SlideShare a Scribd company logo
1 of 52
Chapter 15  ANALGESICA AND ANESTHESIA   2004-11-29 R3  길민경
[object Object],[object Object],[object Object],[object Object]
GENERAL PRINCIPLES
OBSTETRICAL ANESTHESIA SERVICES   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PRINCIPLES OF PAIN RELIEF ,[object Object],[object Object],[object Object]
ANALGESIA AND SEDATION DURING LABOR
MEPERIDINE AND PROMETHAZINE   ,[object Object],[object Object],[object Object],[object Object]
OTHER DRUGS   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NARCOTIC ANTAGONISTS   ,[object Object],[object Object],[object Object],[object Object],[object Object]
GENERAL ANESTHESIA
[object Object],[object Object]
INHALATION ANESTHESIA   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
INHALATION ANESTHESIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
INHALATION ANESTHESIA ,[object Object],[object Object],[object Object],[object Object]
INHALATION ANESTHESIA ,[object Object],[object Object]
INTRAVENOUS DRUGS DURING ANESTHESIA   ,[object Object],[object Object],[object Object],[object Object]
INTRAVENOUS DRUGS DURING ANESTHESIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ASPIRATION DURING GENERAL ANESTHESIA   ,[object Object]
ASPIRATION DURING GENERAL ANESTHESIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ASPIRATION DURING GENERAL ANESTHESIA ,[object Object],[object Object],[object Object]
ASPIRATION DURING GENERAL ANESTHESIA ,[object Object],[object Object],[object Object],[object Object],[object Object]
FAILED INTUBATION   ,[object Object]
REGIONAL ANALGESIA
SENSORY INNERVATION OF THE GENITAL TRACT   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANESTHETIC AGENTS   ,[object Object],[object Object]
ANESTHETIC AGENTS ,[object Object],[object Object],[object Object],[object Object],[object Object]
ANESTHETIC AGENTS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LOCAL INFLITRATION   ,[object Object],[object Object]
PUDENDAL BLOCK
PUDENDAL BLOCK   ,[object Object],[object Object]
PUDENDAL BLOCK   ,[object Object],[object Object],[object Object],[object Object]
PARACERVICAL BLOCK   ,[object Object],[object Object]
PARACERVICAL BLOCK   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SPINAL (SUBARACHNOID) BLOCK   ,[object Object],[object Object],[object Object],[object Object]
SPINAL (SUBARACHNOID) BLOCK   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SPINAL (SUBARACHNOID) BLOCK   ,[object Object],[object Object],[object Object]
SPINAL (SUBARACHNOID) BLOCK   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SPINAL (SUBARACHNOID) BLOCK ,[object Object],[object Object],[object Object],[object Object]
SPINAL (SUBARACHNOID) BLOCK ,[object Object],[object Object],[object Object],[object Object]
SPINAL (SUBARACHNOID) BLOCK ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
EPIDURAL ANALGESIA   ,[object Object],[object Object],[object Object]
EPIDURAL ANALGESIA   ,[object Object],[object Object],[object Object],[object Object],[object Object]
EPIDURAL ANALGESIA   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
EPIDURAL ANALGESIA   ,[object Object],[object Object]
EPIDURAL ANALGESIA ,[object Object]
EPIDURAL ANALGESIA ,[object Object],[object Object],[object Object]
EPIDURAL ANALGESIA ,[object Object],[object Object],[object Object],[object Object]
EPIDURAL ANALGESIA ,[object Object],[object Object],[object Object],[object Object]
EPIDURAL ANALGESIA ,[object Object],[object Object],[object Object],[object Object]
EPIDURAL ANALGESIA ,[object Object],[object Object],[object Object]
EPIDURAL ANALGESIA ,[object Object],[object Object]
EPIDURAL ANALGESIA ,[object Object],[object Object],[object Object],[object Object],[object Object]

More Related Content

What's hot

Management of Post-partum hemorrhage (PPH)
Management of Post-partum hemorrhage (PPH)Management of Post-partum hemorrhage (PPH)
Management of Post-partum hemorrhage (PPH)
Sandesh Kamdi
 

What's hot (20)

