Epidural and spinal anesthesia for vaginal delivery. Consequences of epidural anesthesia during childbirth for mother and baby Anesthesia during childbirth it

Childbirth. All pregnant women are eagerly waiting for them to meet their long-awaited babies. But at the same time with expectation, almost all women feel fear - someone is not ashamed to talk about it, and someone keeps their fear in themselves. However, the fact remains - fear of childbirth is an integral part of a pregnant woman's life. And pain relief during childbirth causes very different reviews. In particular, many say that anesthesia does not work. And expectant mothers are beginning to worry again.

And this is quite natural - after all, all people, without exception, are afraid of the feeling of pain. And in childbirth, pain simply cannot be avoided. And expectant mothers are well aware of this. And, in addition, this panic fear is very much "fueled" from the outside - pregnant women almost every day have to listen to various horror stories about inhuman torments during childbirth.

Frankly, such stories greatly exaggerate and terrify the real picture of childbirth. As a result, the expectant mother tunes in to pain, psychologically squeezes, does not hear the advice and instructions of doctors - gynecologists and midwives. As a result, not only the pain is increased, but the very process of normal natural childbirth is at risk.

How to be in this situation? First of all, you need to calm down and remember that modern medicine offers pain relief during childbirth. You also need to understand what birth pain is and what causes it - this will help to some extent relieve the psychological stress of the expectant mother, which is very, very important.

Causes of labor pain

So, birth pain - what are the reasons for its occurrence? The most important prerequisite for the occurrence of strong pain during the period of labor is the contraction of the muscles of the uterus, which is necessary for the cervix to open. In addition, the pain is caused by the tension in the ligaments that support the uterus. These painful sensations are strong enough and deliver many unpleasant minutes and hours to a woman in labor.

In the period of straining, when the cervix is already open and the child begins to move along the birth canal, acute painful sensations are caused by the strongest pressure of the head on the soft tissues of the pelvis, its bones and perineum. By the way, if the woman's nervous system is sufficiently trained, pain during pushing is not felt at all - only a strong feeling of pressure remains. However, it is unlikely that the vast majority of women in labor in the past were engaged in such exotic training of the nervous system as walking barefoot on glass or coals - so pain in the period of labor is almost inevitable.

Types of pain

Medical professionals distinguish three types of pain, based on the nature of its occurrence and the degree of intensity:

False pain.

The strongest psychological stress, fear of birth pain, concern for the child's condition and the outcome of childbirth leads to pain. In addition, if a woman does not know how to control the reactions of her body, relax, listen and hear the instructions of doctors, the intensity of pain can increase many times over.

True painful sensations.

True painful sensations arise as a result of the already described natural events that accompany any natural generic process - contractions and a period of pressure. This type of pain is physiological and only indicates that the process of labor is proceeding normally. The fact how intensely these pain sensations will be expressed depends on many factors and, first of all, on the individual characteristics of the organism of each particular woman in labor.

Pathological pain sensations.

This type of pain occurs if, for some reason, the natural physiological course of labor is disturbed. Pathological pain sensations are a formidable symptom and require immediate assistance in order to avoid problems for both the mother and the child.

Physiological types of pain relief

In the event that pain becomes too strong and deprives a woman of the ability to think sensibly and control her behavior, doctors decide to resort to pain relief of the birth process. All types of pain relief are divided into two groups - non-drug labor pain relief and pharmacological. As a rule, if there are no complications of the normal course of labor, and the severity of pain is not too severe, doctors recommend natural pain relief during labor.

Psychological relaxation

No matter how strange it may seem, psychological stress and constriction during childbirth can lead to the emergence of very real strong pain sensations. In order to avoid this, a pregnant woman should apply all the knowledge and skills that she received in the preparation for childbirth courses. Remember the correct breathing, relaxation techniques.

Do not forget about your mood either - a lot depends on the psychological mood of the woman in labor. You need to be sure that the birth will end well. And they will not last forever - very little time will pass, and you will finally see your baby, which you have been waiting for nine long months. You should not dwell on your painful sensations - it is better to think about how the baby is now, what colossal work he has to do now to be born.

Instead of screaming in pain and fear, talk to your baby, tell him how much you love and expect him. Think about the fact that your cry scares the baby very much - after all, he very clearly captures all the changes in your emotional state. Do not scare him even more, because he is already scared of what is happening. Talking to your baby will help you and your baby to calm down.

Body positions.

In the event that your pregnancy proceeded normally, without any complications, to relieve your pain, you can try to change the position of your body, taking the position that is most comfortable for you. Most women note the very high effectiveness of the following postures:

1. Squat down and spread your knees wide. Be careful not to lose your balance - sit or near the wall, or ask your partner to support you if you are not giving birth alone.
2. Sit on your knees, first spreading them as wide as possible to the sides. This position is very effective in relieving pain in the coccyx.
3. Get on all fours with your pelvis raised as high as possible. This position should only be taken on a hard surface - you should not do it on a soft bed. And watch your health - at the first appearance of dizziness, change your posture so as not to lose consciousness.
4. Hang on something: on the headboard, around your husband's neck, on the doorpost. This situation greatly reduces the pressure, and accordingly. The intensity of pain is significantly reduced.

Once again, it is necessary to remind you of extra caution - avoid falling.

Massage

Also, do not forget about such a method of pain relief as massage. A well-done massage can relieve pain during labor much more effectively than many drugs. We bring to your attention several massage techniques that will ease the condition of a woman during childbirth.

Lie on your back, relax as much as possible and place both palms on your lower abdomen, in the pubic area. Your fingertips should touch. During each contraction, use your fingertips to massage the lateral surfaces of the tummy very gently in a circular motion, about 10 to 15 movements per contraction.

If lying on your back is uncomfortable or painful, as is the case with many pregnant women, try the following technique. Lie on your right or left side, with your free hand lightly stroking the sacro-lumbar region, increasing the pressure at the peak of the contractions. As a rule, such a measure helps a huge number of women in labor to survive without taking painkillers for almost all childbirth.

At a time when the intensity of the contractions becomes especially strong and the usual massage loses its effectiveness, you can try the following method. Feel for the most sensitive points on the pubis. And with each contraction, when the pain becomes especially severe, press on them with maximum force. This will reduce the intensity of pain by about 40%.

Acupuncture.

Acupuncture is called acupuncture. The points of pain relief during childbirth are used the same as during massage. However, with acupuncture, deeper stimulation is achieved, which gives a more pronounced and lasting effect. Recently, an increasing number of maternity hospitals are starting to use this method of pain relief.

