Ebook A practical approach to obstetric anesthesia (2/E): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook A practical approach to obstetric anesthesia (2/E): Part 2
Ebook A practical approach to obstetric anesthesia (2/E): Part 2
Postpartum IssuesPostcesarean AnalgesiaRichard N. ỈVi.sslerI.IntroductionII.Multimodal therapyA.GoalsB.Components of multimodal therapyIII.Medications Ebook A practical approach to obstetric anesthesia (2/E): Part 2s: oral, systemic, neur axial, and regional administrationA.OpioidsB.Local anestheticsc.Nonsteroidal anti-inflammatory drugsD.AcetaminophenE.Other medicationsF.Medications in breast milkIV7. SummaryKEYPOINT:1The use of multimodal analgesia and differing routes of administration will increase overall Ebook A practical approach to obstetric anesthesia (2/E): Part 2 postcesarean delivery (post-CD) analgesia and reduce the incidence of unwanted side effects.2Opioids are the mainstay of post-CD analgesia. IntravenoEbook A practical approach to obstetric anesthesia (2/E): Part 2
us patient-controlled analgesia (PC A) opioid administration provides superior pain relief compared to intermittent caregiver administration and may hPostpartum IssuesPostcesarean AnalgesiaRichard N. ỈVi.sslerI.IntroductionII.Multimodal therapyA.GoalsB.Components of multimodal therapyIII.Medications Ebook A practical approach to obstetric anesthesia (2/E): Part 2ecreasing overall opioid consumption, improving ambulation, allowing earlier return of bowel function, and improv ing reductions in breast milk levels of opioids compared to systemically administered opioids.4Neuraxial opioids are associated with nausea, vomiting, urinary retention, respirator}' dep Ebook A practical approach to obstetric anesthesia (2/E): Part 2ression, and pruritus.5Continuous wound infiltration with local anesthetic using catheter techniques may offer significant post-CD analgesia, lhe useEbook A practical approach to obstetric anesthesia (2/E): Part 2
of transversus abdominis blockade docs not offer significant analgesic advantage when added to ncuraxial opioid administration.6Nonsteroidal anti-inflPostpartum IssuesPostcesarean AnalgesiaRichard N. ỈVi.sslerI.IntroductionII.Multimodal therapyA.GoalsB.Components of multimodal therapyIII.Medications Ebook A practical approach to obstetric anesthesia (2/E): Part 2s to opioids. Acetaminophen may offer significant analgesia and is safe for mother and child.7Predicting the effects of maternally administered medications that appear in breast milk is complex. Consulting the published guidelines written by professional organizations is recommendedI.IntroductionPai Ebook A practical approach to obstetric anesthesia (2/E): Part 2n relief after cesarean delivery (CD) has many of the same clinical considerations as analgesia following other forms of abdominal surgery. AdditionalEbook A practical approach to obstetric anesthesia (2/E): Part 2
concerns in the post-CD population include the goal of minimizing maternal sedation to facilitate interactions with the newborn, family, and friends;Postpartum IssuesPostcesarean AnalgesiaRichard N. ỈVi.sslerI.IntroductionII.Multimodal therapyA.GoalsB.Components of multimodal therapyIII.Medications Ebook A practical approach to obstetric anesthesia (2/E): Part 2ts should be familiar with current post-CD analgesic techniques. More than 1.28 million CD were performed in the United States in 2013, representing 32.7% of all births.1 As seen in the subsequent text, the anesthetic method used for CD often influences the choices for postcesarean analgesia. Both s Ebook A practical approach to obstetric anesthesia (2/E): Part 2cheduled and unplanned CD have similar acutepostoperative pain scores and analgesic requirements.2Acute postoperative or nociceptive pain following CDEbook A practical approach to obstetric anesthesia (2/E): Part 2
is a combination of visceral pain from the uterus and somatic pain from the abdominal wall. Recent research has focused on the subsequent developmentPostpartum IssuesPostcesarean AnalgesiaRichard N. ỈVi.sslerI.IntroductionII.Multimodal therapyA.GoalsB.Components of multimodal therapyIII.Medications Ebook A practical approach to obstetric anesthesia (2/E): Part 2of 1% to 18%.' At this time, modifications of post-CD analgesia to decrease the incidence of chronic incisional pain are investigational only. This chapter focuses on cunent analgesic strategies for acute nociceptive post-CD pain. However, some data suggest that effective treatment of acute postoper Ebook A practical approach to obstetric anesthesia (2/E): Part 2ative pain may minimize the development of chronic pain in these patients.4Effective post-CD analgesia is an attainable goal recommended by several naEbook A practical approach to obstetric anesthesia (2/E): Part 2
tional professional organizations.5 6 One prospective written survey of pregnant patients before delivery demonstrates that pain during and after CD aPostpartum IssuesPostcesarean AnalgesiaRichard N. ỈVi.sslerI.IntroductionII.Multimodal therapyA.GoalsB.Components of multimodal therapyIII.Medications Ebook A practical approach to obstetric anesthesia (2/E): Part 2postoperative pain, and expected needs of postoperative analgesic medications are moderately predictive of post-CD analgesic requirements.8 However, the practical application of preoperative questionnaires for routine clinical practice is not clear.II. Multimodal therapyA.Goals. Utilizing several me Ebook A practical approach to obstetric anesthesia (2/E): Part 2dications and/or routes of administration that complement each Other.5’9 The goals are:1Increasing the effectiveness of analgesia2Decreasing medicatioEbook A practical approach to obstetric anesthesia (2/E): Part 2
n side effects by decreasing doses of individual medicationsB.Components of multimodal therapy. Examples of multimodal therapy for post-CD analgesia iPostpartum IssuesPostcesarean AnalgesiaRichard N. ỈVi.sslerI.IntroductionII.Multimodal therapyA.GoalsB.Components of multimodal therapyIII.MedicationsPostpartum IssuesPostcesarean AnalgesiaRichard N. ỈVi.sslerI.IntroductionII.Multimodal therapyA.GoalsB.Components of multimodal therapyIII.MedicationsGọi ngay
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