By James R. Scott, Ronald S. Gibbs, Beth Y. Karlan, Arthur F. Haney
A middle reference for citizens and practitioners for over 35 years, Danforth's Obstetrics and Gynecology is now in its completely revised 9th variation. to make sure entire, authoritative insurance of modern adjustments in obstetrics and gynecology, Dr. Scott has chosen 3 extraordinary new co-editors: Ronald S. Gibbs, MD, a expert in maternal-fetal drugs and infectious illnesses; Beth Karlan, MD, a gynecologic oncologist; and Arthur Haney, MD, a reproductive endocrinologist. content material has been reorganized to target the fashionable medical perform of obstetrics and gynecology with greatest authority. This version has extra tables and algorithms that might velocity entry to severe details.
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Extra resources for Danforth's Obstetrics and Gynecology 9th Edition
It is five times more potent than morphine and 40 times more potent than meperidine. It has achieved moderate popularity in the United States in the management of the pain of the first stage of labor. It is usually administered intravenously in doses of 1 to 2 mg. Butorphanol exhibits the same ceiling effect for analgesia and respiratory depression as nalbuphine. Maternal side effects may include sedation, dysphoric reactions, and reversal of other opioid effects. Newer Opioids Sufentanil and remifentanil, the newer synthetic opioids, have not been studied extensively for systemic analgesia during labor.
J Perinatol 2002;22:15–20. World Health Organization Maternal Health and Safe Motherhood Programme. World Health Organization partograph in management of labour. Lancet 1994;343:1399–1404. Chapter 3 Obstetric Analgesia and Anesthesia Danforth’s Obstetrics and Gynecology Chapter 3 Joy L. Hawkins Obstetric Analgesia and Anesthesia PAIN OF PARTURITION SYSTEMIC ANALGESIA AND SEDATION Use of Systemic Medications Systemic Narcotics Patient-controlled Intravenous Analgesia Narcotic Antagonists Sedative Drugs Inhalational Agents REGIONAL ANALGESIA Local Anesthetic Agents Side Effects of Local Anesthetic Drugs Use of Regional Anesthetic Blocks Complications of Regional Block Analgesia OTHER METHODS OF PAIN RELIEF Prepared Childbirth Hypnosis Acupuncture Biofeedback Transcutaneous Electrical Nerve Stimulation Intracutaneous Nerve Stimulation ANESTHESIA FOR CESAREAN DELIVERY Epidural Anesthesia Subarachnoid or Spinal Anesthesia General Anesthesia Analgesia after Cesarean Section SUMMARY POINTS REFERENCES The purpose of this chapter is to acquaint the obstetrician with the various techniques of obstetric analgesia (pain relief) and anesthesia (for surgical procedures) and to describe their indications, advantages, disadvantages, and complications.
Compression of the lumbosacral plexus by the fetal head, particularly in the occiput posterior position, may cause pain even before the onset of labor. The pain of uterine contractions is conducted through small sensory nerve fibers of the paracervical and inferior hypogastric plexuses to join the sympathetic nerve chain at L2-3. The ascending fibers enter the spinal cord through the nerve roots of T-10 to T-12, with a variable contribution from L-1 ( Fig. 1). Because the cutaneous branches of the lower thoracic and upper lumbar nerves migrate caudally for a considerable distance before they innervate the skin, the pain of uterine contractions is often referred to the area over the upper sacrum and the lower lumbar spine.
Danforth's Obstetrics and Gynecology 9th Edition by James R. Scott, Ronald S. Gibbs, Beth Y. Karlan, Arthur F. Haney