But, despite its effectiveness, acupuncture has several rather annoying disadvantages. Firstly, not every maternity hospital, especially in small towns, has acupuncture specialists. In addition, not every woman will feel comfortable enough being stuck with needles like a hedgehog. And during attempts, acupuncture is not very effective.

Percutaneous electroneurostimulation.

This type of anesthesia - TENS for short - is characterized by doctors as very effective and completely safe for both the mother and the child. Its essence is as follows - two electrodes are fixed on both sides of the spinal column, and the other - in the region of the sacrum. The doctor, based on the patient's sensations, selects the frequency and intensity of the electronic charge. After that, the woman herself can turn on the device when she needs it - at the peak of the contractions, when the pain becomes especially unbearable.

However, unfortunately, this method also has two main drawbacks. Firstly, a woman is forced to spend the entire period of contractions in the supine position, which is very difficult for some. And the electromagnetic radiation from the apparatus makes it difficult to conduct electrical monitoring of the fetal cardiac activity. This is due to the fact that electromagnetic fields interfere with the operation of the CTG apparatus.

Eternal glory to the water!

Water can significantly relieve labor pains. For example, an ordinary warm bath can completely replace drugs for pain relief during childbirth. Before the start of each contraction, squat down so that the stomach is completely covered with water. In no case lie on your back - this will greatly complicate the dilatation of the cervix. However, a woman should take a bath only under the constant supervision of medical personnel, since there is a risk of having a baby in the water.

Of course, a warm bath is ideal for pain relief. However, unfortunately, not all maternity hospitals have special pools or baths. However, you should not despair - you can also use an ordinary warm shower for pain relief.

Strictly monitor the temperature of the water - it should not be higher than your body temperature. You can just get in the shower and direct the stream of water to your stomach, or you can get on all fours and direct the stream of water to your sacrum. Experiment - and you will definitely find the position in which you will feel as comfortable as possible.

Please note, it is very important: if your water has already departed, the only possible method of water anesthesia for you is a shower !!! Not a bath at all.

Pharmacological agents for pain relief during childbirth

In the event that the doctor considers that you are too tired, your nerves are at the limit, and it becomes impossible for you to endure the pain, and all of the above methods did not help you, he may prescribe you one of those medicines that are used in obstetric practice.

In modern medicine, several groups of pharmacological drugs are used for these purposes, depending on what types of pain relief are used during childbirth:

Tranquilizers.

The main task of tranquilizers is a calming effect on the nervous system of a woman in labor. They eliminate panic, anxiety, dull heightened perception of pain. A woman can even sleep in between contractions, which will allow her to gain strength before the most responsible and energy-intensive stage of childbirth - before attempts. This is the so-called obstetric sleep.

Relaxants.

Relaxants have a slightly different effect on the body of a woman in labor. They cause the strongest and lasting relaxation of all muscles, which allows the cervix to open more efficiently and quickly.

Drugs for anesthesia.

These pharmacological preparations have a deep complex effect on the woman's body: muscle relaxation, suppression of the sensitivity of pain receptors, depression of consciousness. These drugs are used to introduce a woman into anesthesia in the event that something goes wrong during the birth process.

Narcotic analgesics.

They are used as a last resort, since they have a strong effect not only on the mother's body, but also on the fetus.

Methods of anesthesia during childbirth

Obstetricians - gynecologists use several types of anesthesia:

Local anesthesia

With local anesthesia, a pain reliever is injected into the soft tissue at the entrance to the vagina. As a rule, it is used before perineal incision or as an anesthetic after childbirth - with subsequent suturing. The main contraindication is individual intolerance to the drug - analgesic.

Spinal anesthesia.

Spinal or, as it is also called, epidural anesthesia has recently become increasingly popular, both among women in labor and among the doctors themselves - gynecologists. With this type of anesthesia, the pudendal nerve is blocked with special drugs. As a result, there is a complete loss of vaginal sensitivity, except for the external genital organs.

In addition, anesthesia is subdivided into several subtypes, depending on the place of administration of the drug:

Transintermediate anesthesia - The drug is injected through the perineum.
Transvaginal anesthesia - The medicine is injected through the perineum. As a rule, it is used in the second stage of uncomplicated labor. And sometimes when applying forceps. This type of anesthesia can cause complications such as infection or toxic shock if the drug gets into a blood vessel.

Regional spinal anesthesia is a complete numbing of the entire lower trunk. As a rule, it is used in the event that childbirth takes a protracted course, or as a good alternative to ordinary general anesthesia.

There are a number of direct indications for such anesthesia:

Gestosis - toxicosis of the second half of pregnancy, accompanied by high blood pressure and edema.
Nephropathy is a severe kidney disease.
Heart defects - both congenital and acquired.
Myopia and other damage to the retina.
Abnormal presentation of the fetus.
Premature birth.

General anesthesia during childbirth

General anesthesia is necessary in order to lull the woman in labor, completely turning off her consciousness. It is used only to perform a surgical delivery and if an epidural cannot be given.

In any case, the main thing doctors are guided by when choosing the type of anesthesia is the maximum safety of both the child and the woman in labor. After all, all the drugs that are injected into the mother's body, whatever methods of pain relief are used, immediately enter the child's blood.

But in any case, the most important guarantee of a successful childbirth is your positive attitude and firm confidence in the successful outcome of childbirth. There is very little time left - and you can hug your baby to you!

Pregnancy in a woman's life is one of the most wonderful periods to remember for a lifetime. The natural end of this period is childbirth. Childbirth, in the understanding of many women, is associated with strong painful sensations, everyone tolerates them differently. Quite often, women agree to anesthesia during childbirth because of the sheer amount of negative experiences other women have with childbirth. However, it should be understood that all childbirth is individual, often, you do not need to resort to anesthesia. What is anesthesia during childbirth and when is it needed - we learn from our article.

Is anesthesia really necessary during childbirth?

The term "anesthesia" originally came to us from the Greek language, literally it has two meanings:

The inability of a person to feel anything;
Pain relief for surgical purposes.

Today, pain relief is widely used in the birth process. For some women in labor, doctors strongly recommend using this service. This is due to the fact that childbirth is a long process, and the body of the expectant mother is individual in its own way. Some women get so tired during contractions that they have no strength left to push. To avoid this, women in labor agree to anesthesia in order to take some time off from contractions and not feel pain.

Anesthesia also has some placebo effect. Women who agree to pain relief experience less fear of childbirth, i.e. there is also a psychological aspect to anesthesia.

