Interpretation of nursing key points for various delivery anesthesia methods

Every pregnant mother is very worried that anesthesia will cause harm to the baby during delivery. Below Xingyuncao will analyze various anesthesia methods one by one for everyone.

Cesarean sections are usually performed with combined lumbar and epidural anesthesia, or pure spinal or epidural anesthesia. These methods can be collectively referred to as spinal anesthesia.

1. Let the mother lie on her side, lower her head and bend her knees into a shrimp shape, and puncture the space between the spinous processes of the spine;

2. Spinal anesthesia involves injecting drugs directly into the cerebrospinal fluid around the spinal nerves in the subarachnoid space. The onset of action is relatively fast, and the effect is almost immediate after starting the injection; spinal anesthesia has a strong degree of anesthesia, good intraoperative analgesia, and there will be obvious muscle weakness in the lower limbs;

3. Then insert a catheter in the epidural space to facilitate continuous administration during the operation. Simple epidural anesthesia takes effect slightly slowly, about 10 minutes.

*Before administering anesthesia, the anesthesiologist will usually ask the mother whether she has any lumbar spinal disease or other diseases. After confirming that there are no influencing factors, anesthesia can be implemented. During the anesthesia process, the mother should truthfully answer whether she has numbness, pain, \”electricity\”, etc., so that the anesthesiologist can grasp the situation in a timely manner. If you feel any discomfort, you must report it truthfully so that problems can be discovered in time and danger can be avoided.

* Spinal anesthesia can easily cause changes in blood pressure. Some mothers may feel chest tightness, dizziness, and nausea. When lying on the back, especially after the anesthetic takes effect, the uterus obviously compresses the inferior vena cava, reducing the amount of blood returned to the heart. At the same time, the blood vessels of the lower limbs dilate, and the mother may suffer from hypotension. At this time, the anesthesiologist will take measures such as tilting the operating table to the left to reduce the pressure on the inferior vena cava. He may also use drugs to increase the mother\’s blood pressure and speed up the infusion.

Spinal anesthesia does not leave a catheter and has a shorter action time. It lasts about 30 to 90 minutes depending on the type and dose of the drug, which limits the duration of the surgery. Since the epidural anesthesia catheter is placed, anesthesia can be added during the operation, which is convenient. The anesthesia time can be extended as much as possible and reserved for postoperative analgesia. A caesarean section usually takes 1-2 hours.

1. Generally, you are not allowed to eat or drink on the day before surgery, after 12 o\’clock in the evening, or 8 hours before surgery depending on the time of surgery, to prevent food or water from backflowing and blocking the respiratory tract during the surgery, causing danger;

2. You can turn over 6 hours after the operation to help the gastrointestinal recovery, promote the early recovery of paralyzed intestinal muscle peristalsis, make the gas in the intestines discharge from the body as soon as possible, and also help the discharge of lochia.

3. If you feel the pain in the wound is unbearable, you can ask the doctor to give you some painkillers on the day of surgery or at night. Be patient with the pain afterwards, and it is best not to use painkillers to avoid affecting the recovery of bowel movements.

4. Gastrointestinal function can be restored about 24 hours after surgery. After the gastrointestinal function is restored, you can eat liquid food such as rice soup for 1 day, and avoid flatulent foods such as milk and soy milk. After the intestinal gas is cleared, you can eat semi-liquid food for 1-2 days, such as soup noodles, wontons, etc., and then switch to a normal diet.

5. As long as your physical strength allows, you should get out of bed as soon as possible after delivery and gradually increase the amount of activity. In this way, it can not only increase intestinal peristalsis function, promote uterine reset, but also avoid the occurrence of intestinal adhesions and thrombophlebitis.

1. Spinal anesthesia cannot be performed for back skin infections and lumbar spine diseases.

2. The mother suffers from sepsis and coagulation dysfunction.

3. Parturients with cardiac insufficiency or other diseases cannot cooperate with the anesthesia position.

Special reminder from Xingyuncao: After spinal anesthesia, waist discomfort, low back pain or slight soreness will generally occur within 1-2 weeks. These are normal phenomena. If the discomfort is unusually strong or lasts for a long time, you need to go to the hospital for treatment.

General anesthesia is induced by intravenous anesthetic, tracheal intubation is started after the mother falls asleep, and anesthesia is maintained by inhalation of anesthetic. Under general anesthesia, the woman will remain unconscious and will not feel pain throughout the delivery.

Some anesthetics can pass through the placenta and have a certain impact on the newborn\’s breathing. Severe cases may develop respiratory depression after birth and require tracheal intubation. Therefore, this method of anesthesia is generally not used. Unless there is lumbar spine injury or other contraindications, combined epidural-lumbar anesthesia cannot be used for caesarean section. Or in emergency situations, such as heavy bleeding, food in the stomach, or gastric acid entering the trachea or lungs, serious consequences may occur if the mother is not anesthetized in time.

Postoperatively, the patient is usually placed in the supine position with the head turned to one side to prevent aspiration of oropharyngeal secretions and vomitus. If you experience any discomfort, please contact your doctor immediately. The remaining precautions are the same as for combined epidural lumbar anesthesia.

3. Interpretation of local anesthesia in natural childbirth anesthesia——

Hazard index:*

Nursing index: *

Usage index: *****

Fetal impact index: zero

Side cut

A partial perineal incision is made using local anesthesia, i.e. local injection of anesthetic from the subcutaneous tissue, to avoid irregular tearing of the perineum during delivery. The effect of the drug wears off 1 hour after injection, and local sensation will slowly return. The maternal consciousness is clear and she can clearly feel the touch of sutures, but there is no pain. If you are not allergic to the injected drugs, there are generally no special complications.

4. Intravenous anesthesia

Risk index: ***

Nursing index: ***

Usage index:*

Fetal impact index:*

Suture laceration

Intravenous anesthesia is used when there is a deep or extensive laceration that requires suturing, or when the placenta has not been completely delivered and requires instrumentation into the uterine cavity. The method of anesthesia is to inject drugs intravenously to make the mother lose consciousness.Reduce pain and achieve analgesic effect. Generally, you can regain consciousness about half an hour after stopping the injection.

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