1. LESSON PLAN
ON
ANALGESIA AND
ANAESTHESIA IN
OBSTETRICS
PRESENTED BY,
MS. MILAN SAWANT,
1ST YEAR M.Sc. NURSING,
SAMARTH NURSING COLLEGE, DERVAN

2. DEFINITION OF PAIN
PAIN IS A SUBJECTIVE EXPERIENCE, AND IT IS
WHATEVER THE WOMAN SAYS IT IS FOR HER.

3. PERCEPTION OF PAIN

4. FEAR AND ANXIETY

6. FATIGUE

7. CULTURAL AND SOCIAL FACTORS

8. EXPECTATIONS

9. PAIN PATHWAYS IN LABOR

11. NON
PHARMACOLOGICAL
METHODS

12. 1. PSYCHOPROPHYLAXIS

13. TRANSCUTANEOUS ELECTRICAL NERVE
STIMULATION

15. HYDROTHERAPY

16. ACUPUNCTURE/ACUPRESSURE

19. REGIONAL ANALGESIA IN OBSTETRICS
EPIDURAL ANALGESIA
 SPINAL ANALGESIA/ ANESTHESIA
PATIENT CONTROLLED EPIDURAL ANALGESIA

20. EPIDURAL ANALGESIA/ ANAESTHESIA

21. CONTRAINDICATIONS FOR EPIDURAL
ANAESTHESIA
 PATIENT REFUSAL OR INABILITY TO COOPERATE .
 INCREASED INTRACRANIAL PRESSURE SECONDARY TO A MASS
LESION.
 SKIN OR SOFT TISSUE INFECTION AT THE SITE OF NEEDLE
PLACEMENT
 FRANK COAGULOPATHY.
 UNCORRECTED MATERNAL HYPOVOLEMIA (E.G., HEMORRHAGE) .
 INADEQUATE TRAINING IN OR EXPERIENCE WITH THE TECHNIQUE
.

22. SPINAL ANESTHESIA

23. CONT…..
SPINAL ANESTHESIA INVOLVES THE INJECTION OF A LOCAL
ANESTHETIC DIRECTLY INTO THE SPINAL FLUID,
PROVIDING ANESTHESIA FOR VAGINAL OR LATE IN THE
SECOND STAGE, WHEN THE FETAL HEAD IS ON THE
PERINEUM. IT HAS NO EFFECT ON MATERNAL OR FETAL
RESPIRATIONS BUT MAY CAUSE TEMPORARY
HYPOTENSION AND A POSTSPINAL MATERNAL HEADACHE.

24. PATIENT CONTROLLED EPIDURAL
ANALGESIA

25. CONT…..
PCEA HAS BEEN ASSOCIATED WITH GREATER MATERNAL
SATISFACTION AS COMPARED WITH BOTH INTERMITTENT
BOLUS INJECTION AND CONTINUOUS EPIDURAL
INFUSION.
 PCEA RESULTS IN A LOWER AVERAGE HOURLY DOSE OF
BUPIVACAINE THAN DOES A CONTINUOUS EPIDURAL
INFUSION OF BUPIVACAINE.
RESERVED FOR PATIENTS WHO ARE WILLING AND ABLE
TO UNDERSTAND THAT THEY ARE IN CONTROL OF THEIR
ANALGESIA.