Anesthesia during childbirth can be both medication and non-medication. We will talk about this below. In any case, the permissible dose of the drug must be agreed with a specialist. In some cases, there are certain contraindications to this manipulation.

Be that as it may, agreeing to anesthesia, a woman must understand that the drug injected to her will definitely go to the child, because anesthesia has both advantages and disadvantages. In addition, complete loss of sensation during childbirth is highly undesirable. Natural childbirth is always much better for a baby, but here the issue is already decided on an individual basis. Anesthesia is best used when indicated.

In some cases, anesthesia is necessary for medical reasons, namely:

High blood pressure in a woman in labor, a tendency to hypertension;
Preeclampsia of a pregnant woman, preeclampsia;
Cardiovascular diseases;
Respiratory dysfunction;
Diabetes mellitus in a woman in labor;
Incorrect placement of the cervix;
Severe pain from the birth process in a woman, inability to endure it;
Very large fruit;
Incorrect presentation of the unborn baby;
Explicit fear of the expectant mother before childbirth.

Depending on how the childbirth proceeds, the doctor decides whether to use anesthesia. There are several types of anesthesia, we will talk about them now.

medications are administered strictly according to the doctor's indications, and non-drug methods of facilitating childbirth are available to every mother

Methods of pain relief during childbirth

Anesthesia can be both natural (non-drug) and medicinal.

Non-drug methods of pain relief during labor

If the woman in labor feels well, tolerates contractions normally, then medical pain relief is not applied by the doctor. Natural ways to relieve pain and tension will be appropriate here, namely:

Correct breathing during contractions and pushing;
The ability to relax between contractions, distraction;
Childbirth in water;
Contractions in the correct posture, comfortable for their transfer;
Aromatherapy.

There are other ways to relax during the birth process, these include:

Back massage;
Woman in labor hypnosis;
Acupuncture;
Taking a warm bath.

Every woman knows best herself what will be best for her at the moment. We would like to dwell in more detail on the most effective methods of pain relief during natural childbirth.

The activity of the expectant mother during childbirth

During contractions, a woman should be moderately active: sudden movements are useless, but lying is not very useful either. Doctors advise doing light exercise to relieve pain. Bends in different directions, circular movements with the pelvis, rolling from toe to heel are useful. Many experts recommend using a fitball - contractions on it are the easiest to endure, and very useful for blood circulation.

Breathing exercises

Breathing during labor is the most effective method to endure contractions most painlessly. In addition, it is beneficial for the baby - during childbirth, he may experience oxygen deprivation. With proper breathing, you can minimize pain and tune in to a positive experience. Respiratory gymnastics can be mastered independently - in special courses for expectant mothers, or at home by watching a video on the Internet.

Massage

During the course, expectant mothers will be told which points are on the body, by acting on which it is possible to reduce pain. They are located in the lumbar and sacral spine. If the expectant mother goes to childbirth with her husband or another close person, you can ask him to do a massage.

Childbirth in water

There is also such a method of easy childbirth - this is childbirth in the water. Today, this method causes a lot of controversy. But if you think it is optimal for you, then enlist the support of an experienced midwife. Warm water helps the mother to relax and concentrate on the contractions.

The perinatal period of a baby's life is one of the most important. Childbirth and the first hours of a child's life leave a serious imprint on his further development.

Pain relief during labor

Childbirth is often anesthetized with drugs. Below we will talk about modern medication techniques for pain relief.

Epidural anesthesia

Epidural and spinal anesthesia is used most often in cases of natural childbirth in a woman. Epiduralka affects the area below the back, thereby blocking pain. It begins to take effect 10 to 20 minutes after injection.

Epidural anesthesia is anesthesia in the spine. How an epidural is done: The doctor inserts a medication catheter into the back, through which the pain medication flows. During the administration of the medication, the woman must lie motionless, otherwise there is a risk of getting into the wrong place. All manipulations are performed by an experienced anesthesiologist, after which he observes the woman's condition and decides whether a new dose of anesthesia is needed.

This method has both advantages and disadvantages. The advantages include the following:

There is practically no risk to the baby;
The cardiovascular system is not aggressively affected by the drug;
The anesthetic drug can be administered throughout the period of labor, depending on the condition of the woman in labor.

Cons of epidural anesthesia:

Some women continue to feel pain;
The procedure for introducing a drug through a catheter requires high professionalism, since it is rather complicated in execution;
An epidural cannot be administered to a woman in labor during rapid childbirth, since its action begins after 20 minutes, which is why the question of whether everyone is doing it disappears by itself.;
Back pain sometimes occurs after epidural anesthesia.

Among the types of anesthesia, epidural is one of the safest, there are no complications after it.

Spinal anesthesia

Spinal anesthesia begins to act as soon as the drug is injected into the woman's back, blocking sensations below the breast. It works for an hour or two. In addition, for spinal anesthesia, the doctor uses a very thin needle, which is inserted into the area where the cerebrospinal fluid is located. This type of anesthesia can also be used for caesarean section, if strong medications are used.

Additionally, during this procedure, a woman is inserted a catheter into a vein to avoid possible complications.

Many mothers may be concerned about how long such anesthesia works. The answer is: 2 to 4 hours. Epidural acts 2 times less, but there are practically no consequences for the back with it.

Pros of spinal anesthesia:

Lack of pain when the needle is inserted into the spine;
The fetus is not at risk;
The cost is lower than epidural anesthesia;
The woman sees everything, she has a clear consciousness;
Instant effect.

However, this procedure also has disadvantages:

After anesthesia in this way, a woman should lie for several hours without getting up;
After a puncture, after a while, headaches are possible;
Pain symptoms in the back are possible;
The development of hypotension.

Pudendal anesthesia

It is also called local anesthesia, since the doctor only anesthetizes the perineal area. A woman may not feel this, since this is performed during a fight. The need for this anesthesia is caused by an episiotomy. For both the expectant mother and the baby, pudendal anesthesia is not harmful.

General anesthesia

General anesthesia is used during childbirth only in case of urgent need, and only for caesarean section. An indication for such a procedure may be a sharp deterioration in the condition of the child or mother, as well as uterine bleeding. The doctor injects the patient with medicine into a vein, after which the woman falls asleep.

Why is general anesthesia dangerous? By the fact that it affects the fetus, it causes drowsiness and deterioration of blood supply, a negative effect on its nervous system and further physical development. However, this is the best method to save both mom and her baby.

After a while, a woman may experience dizziness, nausea, vomiting, drowsiness, body pain, but these symptoms disappear the next day.

