OB Anesthesia

Question 1

What are parenteral opioids used for OB anesthesia?

Answer 1

Cause N/V.
Fentanyl
Morphine
Nalbuphine (mixed agonist-antagonist so less respiratory depression)
Butorphanol (mixed agonist-antagonist so less respiratory depression)
Remifantanil (PCA) - most short acting!

Question 2

Which analgesics should you avoid in patients receiving full opioid agonist treatment course (eg. hydrocodone)

Answer 2

mixed agonist-antagonist (nalbuphine, butorphanol, pentazocine) or partial agonist (buprenorphine) bc can cause withdrawal

Question 3

What are risks of local anesthestics used for anesthesia?

Answer 3

used for blocks (pudendal nerve)
- allergic reactions
- Toxicity from large amount or in vasculatory system: seizures/coma or cardiac (arrhythmias, myocardial depression). seizures/comas occur first!
- correct hypoxemia and acidosis w/ IV lipids

Question 4

Why do we avoid meperidine in labor?

Answer 4

Long half-life and metabolite CANNOT be antagonized by naloxone

Question 5

epidural analgesia prolongs second stage of labor by how many minutes?

Answer 5

5-10 min