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YEAR 3 REVISION > Pain Relief > Flashcards

Flashcards in Pain Relief Deck (27)
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1
Q

What are the types of regional anaesthesia?

A
  1. Epidural
  2. Spinal
  3. Combined
2
Q

What is the difference between an epidural and spinal?

A
  • Epidural = catheter stays in back, ideal for long periods of time, topped up for CS
  • Spinal = single injection, standard for operative delivery without epidural
3
Q

What is in an epidural?

A

Bupivicaine and fentanyl

4
Q

Who can’t have an epidural?

A
  • Patient refusal
  • Clotting disorders
  • Some cardiac/ neurological conditions
  • Some types of back surgery
  • If had clexane in last 12 hrs
5
Q

What are some of the complications associated with epidurals?

A
  • Hypotension
  • Ineffective
  • Neurological problems
  • Dural tap
  • Abscess/ haematoma
6
Q

What should be done alongside an epidural?

A
  • BP 4x5 mins and then half hourly
  • 4x5 min BP every time new dose given
  • Fluids
7
Q

What are some complementary therapies that may be used in labour?

A
  • Acupuncture
  • Aromatherapy
  • Herbal remedies
  • Homeopathy
  • Reflexology
  • Hypnobirthing
8
Q

What are some essential oils used for aromatherapy?

A
  • Camomile
  • Lavender
  • Grapefruit
  • Rose
  • Frankincense
9
Q

How should raspberry leaf tea be used?

A
  • From 32/40 (takes a while for it to take effect)

- Thought to make contractions more effective

10
Q

What are the contraindications for raspberry leaf tea?

A
  • Previous preterm birth
  • Synto
  • Previous CS/ ELCS
  • APH
11
Q

Name some common herbal remedies

A
  • Raspberry leaf tea
  • Primrose oil
  • Castor oil
12
Q

What is homeopathy?

A
  • Using minute doses of substances

- Arnica recommended by homeopaths to treat shock, trauma or bruising postnatally

13
Q

What is reflexology?

A

The idea that pressure points on the feet represent different organs in the body

14
Q

Describe pethidine

A
  • Opiate
  • Anti-emetic should be given with it
  • May make baby lethargic if given soon before delivery
15
Q

How often should ranitidine be given for women with an epidural?

A

6 hourly (150mg)

16
Q

When should antacids be given?

A

When women are given opioids, and epidural or going for a CS

17
Q

What is a contraindication of an epidural?

A

Clexane in the last 12 hours

18
Q

What advice should be given to women using entonox?

A
  • Breathe in AND out through tube
  • Start breathing when contraction begins, not at the peak
  • Don’t use between contractions
  • May make you feel sick/ dizzy
19
Q

What is meant by sensory block?

A

What they can feel (use ice)

20
Q

What is meant by motor block?

A

How much they can move (ask to mobilise/ straight leg raise)

21
Q

What is an unusual way of assessing if an epidural is working well?

A

If they have warm feet, due to vasodilation, the block is working well

22
Q

What are the 3 conditions that a patient must be in to have an epidural?

A
  1. Delivery within 48 hours
  2. Can sit still
  3. Not actively pushing
23
Q

When should feeling ideally start coming back in the legs after an epidural?

A

Within 2-4 hours from delivery

24
Q

How can epidurals affect labour?

A
  • Associated with delayed 2nd stage

- Associated with raised temps in labour

25
Q

How can epidurals affect the foetus?

A
  • Associated with use of oxytocin drip

- Better APGAR scores

26
Q

What is a PDPH?

A

Post Dural Puncture Headache:

  • Usually diagnosed within 24-48 hours
  • Can cause neck pain at front and back
  • Photophobia
  • Nausea
  • Tinnitus
  • Treated using a blood patch
27
Q

How does a blood patch work?

A

Another epidural is inserted in the same space and Dr inserts blood taken from the patient’s arm to increase BP