Inhalation anesthesia

This is anesthesia during childbirth, which is used when the cervix is not ready for full disclosure, while the woman in labor is experiencing severe pain from labor. She does not suppress the birth process, the woman quickly regains consciousness. In addition, this method is the safest.

epidural and spinal anesthesia are popular today, these and other techniques have their pros and cons

Postpartum pain relief

Often, doctors are faced with the fact that a woman who has given birth experiences severe pain. What complications can there be after childbirth?

Spasms of the uterus caused by its contractions;
Pain at the tears;
Inability to go to the toilet;
Chest pain;
Improper attachment to the breast, causing cracked nipples.

With the above symptoms, the doctor will offer to drink an anesthetic medicine, and apply medicinal ointment to the place of breaks or incisions. In other cases, pain rarely accompanies a woman, provided she adheres to the rules of hygiene.

Other ways to self-relieve local anesthesia:

Take a shower regularly;
A cooling compress on the perineum (you can use a water bottle and store it in the freezer);
Do not make sudden movements;
You can store your panty liners in the refrigerator to minimize pain.

Medicines for pain relief

They are divided into several types:

Antispasmodics;
Non-narcotic analgesics;
Narcotic analgesics;
Analgesics;
Sedatives.

Antispasmodics

They relieve pain in parturient women well and contribute to the early opening of the cervix, thereby shortening the stage of contractions. Antispasmodics are indicated for young women in labor and older women. There is no risk to the fetus in a woman. These include: no-shpa, papaverine, buscopan.

Non-narcotic analgesics

They have an analgesic and psychological effect, relieving anxiety in a woman in labor. This includes analgin and tramadol.

Narcotic analgesics

They are safe for the child, but for the mother they have a number of side effects:

Nausea, vomiting, dizziness;
Shortness of breath;
Reduce blood pressure dramatically;
Constipation;
Depression.

These include Pentazocine, Pethidine, Butorphanol, Promedol. The latter is the most effective in pain relief.

Analgesics

They block some of the pain sensations, the consciousness remains clear. They have many negative consequences for the child and for the mother. This includes opioids and other pain relievers.

Sedatives

Their action is more aimed at relieving anxiety in the expectant mother, unfortunately, they do not affect the fetus in the best way. The baby may have a decrease in blood pressure and an increase in heart rate, respiratory functions are impaired. This includes Diazepam, Droperidol, Thiopental.

Any pain relieving analgesics carry certain risks for the baby and the expectant mother. However, their use in exceptional cases may be justified.

Pros and cons of anesthesia during childbirth

There are pros and cons to pain relief. To date, opinions on the importance of anesthesia in childbirth are fundamentally divided. Consider the pros of having anesthetized childbirth.

Anesthesia during childbirth: why for?

The obvious benefits of pain relievers are hard to miss:

The opening of the cervix is accelerated, and, accordingly, the time of contractions is reduced;
The baby passes through the birth canal more successfully;
Relieving stress in a woman in labor;
Psychoprophylactic effect on fetal hypoxia.
The drug does not stay in the baby's body, the risk is minimal.

Despite the obvious advantages, anesthesia still has negative consequences.

Anesthesia during childbirth: why against?

Despite the fact that the risk is minimal, it still exists:

Inaccuracy of drug administration;
Drowsiness and lethargy of the child;
The natural dilatation of the cervix is difficult, labor lasts longer;
Contractions often stop, which is undesirable for the birth process;
Women in labor complain of headaches after anesthesia, nausea, body aches.

Whether to do anesthesia during childbirth or not - every woman has the right to decide for herself. On the forums, you can often see positive feedback from young mothers regarding pain relief. Many say that anesthesia during childbirth made the contractions and the pushing phase much easier.

Unfortunately, now more and more women are resorting to childbirth under anesthesia without any visible indications, while not thinking about the side effects. It is very important to listen to the doctor's opinion and understand at what stage of childbirth it is done. In case of rapid labor, anesthesia is contraindicated; in difficult labor, it is recommended.

How much does labor anesthesia cost? The price of anesthesia varies depending on the method of pain relief and the amount of medication.

Does anesthesia hurt? This question worries many expectant mothers. However, if the health of the future baby is on the scales, then this issue fades into the background. In childbirth, it is not easy not only for you, but also for the child. No matter how high-quality modern methods of pain relief are, natural childbirth is always preferable.

The issue of pain relief during childbirth is always relevant for expectant mothers and is resolved each time on an individual basis, depending on many factors.

As the due date approaches, each expectant mother, one way or another, thinks about the upcoming difficulties that are associated with the birth of a child. We are talking about severe pains that invariably accompany the birth process. Of course, each person is different, and for some women, pain during birth is a completely tolerable, albeit unpleasant sensation, while for others it is a source of incredible torment.

It has been proven that in most cases a woman experiencing severe pain for a long time, at the decisive moment, may simply not be ready to give birth to a child in a natural way, the body is exhausted, and the woman in labor simply does not have the strength to push. To prevent this from happening, pain relievers are used during childbirth.

Pain relief during childbirth can be used for a variety of reasons:

As we have already said, the task of pain relief is the comfort of a woman and her readiness for the birth of a child. In a quarter of women in labor, the pain threshold is so low that, while experiencing pain during labor, some simply experience a feeling of panic, may perform inappropriate actions, and do not listen to the doctor's instructions. In this case, the pain reliever used during childbirth is designed to eliminate the woman's restless behavior.
Painful sensations are also relieved if a too large baby or twins are expected, and even during prolonged, or, conversely, premature, or "rapid" childbirth.
It happens that during the labor process, an emergency surgical intervention is required, for example, the application of forceps, or the removal of the placenta. In such cases, special drugs are also used, usually intravenous.
The use of an anesthetic is considered effective if there is a risk of fetal hypoxia, or the expectant mother has weak labor. Here the effect is directed a little in the other direction, and not to relieve pain. With hypoxia, for example, the use of such drugs reduces the risk of oxygen starvation in the baby.

As for the risks associated with the use of drugs that relieve discomfort, then, contrary to popular belief that this can have a detrimental effect on the health of the child, doctors believe otherwise. As we have already said, the issue is resolved individually each time, and the effect is, of course, directed, first of all, to bring benefit, not harm. Of course, each drug has its own list of contraindications, but we will talk about this a little lower when we analyze what modern methods of pain relief exist during childbirth.