Manual removal of placenta
Manual removal of placentaManual removal of placenta
Manual removal of placenta
 
Antepartum haemorrhage i
Antepartum haemorrhage iAntepartum haemorrhage i
Antepartum haemorrhage i
 
obstetric emergency
 obstetric emergency obstetric emergency
obstetric emergency
 
LACTATION MANAGEMENT
LACTATION MANAGEMENT LACTATION MANAGEMENT
LACTATION MANAGEMENT
 
Various child birth practices and evidenced based practice
Various child birth practices and evidenced based practiceVarious child birth practices and evidenced based practice
Various child birth practices and evidenced based practice
 
Abnormal uterine action
Abnormal uterine actionAbnormal uterine action
Abnormal uterine action
 
Non stress test
Non stress testNon stress test
Non stress test
 
Role of midwife and independent nurse midwifery practitioner
Role of midwife and independent nurse midwifery practitionerRole of midwife and independent nurse midwifery practitioner
Role of midwife and independent nurse midwifery practitioner
 
Amniotic fluid-embolism - Define, Sign, Symptoms, Etiology, Pathology, Diagno...
Amniotic fluid-embolism - Define, Sign, Symptoms, Etiology, Pathology, Diagno...Amniotic fluid-embolism - Define, Sign, Symptoms, Etiology, Pathology, Diagno...
Amniotic fluid-embolism - Define, Sign, Symptoms, Etiology, Pathology, Diagno...
 
Nursing Management for obstetrical procedures
Nursing  Management  for obstetrical proceduresNursing  Management  for obstetrical procedures
Nursing Management for obstetrical procedures
 
Obstetrical shock
Obstetrical shockObstetrical shock
Obstetrical shock
 
Oxytocin
OxytocinOxytocin
Oxytocin
 
Amniotic Fluid Embolism
Amniotic Fluid EmbolismAmniotic Fluid Embolism
Amniotic Fluid Embolism
 
Management of Post-partum hemorrhage (PPH)
Management of Post-partum hemorrhage (PPH)Management of Post-partum hemorrhage (PPH)
Management of Post-partum hemorrhage (PPH)
 
Manual Removal of Placenta
Manual Removal of PlacentaManual Removal of Placenta
Manual Removal of Placenta
 
4th stage of labor m.sc 1st year
4th stage of labor m.sc 1st year4th stage of labor m.sc 1st year
4th stage of labor m.sc 1st year
 
Anaesthesia & analgesia in labour
Anaesthesia & analgesia in labourAnaesthesia & analgesia in labour
Anaesthesia & analgesia in labour
 
Manual removal of placenta
Manual removal of placentaManual removal of placenta
Manual removal of placenta
 
Shock in obstetrics
Shock in obstetricsShock in obstetrics
Shock in obstetrics
 
Electronic fetal monitoring
Electronic fetal monitoringElectronic fetal monitoring
Electronic fetal monitoring
 

Similar to Analgesia and anaesthyesia

Obstetrics and anesthesia.ppt
Obstetrics and anesthesia.pptObstetrics and anesthesia.ppt
Obstetrics and anesthesia.ppt
sreenivascj1
 
7 obstetric analgesia10
7 obstetric analgesia107 obstetric analgesia10
7 obstetric analgesia10
obsgyna
 
6. Special Techniques
6. Special Techniques6. Special Techniques
6. Special Techniques
SUNY Ulster
 
Pharmacologic management 7
Pharmacologic management 7Pharmacologic management 7
Pharmacologic management 7
Xtine Marie
 
Effects of Maternal Analgesia and Anesthesia on the Fetus and Newborn
Effects of Maternal Analgesia and Anesthesia on the Fetus and NewbornEffects of Maternal Analgesia and Anesthesia on the Fetus and Newborn
Effects of Maternal Analgesia and Anesthesia on the Fetus and Newborn
King_maged
 

Similar to Analgesia and anaesthyesia (20)

Obstetrics and anesthesia.ppt
Obstetrics and anesthesia.pptObstetrics and anesthesia.ppt
Obstetrics and anesthesia.ppt
 
anesthesia in OB.pptx
anesthesia in OB.pptxanesthesia in OB.pptx
anesthesia in OB.pptx
 
