column through the needle. The needle is removed and the plastic tube kept in place.               Local anaesthetic agent is injected through this plastic tube at periodic intervals depending upon the need of the patient – no matter how long the labour. The catheter is kept for some time after delivery and then removed. This can also be used to give anaesthesia during Caesarean section. For further details regarding the same, it is best to approach your doctor who can then manage a meeting with the hospital anesthetist, so that all your doubts regarding the technique can be cleared.

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INDICATIONS FOR ENDOTRACHEAL INTUBATION

Inadequate ventilation, whether due to sedation and neuromuscular paralysis in the operating room, an obstructed or compromised airway, altered mentation, loss of consciousness, or respiratory failure can lead to brain injury or death within minutes. It is, thus, of great importance to know how to evaluate and address a patient who may require ventilatory support. INDICATIONS FOR ENDOTRACHEAL INTUBATION Indications for ENDOTRACHEAL INTUBATION in the operating room include: the need to deliver positive pressure ventilation, protection of the respiratory tract from aspiration of gastric contents, surgical procedures involving the head and neck or in non-supine positions that preclude manual airway support, almost all situations involving neuromuscular paralysis, surgical procedures involving the cranium, thorax, or abdomen, procedures that may involve intracranial hypertension. Some non-operative indications are: profound disturbance in consciousness with the inability to protect the airway, tracheobronchial toilet, severe pulmonary or multisystem injury associated with respiratory failure, such as sepsis, airway obstruction, hypoxemia, and hypercarbia. Objective measures may also be used to help determine the need for intubation: respiratory rate > 35 breaths per minute, vital capacity <>

STATICS ! Don’t forget it before intubation

Before intubation, please prepare this STATICS S is Scope, this is for stetoscope, laryngoscpe with bright lamp. T for Tubes. Choose an appropriate size. For adult or children. A for Airway device. It’s call Mayo or Guedel. This uses to prevent falling tongue. T is Tape. Don’ forget to this simple device. You can’t fixation an ET without this. I is Introducer. You can say “it is stylet for making intubaation easy” C for Connector to connect tube and anesthesia machine. S is Suction. Suction the mucus or saliva Oke ! See You..

Anesthesia in Meulaboh Aceh

Since July 27th 2007, I have asked to do anesthesia in Cut Nyak Dien hospital Meulaboh Aceh. My first patient was a woman who will performed sectiocesaria. The anesthesia technique was regional anesthesia, especially sub arachnoid block, with marcain spinal, at lumbal space III-IV. This technique has advantages compare with general technique, because it's not affect respiration and consciousness. I hope during my job in Aceh will having success until I come home one month later.

What types of anesthesia are available?

You will have one of three kinds of anesthesia during surgery. Monitored anesthesia care (MAC) is often used for surgery that is short and does not require the surgeon to cut muscle or bone. Sedatives and pain killers are given through an IV. The area around the surgical site is numbed with a local anesthetic. You may choose to remain awake or sleep lightly. If you are uncomfortable, your anesthesiologist can usually make you sleepier or the surgeon can inject more local anesthesia. Regional anesthesia is often used for surgery on the arms, legs, lower abdomen and during childbirth. A local anesthetic is injected to block nerve impulses in a nerve or group of nerves coming from the site of the surgical procedure. The area will begin to feel numb within minutes. Sedatives are typically administered through an IV catheter. With regional anesthesia, you may remain awake or choose to sleep lightly. General anesthesia is most often used for more extensive surgery, such as abdominal, heart, brain or chest surgery. You are unconscious throughout the surgery.

In certain situations a combination of general and regional anesthesia may be appropriate.

Following your pre-anesthetic evaluation, your anesthesiologist will recommend an anesthetic choice for the case, taking into account your health status and preference and the nature of the surgical procedure.

Sellick Maneuver

The Sellick Maneuver is performed by applying gentle pressure to the anterior neck (in a posterior direction) at the level of the Cricoid Cartilage. The Maneuver is most often used to help align the airway structures during endotracheal intubation. The real value of this procedure is often misunderstood and therefore, is often underutilized. The REAL value of the Sellick Maneuver is to provide a means to prevent gastric insufflation and vomiting during ventilations in an unprotected airway. BLS and ALS medics can direct a member of the resuscitation team to provide this maneuver early and continually until a properly placed endotracheal tube has been inserted. Remember that aspiration pneumonitis has a high mortality rate and proper use of this method can minimize its occurance.

Arthritis Pain Killer

Do you feel pain on your hinge ? Maybe you’ve got arthritis. But don’t worry, because there are many treatment to reduce your pain. Two kind of treatment i.e farmacological or non-farmacological. The farmacological one is NSAID such as aspirin, ketorolac, and sodium diclofenac.