Types of pain relief during childbirth

The methods of pain relief during labor can be completely different, from the use of drugs, to techniques that explain how to pain relief during labor yourself. We will start, perhaps, with the pain relief of childbirth in modern conditions, that is, those methods, the main principle of which is one or another introduction of medications into the body.

Pain relief during labor

Medicines designed to reduce pain during labor can enter the body in a variety of ways, from inhalation and compresses to intramuscular and intravenous administration. Let's take a closer look at what and how childbirth is anesthetized.

Inhalation

For such labor pain relief, a mixture of nitrous oxide and oxygen is used. This combination gives a fairly high efficiency and is used during cervical dilatation. The description of this method, by the way, gives an answer to the question "Do labor pain relief in the first period?" The advantage of this method is that the woman herself determines the degree of pain and takes a breath as needed.

Intravenous pain relief

What is injected into a vein during childbirth for pain relief? Most often, these drugs, designed to provide pain relief during childbirth, are various analgesics. By the way, they enter the body not only, but also intramuscularly, and with the help of special compresses. This method of facilitating the prenatal period is aimed at ensuring that a woman can fully rest between contractions and gain the strength that will be needed during attempts.

Sometimes the doctor, when deciding what kind of pain relief to use during childbirth, opts for such a drug as promedol. Although promedol belongs to narcotic drugs, it has been proven that its one-time use will not harm either the mother or the child. This drug is not used at the last stage of labor, otherwise this method can affect the baby's respiratory activity, in other words, it will be difficult for him to take the first breath.

Often, and especially during the birth of the first baby, a situation arises that labor activity is significantly delayed. In such cases, in order to give the expectant mother a rest, doctors put her to sleep.

Epidural anesthesia

Here, birth pain relievers are injected into the back (spine) using a catheter. This method provides almost complete relief from pain symptoms, but it must be remembered that along with the pain, the ability to move independently for some time may disappear. It depends on the dosage of the injected drug, sometimes a woman can fully stand on her feet. The downside is the fact that while using this method, the woman in labor loses the ability to fully push. Therefore, shortly before the onset of attempts, the administration of the drug is suspended.

Non-drug methods of labor pain relief

Methods of natural pain relief during childbirth include quite a lot of the most diverse, and most importantly, safe for the health of mother and child, methods. There are pain relief points during childbirth, and different positions for pain relief, and much more. But first things first.

Psychological preparation

It is very good if the expectant mother knows and understands what exactly awaits her. Getting the right mindset is essential during these difficult hours leading up to the birth of your baby. For mothers giving birth for the first time, there are a variety of schools and courses on pregnancy and childbirth, of course, are recommended to attend.

Reflexology

Or acupuncture. This method is completely safe and, at the same time, very effective. Unfortunately, this method is not very common in our country due to the banal lack of qualified specialists in this area. And it's a pity, because the use of acupuncture in childbirth has a beneficial effect on labor in general, it not only relieves pain.

Water procedures

Having a baby is a long process, and therefore doctors often do not recommend going to the hospital immediately after the first symptoms appear. And to relieve pain at home, the expectant mother can spend some time in a warm bath. During such water procedures, muscle relaxation occurs, due to which the pain becomes noticeably less and much more bearable. In addition, the comfort and home environment will help you tune in to a positive outcome. By the way, some maternity hospitals offer to use a warm shower for the same purposes, already being in the prenatal ward.

Some mothers decide to have a baby in the water. And although the comfort during this method will be higher, do not forget about qualified medical care, which will be fully provided to the expectant mother only at the delivery table.

Massage

Certain, sometimes quite strong stimulation of the points located on the lower back and sacrum, significantly reduces the discomfort that occurs during contractions. A woman can perform such manipulations both independently and with the help of her spouse, or another close person who is next to her during joint childbirth. In the latter case, the effect of the massage will be stronger precisely due to contact with a loved one.

Electrodes

The method is used very rarely, but, nevertheless, it makes sense to talk about it. A fairly safe option for relieving pain, it will not harm either mother or child. In this case, the electrodes are fixed in the lumbar region and the nerve endings are stimulated using alternating current.

Breathing techniques

Correct breathing during contractions is a very important aspect. It is this method that is recommended for use most often. Our body in many situations itself knows what to do, sometimes it needs very little help. If you breathe correctly during contractions, you can not only significantly reduce pain, but also relax the body in general, which is very good for the baby. During correct inhalation and exhalation, the body produces the hormone endorphin, which, entering the bloodstream, plays the role of a natural anesthetic.

Correct behavior

Active behavior during contractions includes the use of various postures that will relieve the spine, as well as swaying, bending, which are used for the same purpose. Often a special ball is used, sitting on which during contractions, the woman in labor reduces pain.

Do these methods of pain relief help with childbirth? Undoubtedly. But only if the woman is focused on the result. Having a baby is hard work and must be taken seriously. Therefore, we prepare in advance, adjust mentally, try not to panic, and then everything will be fine. After all, fear, panic and "pinching" will only intensify the pain, and, moreover, can harm the unborn baby.

Pain relief after childbirth

After the baby is born, pain can occur for several reasons. This is a contraction of the uterus, pain after rupture, discomfort due to a suture obtained as a result of a cesarean section. What pain reliever can be used after childbirth?

There are not many options for anesthetizing the body after childbirth. Strictly speaking, there are only two of them: ibuprofen and paracetamol. But there are a lot of medicines containing these active substances, and they have a different form of release. It can be anesthetic suppositories, and pills, and potions, and injections (the latter are used for pain relief mainly in maternity hospitals.

How much does pain relief during childbirth cost

If you are going to give birth in a state institution, if there are appropriate indications, anesthesia or even anesthesia will be given to you free of charge. Otherwise, the cost of pain medication during labor will vary depending on the qualifications of the anesthesiologist, maternity hospital status, and other factors. For example, rates for can vary from $ 100 to $ 800, depending on each specific case. Therefore, the cost of such assistance during labor is best discussed in advance with the attending physician, as well as its expediency.

Pain relief during childbirth: pros and cons

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A wonderful nine months of waiting have passed, very soon there will be an addition in your family. But, the closer the day of the baby's appearance, the more fears the expectant mother has. Many people want to have labor pain relief. But this is a natural process, every woman can easily cope without anesthetic drugs.

This article will focus on such an issue as labor pain relief, its pros and cons will be described in detail. You will also learn how such interference from obstetricians threatens you and your unborn child. The types can be varied. Which ones exactly? Read on for more details.

Labor pain relief: obstetrics, new methods

During childbirth, pain occurs due to muscle spasm, which is aggravated by the release of adrenaline. Often, a woman has a panic attack that aggravates physical suffering.