4493677 - Copy.ppt
4493677 - Copy.ppt4493677 - Copy.ppt
4493677 - Copy.ppt
 
12572001.ppt
12572001.ppt12572001.ppt
12572001.ppt
 
7 obstetric analgesia10
7 obstetric analgesia107 obstetric analgesia10
7 obstetric analgesia10
 
4493677.ppt
4493677.ppt4493677.ppt
4493677.ppt
 
RSI + dAS 2015 (1).pptx
RSI + dAS 2015 (1).pptxRSI + dAS 2015 (1).pptx
RSI + dAS 2015 (1).pptx
 
RSI + dAS 2015.pptx
RSI + dAS 2015.pptxRSI + dAS 2015.pptx
RSI + dAS 2015.pptx
 
Labour analgesia - ajay
Labour analgesia - ajayLabour analgesia - ajay
Labour analgesia - ajay
 
Labour analgesia - ajay
Labour analgesia - ajayLabour analgesia - ajay
Labour analgesia - ajay
 
Epidural
EpiduralEpidural
Epidural
 
Anaesthesia for LSCS
Anaesthesia for LSCSAnaesthesia for LSCS
Anaesthesia for LSCS
 
Post Operative Nausea & Vomiting
Post Operative Nausea & VomitingPost Operative Nausea & Vomiting
Post Operative Nausea & Vomiting
 
Anaesthesia in obstetrics and role of midwife
Anaesthesia in obstetrics and role of midwifeAnaesthesia in obstetrics and role of midwife
Anaesthesia in obstetrics and role of midwife
 
Painless labor
Painless laborPainless labor
Painless labor
 
Obstetric Anaesthesia Updated (2).pptx
Obstetric Anaesthesia Updated (2).pptxObstetric Anaesthesia Updated (2).pptx
Obstetric Anaesthesia Updated (2).pptx
 
6. Special Techniques
6. Special Techniques6. Special Techniques
6. Special Techniques
 
Pharmacologic management 7
Pharmacologic management 7Pharmacologic management 7
Pharmacologic management 7
 
analgesicsandanestheia-201123103344 (1).pdf
analgesicsandanestheia-201123103344 (1).pdfanalgesicsandanestheia-201123103344 (1).pdf
analgesicsandanestheia-201123103344 (1).pdf
 
Effects of Maternal Analgesia and Anesthesia on the Fetus and Newborn
Effects of Maternal Analgesia and Anesthesia on the Fetus and NewbornEffects of Maternal Analgesia and Anesthesia on the Fetus and Newborn
Effects of Maternal Analgesia and Anesthesia on the Fetus and Newborn
 

More from narasimha reddy

renal preservation and ARF management
renal preservation and ARF managementrenal preservation and ARF management
renal preservation and ARF management
narasimha reddy
 
Mechanism of general anaesthesia at molecular level.
Mechanism of general anaesthesia at molecular level.Mechanism of general anaesthesia at molecular level.
Mechanism of general anaesthesia at molecular level.
narasimha reddy
 
Chronic pain management
Chronic pain management Chronic pain management
Chronic pain management
narasimha reddy
 
Sevoflurane in neuroanaesthesia
Sevoflurane in neuroanaesthesiaSevoflurane in neuroanaesthesia
Sevoflurane in neuroanaesthesia
narasimha reddy
 
Sevo in neuro anesthesia
Sevo in neuro anesthesiaSevo in neuro anesthesia
Sevo in neuro anesthesia
narasimha reddy
 
Pharmacokinetics of inhalational agents relavant to anaestheist
Pharmacokinetics of inhalational agents relavant to anaestheistPharmacokinetics of inhalational agents relavant to anaestheist
Pharmacokinetics of inhalational agents relavant to anaestheist
narasimha reddy
 
Congenital diaphragmatic hernia2
Congenital diaphragmatic hernia2Congenital diaphragmatic hernia2
Congenital diaphragmatic hernia2
narasimha reddy
 
Anaesthesia outside operating room
Anaesthesia outside operating roomAnaesthesia outside operating room
Anaesthesia outside operating room
narasimha reddy
 
