Subject(s)
Analgesia, Obstetrical , Anesthesia, Obstetrical , Analgesia, Epidural , Female , Humans , Labor, Obstetric , Pregnancy , UltrasonographySubject(s)
Analgesia, Epidural/methods , Analgesia, Obstetrical/methods , Walking , Ambulatory Care/methods , Female , Humans , PregnancyABSTRACT
Childbirth is frequently accompanied by pain. For religious, cultural and philosophical reasons many groups have sought to prevent treatment of pain. Pain may have adverse effects on the mother and fetus. The psychological effects of severe pain should not be overlooked particularly where it is associated with an adverse fetal or maternal outcome. There are a number of different forms of pain relief in labour with differing side-effects and efficacies. The controversy concerning medical management of women in labour has been used to dissuade women from requesting pain relief. This debate has encouraged the use of a patient-centred philosophy of care that encourages the patient to retain control. However, good pain relief may allow the women to retain control if administered in a sensitive manner. The ideal analgesic in labour is discussed. Recent and future developments of analgesia in childbirth are discussed with respect to this.
Subject(s)
Obstetric Labor Complications/prevention & control , Pain/prevention & control , Acupuncture Analgesia , Analgesia, Obstetrical/methods , Anesthesia, Conduction/methods , Choice Behavior , Female , Home Childbirth , Humans , Narcotics/pharmacology , Narcotics/therapeutic use , Obstetric Labor Complications/physiopathology , Pain/physiopathology , Patient Education as Topic , Pregnancy , Relaxation Therapy , Social Support , Transcutaneous Electric Nerve StimulationSubject(s)
Analgesia, Epidural/methods , Analgesia, Obstetrical/methods , Labor, Obstetric , Walking , Female , Humans , Posture , PregnancyABSTRACT
1. Cholinergic neurones in the basal forebrain are linked to cortical activation and arousal. 2. The present study was designed to examine the hypothesis that clinically relevant doses of halothane (0.1 to 5%) would significantly reduce depolarization-evoked acetylcholine (ACh) release from rat cortical slices. 3. ACh release was measured from rat cortical slices by a chemiluminescent technique. 4. Depolarization-evoked ACh release was inhibited significantly by halothane with an IC50 of 0.38%. This value equates to 0.3 MAC (the minimum alveolar concentration at which no movement occurs to a standard surgical stimulus in 50% of subjects) for the rat. 5. The potent effect of halothane on ACh release suggests that this mechanism may be a target for the action of volatile anaesthetic agents. This in vitro effect on ACh release is consistent with effects of halothane reported in vivo.