Pain relief for childbirth is often not required for a woman who is psychologically prepared and has consciously approached planning the birth of a baby. But still, there are times when anesthesia is performed according to the doctor's instructions.

Indications for pain relief

Anesthesia is given during childbirth if:

premature birth;
strong pain;
prolonged contractions;
multiple pregnancy;
cesarean section;
slow labor activity;
fetal hypoxia;
the need for surgery.

If none of the above is observed, then pain relief during labor is usually not required.

Types of anesthesia

Modern medicine can provide the following types of pain relief during childbirth: medication and non-medication. In this case, your doctor himself must prescribe the type of anesthesia that will not harm you or your child. It should be noted that a woman in labor herself cannot prescribe anesthesia for herself, if there are no direct indications for this.

Non-drug methods of labor pain relief

This safest group of methods is especially popular among obstetricians. What does this refer to? Effective and simple exercises that can be started at any stage of labor: breathing exercises, labor massage, aquatherapy and reflexology.

Despite the availability of more effective medicinal methods, many deliberately abandon them in favor of non-medicinal ones. Natural pain relief during childbirth includes:

activity;
correct breathing;
massage;
childbirth in the water;
reflexology.

The arrival of a baby is the most important event in your life. Non-drug methods of labor pain relief, completely harmless and useful for both you and your baby, will help you to leave only positive impressions of this day.

Activity during labor

It is very important to choose an active position during fights, and not a passive one. Help yourself and your baby to be born.

If you have not complicated labor, then choose exercises for yourself on your own, the main thing is to make it easier for you. However, sudden movements are strictly prohibited. Take note of the following:

rolling from toe to heel;
bends forward and to the side;
swinging the pelvis, circular movements;
flexion and flexion of the spine;
active walking;
swinging on the fitball.

Breathing exercises

It is worth mastering breathing techniques even before childbirth, during pregnancy. The advantage of this method is the possibility of combining it with other types of pain relief. You do not need a doctor's supervision, you yourself are able to control the process. You will feel relief immediately, and most importantly - pull yourself together. There are several breathing techniques. If someone close to you will be present with you during childbirth, he should be familiar with these exercises in order to help you during childbirth.

How it works? You need to distract yourself from the pain by concentrating on your breathing. The deeper and smoother it is, the easier it is for you and your child, because more oxygen is supplied to him. And if this method is used together with the effect will be much better, your child will feel comfortable. There are several periods during which breathing should be different:

first contractions;
an increase in the intensity of contractions;
dilatation of the cervix;
period of attempts.

During the first contractions

This species differs in that it is even and deep breathing, which oxygenates the blood of the child and mother. Concentrate on the account. Inhale through your nose for four counts and exhale through your mouth for six counts. Lips should be folded in a tube. You are distracted from pain, gymnastics has a relaxing effect. It can be used even during times of panic or severe stress to calm down.

With intense contractions

During this period, you need to calm down, now is the time to apply the dog breathing technique. These are superficial, shallow breaths in and out through the mouth, the tongue needs to be pushed out of the mouth a little. You shouldn't think about how you look at the moment, the maternity hospital is a place where you need to think only about your well-being and about your child, especially, believe me, you are not the only one!

The moment of cervical dilatation

This is the very peak, you will not be more painful than now! But you need to endure it, childbirth without anesthesia with a drug method is still preferable. Now it is worth quickening your breathing, making shallow quick breaths and exhalations. Fold your lips in a tube, inhale with your nose, and exhale with your mouth. When the contraction releases, calm down a little, it is better to breathe deeply and evenly. This method can slightly ease acute pain.

Period of pushing

All the worst is over, there are no more contractions. Your baby will be born very soon. If childbirth is not complicated, then the child will appear after 1-2 attempts. You need to push 2-3 times per push. Do not panic, because now is the final moment, almost painless. If you feel sorry for yourself and do not obey the orders of the obstetrician, you will have to use tools, from which there will be quite painful sensations. When the pushing begins, you need to take a deep breath-exhale-deep breath and hold your breath for 10-15 seconds, while pushing. Do not push into the anus or straining your eyes, as you can get hemorrhoids, stroke and other unpleasant and dangerous consequences.

Another important announcement: the period between contractions and pushing is needed in order to rest, relax, and even out your breathing. You need to train daily during pregnancy so that you can pull yourself together during childbirth. Bring your breathing to automaticity, and you will be in control of yourself and make your birth easier.

Other options

Modern methods of labor pain relief include a large list of all kinds of procedures, but massage, water birth and reflexology are especially effective (non-drug).

How to Massage During Contractions? There are points on the body, by acting on which you can noticeably reduce and soothe pain. In our case, the sacral area. You can do this both independently and ask the person who is nearby. This area can be stroked, pinched, massaged, lightly tapped. To avoid redness and irritation in the massage area, periodically lubricate the area with cream or oil.

How does water help? In a warm bath, the pain of contractions is easier to tolerate, and water also has a relaxing effect. The expectant mother can take a comfortable position for herself and just relax, while you will avoid chills, fever and sweating, dry skin.

What is reflexology? Modern pain relief of childbirth also includes such a method as acupuncture. It helps to improve labor and reduce the pain of contractions. As you can see, there are a lot of options, which one you choose is your personal decision.

Medication pain relief

In addition to the above natural methods, there are more effective, but, accordingly, more dangerous. Modern methods of medication for pain relief during labor include the following:

epidural block;
spinal block;
spinal-epidural combination;
drugs;
local anesthesia;
perineal block;
tranquilizers.

Epidural block

Everyone has heard, but not everyone knows the intricacies of this procedure. Let's start with the fact that during childbirth it can be both partial and complete. If childbirth takes place naturally, then drugs are administered on the basis that they are only enough for the first (that is, contractions), during the attempts, the effect of the drug ends. In this case, only pain signals in the area below the navel are blocked, the motor ability remains, the person is conscious and can hear the first cries of his baby. If you wish or for special indications, the second stage of labor (pushing) can also be anesthetized, but this is dangerous, since you do not feel the signals from your body and the birth can be significantly delayed or go wrong at all. If there is no such need, then do not anesthetize the attempts, during them the pain is more bearable.

The second option - In this case, a dose is injected more than in the previous option, and motor activity is also blocked. The advantage of such anesthesia is the ability to immediately see the baby and hear him.