Pharmacokinetics of inhalational agents relavant to anaestheist
Pharmacokinetics of inhalational agents relavant to anaestheistPharmacokinetics of inhalational agents relavant to anaestheist
Pharmacokinetics of inhalational agents relavant to anaestheist
narasimha reddy
 
Anaesthesia outside operating room
Anaesthesia outside operating roomAnaesthesia outside operating room
Anaesthesia outside operating room
narasimha reddy
 

More from narasimha reddy (20)

renal preservation and ARF management
renal preservation and ARF managementrenal preservation and ARF management
renal preservation and ARF management
 
Mechanism of general anaesthesia at molecular level.
Mechanism of general anaesthesia at molecular level.Mechanism of general anaesthesia at molecular level.
Mechanism of general anaesthesia at molecular level.
 
Labour analgesia
Labour analgesia Labour analgesia
Labour analgesia
 
Chronic pain management
Chronic pain management Chronic pain management
Chronic pain management
 
Sevoflurane in neuroanaesthesia
Sevoflurane in neuroanaesthesiaSevoflurane in neuroanaesthesia
Sevoflurane in neuroanaesthesia
 
Sevo in neuro anesthesia
Sevo in neuro anesthesiaSevo in neuro anesthesia
Sevo in neuro anesthesia
 
Evolution of reducing valves
Evolution of reducing valvesEvolution of reducing valves
Evolution of reducing valves
 
Non return valves
Non return valvesNon return valves
Non return valves
 
peadiatric premedication and preparation
peadiatric premedication and preparationpeadiatric premedication and preparation
peadiatric premedication and preparation
 
Vaporizers
Vaporizers Vaporizers
Vaporizers
 
Pharmacokinetics of inhalational agents relavant to anaestheist
Pharmacokinetics of inhalational agents relavant to anaestheistPharmacokinetics of inhalational agents relavant to anaestheist
Pharmacokinetics of inhalational agents relavant to anaestheist
 
Congenital diaphragmatic hernia2
Congenital diaphragmatic hernia2Congenital diaphragmatic hernia2
Congenital diaphragmatic hernia2
 
Anaesthesia outside operating room
Anaesthesia outside operating roomAnaesthesia outside operating room
Anaesthesia outside operating room
 
Common~1
Common~1Common~1
Common~1
 
Neonat~1
Neonat~1Neonat~1
Neonat~1
 
Pharmacokinetics of inhalational agents relavant to anaestheist
Pharmacokinetics of inhalational agents relavant to anaestheistPharmacokinetics of inhalational agents relavant to anaestheist
Pharmacokinetics of inhalational agents relavant to anaestheist
 
Anaesthesia outside operating room
Anaesthesia outside operating roomAnaesthesia outside operating room
Anaesthesia outside operating room
 
Neonat~1
Neonat~1Neonat~1
Neonat~1
 
Neonat~1
Neonat~1Neonat~1
Neonat~1
 
Neonat~1
Neonat~1Neonat~1
Neonat~1
 

Recently uploaded

Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
adilkhan87451
 
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
9953056974 Low Rate Call Girls In Saket, Delhi NCR
 

Recently uploaded (20)

Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service AvailableCall Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
 
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
 
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
 
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadO898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
 
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
 
Call Girls Kakinada Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kakinada Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Kakinada Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kakinada Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available
 
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
 
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
 
Call Girls Vadodara Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Vadodara Just Call 8617370543 Top Class Call Girl Service AvailableCall Girls Vadodara Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Vadodara Just Call 8617370543 Top Class Call Girl Service Available
 
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on WhatsappMost Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
 
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
 
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
 
Call Girls Kurnool Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kurnool Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kurnool Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kurnool Just Call 8250077686 Top Class Call Girl Service Available
 
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
 
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
💕SONAM KUMAR💕Premium Call Girls Jaipur ↘️9257276172 ↙️One Night Stand With Lo...
 
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7Call Girls in Gagan Vihar (delhi) call me [🔝  9953056974 🔝] escort service 24X7
Call Girls in Gagan Vihar (delhi) call me [🔝 9953056974 🔝] escort service 24X7
 
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
 

Analgesia and anaesthyesia