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Labour Analgesia Presentation 2

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ADVANCES IN LABOUR ANALGESIA. “ WALKING EPIDURAL” BY DR ZAHID AKHTAR RAO MBBS;MCPS;FCPS MILITARY HOSPITAL RAWALPINDI
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ADVANCES IN LABOUR ANALGESIA INCLUDES: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TRADITIONAL EPIDURALS: ,[object Object],[object Object]
EFFECT OF LOW DOSE MOBILE VS. TRADITIONAL EPIDURAL TECHNIQUES ON MODE OF DELIVERY. ,[object Object],[object Object],[object Object],[object Object]
LOW DOSE EPIDURALS : ,[object Object],[object Object],[object Object],[object Object]
WALKING EPIDURALS: ,[object Object],[object Object],[object Object],[object Object]
PCEA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CSE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SIDE EFFECTS OF CSE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ON THE OTHER HAND

.. HOW FAST DO WE NEED A BLOCK TO BE ? ,[object Object],[object Object],[object Object],[object Object]
CONTINUOUS EPIDURAL INFUSION ,[object Object],[object Object],[object Object]
PCEA VS.CEI FOR LABOUR ANALGESIA. ,[object Object],[object Object],[object Object],[object Object]
STUDY CARRIED OUT BY DR. C.HARMS AND HIS COLLEGUES. ,[object Object],[object Object],[object Object],[object Object],[object Object]
DR GUPTA AND HIS COLLEGUES COMPARED THE CSE & LOW DOSE EPID.; IN RELATION TO AMBULATORY LABOUR ANALGESIA: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
With 15ml bolus of 0.1%(15mg) bup. +05ug/ml (75ug) fent. Ambulation achieved in 65% of parturient with epidural analgesia . (Anaesthesia 1998;53: 951-5)
Epidural analgesia with 20ml of 0.08%(16mg) bup.+2ug/ml (40ug) fent. Pain free ambulation achieved in 65% of parturient. (Canadian Journal of Anesthesia 50:R8(2003))
With 20ml of either 0.08% ropivacaine+2ug/ml fentanyl or 0.08% bupivacaine+2ug/ml fentanyl given in epidural space. ,[object Object],[object Object],[object Object]
DR MAHARJAN SK AND HIS COLLEGUE MATERNITY HOSPITAL, THAPATHALI KHATMANDU, NEPAL. ,[object Object],[object Object],[object Object],[object Object]
A POPULATION BASED STUDY OF 94,217 PRIMIPARAE. EPID ANALG & ITS RELATION TO CS & INSTRUMENTAL DELIVERIES. (Eur J Obstet Gynecol Report Biol. 2005 Dec 09.) ,[object Object],[object Object],[object Object]
STUDY BEING CARRIED OUT AT MILITARY HOSPITAL RAWALPINDI. ,[object Object],[object Object]
GROUP-A: 25 PARTURIENTS GIVEN 10 ml OF BUP.0.25%+5mg/ml TRAMADOL. ,[object Object],[object Object],[object Object]
GROUP-B: 50 PARTURIENTS GIVEN 10ml OF BUP.0.1%+5mg/ml TRAMADOL. ,[object Object],[object Object],[object Object],[object Object]
MODE OF DELIVERIES EPID. 0.25% Bup. (GP-A) ,[object Object],[object Object],[object Object]
MODE OF DELIVERIES EPID. 0.1% Bup.(GP-B) ,[object Object],[object Object],[object Object],[object Object],[object Object]
“ DURING THE FIRST STAGE OF LABOUR THE PATIENT USUALLY PREFERS TO MOVE ABOUT HER ROOM

 THEREFORE, SHE SHOULD NOT BE COMPELLED TO TAKE TO HER BED UNLESS SHE FEELS SO INCLINED.” RECOMMENDATIONS
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CONCLUSION MODERN LABOUR EPIDURAL ANALGESIC TECHNIQUES AND MEDICATIONS HAVE RESULTED IN MORE CONSISTENT, PRIDICTABLE AND EFFECTIVE ANALGESIA. OUR GOAL IS TO IMPROVE PATIENT CARE AND SAFETY; WHILE INCREASING THE SATISFACTION AND PARTICIPATION OF WOMEN IN THEIR LABOUR AND DELIVERY EXPERIENCE.
Thank You

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Labour Analgesia Presentation 2

  • 2. ADVANCES IN LABOUR ANALGESIA. “ WALKING EPIDURAL” BY DR ZAHID AKHTAR RAO MBBS;MCPS;FCPS MILITARY HOSPITAL RAWALPINDI
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  • 25. With 15ml bolus of 0.1%(15mg) bup. +05ug/ml (75ug) fent. Ambulation achieved in 65% of parturient with epidural analgesia . (Anaesthesia 1998;53: 951-5)
  • 26. Epidural analgesia with 20ml of 0.08%(16mg) bup.+2ug/ml (40ug) fent. Pain free ambulation achieved in 65% of parturient. (Canadian Journal of Anesthesia 50:R8(2003))
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  • 35. “ DURING THE FIRST STAGE OF LABOUR THE PATIENT USUALLY PREFERS TO MOVE ABOUT HER ROOM

 THEREFORE, SHE SHOULD NOT BE COMPELLED TO TAKE TO HER BED UNLESS SHE FEELS SO INCLINED.” RECOMMENDATIONS
  • 36.
  • 37. CONCLUSION MODERN LABOUR EPIDURAL ANALGESIC TECHNIQUES AND MEDICATIONS HAVE RESULTED IN MORE CONSISTENT, PRIDICTABLE AND EFFECTIVE ANALGESIA. OUR GOAL IS TO IMPROVE PATIENT CARE AND SAFETY; WHILE INCREASING THE SATISFACTION AND PARTICIPATION OF WOMEN IN THEIR LABOUR AND DELIVERY EXPERIENCE.