Spinal block

This is also an injection that is done in the lower back, into the fluid around the spinal cord. It is less costly than epidural anesthesia.

you remain conscious;
the effect lasts two hours;
anesthetizes the whole body from the thoracic region and below.

can cause severe headaches;
lowers blood pressure;
may cause breathing difficulties.

Spinal-epidural combination

This is a relatively new technology when the two above methods are combined. Such anesthesia lasts much longer, while the mother is conscious. The first two hours are followed by the epidural.

Drugs

As strange and controversial as it sounds, drugs are also used during childbirth, but extremely rarely, in special cases. What drugs are used? It:

"Promedol";
Fortal;
"Lexir";
"Pethidine";
"Nalbuphin";
"Butorphanol".

Narcotic substances can be injected both intramuscularly and intravenously (through a catheter), the second option is the most successful, since the dosage of the drug can be regulated. This method is good because the pain is blocked for about six hours and the woman in labor can rest. The effect comes in a couple of minutes. Of course, there are also negative sides: it is possible that breathing slows down both for you and for the child.

Local anesthesia

It is not used to relieve pain during labor, but it is very effective for making an incision in the vagina or stitches after tears. The injection is done directly into the vaginal area, the effect occurs almost instantly, temporarily painful sensations in the area of the injection are blocked. Neither you nor your child can have any bad side effects.

Perineal block

The injection is done directly into the vaginal wall, while pain is blocked on only one side. Such an injection is given just before the baby is born. The effect of the drug is no more than an hour and has no side effects. This type of anesthesia is not suitable for the period of labor.

Tranquilizers

Tranquilizers are used to relax, injections are given at the first stage, when contractions are rare and not so sensitive. Such medication pain relief of childbirth dulls awareness and has a hypnotic effect, lowering the child's activity, but at the same time does not completely relieve pain. Tranquilizers can be in the form of tablets, or administered intravenously or intramuscularly. When administered intravenously, the effect is immediate.

Postpartum period

Anesthesia is also carried out after childbirth. What for? So that a woman can relax and gain strength. What may be troubling:

spasms caused by contraction of the uterus;
places of breaks and cuts;
difficult trips to the toilet;
chest pain;
cracking of the nipples (with improper feeding).

If the pain is caused by tears and cuts, then pain pills or ointments are offered, but if the birth was taken correctly and you follow personal hygiene, then there should be no pain, or it should be minimal. During suturing, the doctor is obliged to anesthetize, and how this will happen should be discussed with you in advance.

There are several ways to minimize pain:

frequent and short water treatments;
special cooling pad (helps to avoid swelling);
keep pads in the refrigerator (they will dull pain);
tune in for a speedy recovery;
less disturb the place of cuts and tears (avoid infection, do not make sudden movements, this will contribute to a quick recovery);
sitting on a special cushion (exerts minimal pressure on the problem area).

The pain associated with contraction of the uterus goes away on its own a week after the birth of the baby. To reduce them:

do special exercises;
lie on your stomach;
do a massage.

The following exercise will help with back pain: Lie on a hard surface, bend your right knee and hold the knee with your right hand. With your left hand, guide the heel of your right foot towards your groin. Stay in this position for a few seconds, rest and repeat the exercise. If your back hurts on the left side, then do the same with your left leg.

The human body is permeated with hundreds and thousands of nerve endings. They quietly "live" in their tissues, we do not notice their presence. But as soon as the nerve roots are unceremoniously disturbed by a mechanical stimulus, they very loudly declare themselves with instant pain. Remember how it hurts if you accidentally inflicted even a seemingly insignificant cut on yourself or banally pricked yourself with a sharp object.

What can we say about surgical manipulations, from small outpatient interventions to hours-long operations in a hospital, when the surgeon's hands, his scalpel, clamps, tweezers and the whole honest company of mechanical stimuli fiddle with tissues and nerve endings in them? If the nerve branches of the body were disturbed for such a long time, the person would die from painful shock. Therefore, during surgical procedures, anesthesia, or anesthesia, comes to the aid of surgeons.

Table of contents:

What does the term "anesthesia" mean?

The elegant word "anesthesia" is deciphered as follows: "an-" - means negation, "-esthesia" - translated from ancient Greek as "sensitivity". That is, anesthesia is any method (or a set of methods) that leads to a temporary decrease or disappearance of tissue sensitivity.

Types of pain relief

There are two large groups of pain relief:

local(when the sensitivity of certain tissues of the human body "turns off");
general(when a person, figuratively speaking, is asleep and does not feel anything).

Let's make a reservation right away that anesthesia is only general, such a thing as "local anesthesia", No- nevertheless, this erroneous term is deeply rooted in patients' near-surgical conversations. You will captivate your surgeon if you ask the following: "Is the operation to be performed under local anesthesia or general anesthesia?"

Each of the mentioned groups of anesthesia includes several options for pain relief. The choice depends on:

Varieties of local anesthesia:

superficial;
infiltration;
guiding regional and central.

Varieties of general anesthesia:

inhalation anesthesia;
intravenous anesthesia;
endotracheal (or intubation) anesthesia.

Superficial anesthesia

Popular in dentistry, ophthalmology, otorhinolaryngology, outpatient (that is, in outpatient settings) surgery and traumatology.

For the purpose of superficial anesthesia, the skin or mucous membranes are lubricated or sprayed with preparations containing an ingredient that blocks impulses in the nerve roots and prevents pain from developing during surgical manipulation.

With superficial anesthesia, such forms of drugs are used as:

ointments;
gels;
creams;
sprays.

"Pros": the concentration of pain relievers is low, so they almost never cause side effects.

"Minuses": With this anesthesia, a short-term surgical procedure can be performed on a limited area of the body.

Indications: used if you need to perform any manipulations in the tissues located superficially.

Contraindications: individual intolerance to the anesthetic.

Infiltration anesthesia

It is used when the doctor needs to get deep into the tissues in order to perform a small amount of manipulation (operation):

Previously, infiltration anesthesia was practiced by individual surgeons for some abdominal operations (for example, with appendectomy), but did not become popular in such cases, since, to put it mildly,did not give a full effect.

For infiltration anesthesia, an anesthetic (novocaine, lidocaine, trimecaine or others) is drawn into a syringe and injected into the tissue step by step, layer by layer.

The algorithm of action is as follows:

the very first injection of an anesthetic drug is performed intradermally (the so-called "lemon peel" is made);
the needle is pushed deeper and deeper, while gradually and evenly injecting an anesthetic drug throughout the volume of tissues that will be involved in a surgical manipulation or operation (figuratively speaking, they "saturate" the tissues with anesthetic, like a cake with syrup).

