Title Spinalna analgezija tijekom poroda - prednosti i nedostaci
Title (english) Spinal analgesia during childbirth - advantages and disadvantages
Author Antonio Kauzlarić
Mentor Vlatka Sotošek Tokmadžić (mentor)
Committee member Alen Protić (predsjednik povjerenstva)
Committee member Janja Tarčuković (član povjerenstva)
Committee member Aleks Finderle (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Anaesthesiology,reanimatology and Intensive Care) Rijeka
Defense date and country 2023-07-14, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Anesthesiology and Reanimatology
Abstract Intenzitet porođajne boli utječe na rodiljin doživljaj poroda. Porođajna bol uzrokovana je kontrakcijama maternice i prolaskom ploda kroz porođajni kanal. Najzastupljenija farmakološka metoda obezboljavanja tijekom poroda je neuroaksijalna anestezija, u koju spada i spinalna analgezija. Lijekovi koji se koriste u spinalnoj analgeziji su lokalni anestetici kojima se mogu dodati niske doze opioidnih analgetika. Svrha ovoga rada je analizom dostupne literature i istraživanja prikazati najznačajnije prednosti i nedostatke spinalne analgezije tijekom poroda. Brz nastup djelovanja spinalne analgezije, učinkovito smanjenje intenziteta boli i niska incidencija komplikacija i nuspojava jedne su od najznačajnijih prednosti spinalne analgezije tijekom poroda. Niska doza opioida u spinalnoj analgeziji prema prikazanim istraživanjima u dozi u kojoj se primjenjuje ne utječe na rezultate Apgar testa, stoga nema negativne učinke na plod. Komplikacije se mogu podijeliti na one uzrokovane tehnikom izvođenja i uzrokovane lijekovima koje smatramo nuspojavama. Svaki lijek mora se primijeniti u adekvatnoj dozi, a nuspojave zbog neadekvatne doze lijeka mogu biti blaže poput svrbeža, mučnine i povraćanja pa sve do težih poput totalnog spinalnog bloka ili sistemske toksičnosti. Osim brige o pravilnoj dozi lijeka bitna je i vještina izvođenja spinalne analgezije. Oprezan i pravilan način izvođenja spinalne analgezije smanjuje rizik od infekcije, a također pravilno odabrano mjesto uboda i smjer igle smanjuju mogućnost ozljede živaca i leđne moždine. Odabir adekvatne veličine i oblika spinalne igle smanjuje rizik od postpunkcijske glavobolje. Iako komplikacije i nuspojave postoje, s obzirom na jako nisku incidenciju, koristi spinalne analgezije nadmašuju eventualne rizike od komplikacija.
Abstract (english) The intensity of labor pain affects the mother's experience of childbirth. Labor pain is caused by uterine contractions and the passage of the fetus through the birth canal. The most common pharmacological method of analgesia during childbirth is neuraxial anesthesia, which also includes spinal analgesia. Medications used in spinal analgesia are local anesthetics, to which low doses of opioid analgesics can be added. The purpose of this work is to present the most significant advantages and disadvantages of spinal analgesia during childbirth by analyzing the available literature and research. The rapid onset of action of spinal analgesia, effective reduction of pain intensity and low incidence of complications and side effects are one of the most significant advantages of spinal analgesia during childbirth. According to the presented research, the low dose of opioids in spinal analgesia in the dose in which it is administered does not affect the results of the Apgar test, therefore it has no negative effects on the fetus. Complications can be divided into those caused by the execution technique and those caused by drugs that we consider side effects. Each drug must be administered in an adequate dose, and side effects due to an inadequate dose of the drug can be mild, such as itching, nausea, and vomiting, to more severe, such as total spinal block or systemic toxicity. In addition to taking care of the correct dose of the drug, the skill of performing spinal analgesia is also important. A careful and correct way of performing spinal analgesia reduces the risk of infection, and also a properly chosen injection site and needle direction reduce the possibility of nerve and spinal cord injury. Choosing the appropriate size and shape of the spinal needle reduces the risk of post-puncture headache. Although complications and side effects exist, considering the very low incidence, the benefits of spinal analgesia outweigh the possible risks of complications.
Keywords
porođajna bol
neuroaksijalna anestezija
spinalna analgezija
lokalni anestetici
opioidni analgetici
Keywords (english)
labor pain
neuraxial anesthesia
spinal analgesia
local anesthetics
opioid analgesics
Language croatian
URN:NBN urn:nbn:hr:184:631511
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2023-06-23 08:35:39