Pain Management in Labor

These flashcards cover key terminology and concepts related to pain management in labor as outlined in the lecture notes.

What is pain?

Pain is what the patient says, and it is subjective.

Goals of pain management in labor

To relieve pain without harm to the mother or the baby.

Sources of pain during labor

Myometrial anoxia, cervical stretching, pressure on pelvic nerves, traction on supporting structures, distention of the pelvic floor.

Pain during the first stage of labor

Pain comes from dilation of the cervix and lower uterine segment distention, affecting T1, T12 dermatones.

Pain during the second stage of labor

Pain stems from the body of the uterus and lower uterine segment distention, affecting S2, S3, S4.

Factors affecting pain perception

Past experiences, age, knowledge of labor, cultural expectations, psychosocial development, fatigue, environment, support system, PTSD, fear, and anxiety.

Non-pharmacological pain management techniques

Rest, massage, position changes, acupressure, breathing and relaxation, guided imagery, hypnosis, environmental changes, aromatherapy, hydrotherapy, heat/cold therapy.

Pharmacological pain management options

Analgesia and Anesthesia, including epidurals and general anesthesia.

Morphine usage in labor

IV, used early for maternal rest.

Fentanyl

Analgesic given IM, short acting, helps patient to labor down in second stage.

Nubain

Opioid agonist-antagonist, used in early labor only.

Antidote for opioids

Naloxone.

Nitrous oxide in labor

Colorless gas mixed with oxygen, self-administered, safe for labor.

Epidural anesthesia responsibilities

Establish baseline vital signs, monitor mother and fetus, administer fluid bolus.

Pros of epidural anesthesia

Pain relief, increased relaxation, participation in birth.

Cons of epidural anesthesia

Risk of infection, slow labor, potential for nerve damage, respiratory distress.

Complications associated with epidurals

Decreased movement, maternal fever, headache, nausea.

Spinal anesthesia usage

Used for cesarean deliveries, penetrates dura and infuses medication in spinal fluid.

General anesthesia during labor

Used for emergencies, requires antacid prior to delivery.