An ideally performed infiltration anesthesia is one during which the patient feels only the first needle prick.

"Pros": anesthetics for infiltration anesthesia act at the local level without causing harm to organs and organ systems.

"Minuses": the impossibility of expanding, if necessary, the operating field without the introduction of an additional dose of anesthetic (for example, if pus leaks were found with an abscess, which need to be thoroughly sanitized (cleaned out), but which are outside the zone of anesthesia).

Indications: simple and short-term surgical procedures and operations.

Contraindications: high pain threshold of the patient, extensive surgical field, individual intolerance to drugs for anesthesia.

Conductive anesthesia

Often the volume of the operation is assumed to be such that it is necessary to "turn off" the sensitivity of a large array of tissues. Instead of performing infiltration anesthesia for a very long time and injecting a large amount of anesthetic into the tissue, doctors came up with the idea of blocking a large nervous structure, on which sensitivity in a specific area of the body depends. At the same time, the transmission of nerve (pain) impulses in a variety of nerve branches, branches and small nerve endings that extend from a given large structure (nerve trunk, plexus, and so on) is automatically blocked.

Conductive anesthesiawideused for surgical interventions in:

traumatology;
orthopedics;
vascular surgery;
urology;
maxillofacial surgery;
obstetrics and gynecology;
abdominal surgery;
purulent surgery;
proctology.

Varieties of regional anesthesia:

Varieties of conductorcentral anesthesia:

spinal- the anesthetic is injected into the subarachnoid space, where it is evenly distributed and blocks impulses in the spinal roots, which (impulses) will no longer disturb the spinal cord;
- the anesthetic is injected into the epidural space without piercing the dura mater (which is an undoubted "plus" of this type of conduction central anesthesia);
caudal- "daughter" version of epidural anesthesia at the lowest level of the spine - the level of the sacrum ("cauda" is translated from Latin as "tail").

"Pros": the patient can contact the surgeon, his partial motor activity remains, there is no systemic toxic poisoning with the anesthetic, because it is not injected into the bloodstream.

"Minuses": the ability to injure large nerve structures with a needle.

Indications: the need to anesthetize large areas of tissue, the impossibility of performing inhalation, intravenous or endotracheal anesthesia (for example, in the elderly, with severe diseases of the respiratory and cardiovascular systems).

Contraindications: inability to perform due to anatomical features (for example, deformity of the spine or scar tissue at the puncture site with a needle).

Inhalation anesthesia

It is in the competence of anesthesiologists. It is one of the types of anesthesia that are often used and loved by anesthesiologists for the reason that it is easy to perform and acts for a short time (after small surgical interventions, you do not need to wait long for the patient to get out of medication sleep).

The technique of carrying out inhalation anesthesia is pretty straightforward. Through a mask, drugs are injected into the respiratory system that induce drug sleep. It "disconnects" the patient from the outside world and its stimuli - most importantly, from pain due to the introduction of surgical instruments into the tissue.

Most often, narcotan, nitrous oxide, trilene, fluorothane, etran are used for inhalation anesthesia.

"Pros": Relatively easy to manage.

"Minuses": short duration - and this is not in the hands of the surgeon, he is forced to perform the manipulation promptly so that the patient does not wake up before it ends.

Indications: simple and short-term manipulations, which, however, require that the patient be put into medication sleep.

Contraindications: acute diseases of the respiratory system.

Intravenous anesthesia

The name speaks for itself - the patient is immersed in medication sleep after intravenous administration of drugs. Intravenous anesthesia is more complicated because it requires the calculation of the doses administered. But in comparison with inhalation anesthesia, its “plus” is unambiguously that it acts more long-term and deeply - figuratively speaking, the patient sleeps better.

It is used for simple, short-lived and uncomplicated surgical interventions in a hospital (appendectomy, suturing of extensive wounds, sometimes hernia repair, and so on, as well as for surgical interventions in children). It is applicable in outpatient surgery if the patient refuses to be admitted to the hospital, and the surgical intervention can be performed in the operating room or dressing room of the polyclinic department, but it can be delayed or fraught with pain. First of all, we are talking about opening huge abscesses, requiring thorough sanitation (cleaning of pus), painful manipulations in the perineum and rectum, and so on.

For classical anesthesia, thiopental, recofol, sodium oxybutyrate are used, for ataralgesia (surface anesthesia) - sibazon with fentatil.

"Pros": immerses you in a medication sleep of sufficient depth.

"Minuses": does not provide muscle relaxation during major and prolonged surgical operations.

Indications: stationary surgical interventions of medium level of complexity.

Contraindications: diseases of the CVS (cardiovascular system), certain diseases of the respiratory system (for example), severe disorders of the central nervous system and psyche.

Endotracheal (intubation) anesthesia

This is the most difficult of all without anesthetic methods. At the same time, it is the most effective one. During his time, the patient not only falls deeply into sleep - with the help of special preparations, the muscles relax, which is very important for the convenience of surgeons performing many of the components of the operation.

Muscle relaxants drugs that relax the muscles, including "turn off" the diaphragm and intercostal muscles - the patient cannot breathe on his own, so he is connected to the external respiration apparatus using an endotracheal tube. Hence the name of this method of anesthesia.

Stages of endotracheal anesthesia the following:

intravenous administration of drugs that immerse the patient in medication sleep;
the introduction of muscle relaxants that "turn off" the muscles;
tracheal intubation (introduction of a laryngoscope into the trachea, and with its help - an endotracheal tube);
artificial ventilation of the lungs and maintaining the state of medication sleep.

"Pros": provides complete immobilization of the patient, which means absolute freedom of action for surgeons who do not need to overcome the patient's muscle tension during the operation.

"Minuses": difficult to perform, involves the introduction of a whole mix of drugs (in particular, narcotic and muscle relaxants), which can subsequently be reflected in the activity of the central nervous system.

Indications: long-term complex abdominal surgery for diseases of the biliary system, stomach, intestines, retroperitoneal organs and chest, peritonitis, and so on.

Contraindications: diseases of the respiratory and cardiovascular systems, old age.

About the ideal method of anesthesia

He's gone. Each method of pain relief is appropriate under certain conditions. When choosing an anesthesia method, it is necessary to take into account the upcoming surgical manipulation (in particular, its volume and duration), carefully analyze the clinical situation, the patient's condition, the presence of concomitant diseases, indications and contraindications for performing one or another method of anesthesia.

Oksana Vladimirovna Kovtonyuk, medical commentator, surgeon, consultant physician