Анестезия при родах

Во время родов происходит спазм мышц, что вызывает сильнейшую боль. Это может вызывать у женщин приступы панической атаки, что приводит к усугублению положения. Обезболивание во время родов представляет собой медицинскую процедуру, целью которой является обеспечить рожающей женщине максимально комфортные условия. Уменьшить стресс путем устранения болевых ощущений. Это очень значимый процесс, который способен повлиять на дальнейшее течение родовой деятельности.

анестезия при родах

Виды обезболивания при родах

Методы обезболивания во время родов можно разделить на два вида: медикаментозный, немедикаментозный или естественный.

Естественные методы обезболивания

Немедикаментозные методы снятия родовой боли являются самыми безопасными. Несмотря на то, что лекарственные методы более эффективны, многие женщины намеренно отдают предпочтение естественному обезболиванию, так как этот метод не несет никаких негативных последствий.

К естественным методам обезболивания относятся:

  • разные виды техник дыхания;
  • массаж;
  • релаксация;
  • акватерапия;
  • рефлексотерапия и др.

Если врач одобрил роды без медикаментозного вмешательства, и процесс пойдет естественным путем, то женщине следует вести себя активнее. Пассивное поведение не принесет облегчения и только затянет процесс. Нужно постоянно ходить, совершать плавные круговые движения тазом. Главное не совершать резких движений.

  • Техники дыхания

Начинать осваивать разные техники дыхания нужно еще до родов. Тогда женщине будет проще отвлекаться от боли, концентрируя свои мысли на правильном дыхании. Ребенку это принесет лишь пользу, чем правильней мама будет дышать, тем больше кислорода он получит.

  • Акватерапия

Сегодня в основном все частные родильные дома и платные палаты оборудованы отдельными душевыми кабинами. Этим можно активно пользоваться, например, поливать живот теплой водой из душа. Это снимет мышечный спазм, и боль станет гораздо тише.

  • Массаж

На теле женщины существуют отделы, массируя которые, можно значительно облегчить боль. Расположены они в поясничном и крестцовом отделах спины.

естественное обезболивание при родах

Медикаментозные виды анестезии

Обезболивание с помощью медикаментов включает в себя следующие виды:

  • эпидуральная анестезия;
  • спинальная блокада;
  • спинально-эпидуральный комплекс;
  • наркотики;
  • общий наркоз;
  • промежностная анестезия.

Все эти методы гораздо эффективнее естественных видов обезболивания. Однако каждый из них может нести негативные последствия, как для роженицы, так и для ребенка. Поэтому назначить медикаментозную анестезию может только врач, который будет тщательно следить за ходом протекания родового процесса, чтобы быть уверенным, что ребенок находится в безопасности.

Эпидуральная блокада

Эпидуральная анестезия проводится в область позвоночника. Проводить данную процедуру позволено только опытному врачу анестезиологу. Врач вводит катетер с препаратом в межпозвоночное пространство, при этом женщина должна находиться в неподвижном состоянии, чтобы исключить риск неправильного попадания.

Анестезиолог внимательно следит за состоянием роженицы, фиксируя реакцию тела на препарат. Эффект отмечается спустя пол часа после применения препарата. При естественных родах происходит частичное обезболивание, действия препарата хватает только на период схваток.

При этом происходит блокада болевых ощущений в области ниже пупка с сохранением двигательной активности. При рождении ребенка путем кесарева сечения, используют большую дозу препарата. Блокируются болевые ощущения и двигательная активность ниже грудной клетки. При этом женщина прибывает в сознании и может увидеть малыша в первые секунды жизни и услышать его крик.

Плюсы эпидуральной анестезии

  • Риск для новорождённый минимален;
  • Препарат вводится на протяжении периода схваток, если нет противопоказаний со стороны состояния роженицы;
  • Препарат не воздействует на сердечно сосудистую систему.

Минусы эпидуральной блокады

  • На многих женщин такой вид обезболивания не действует, и они продолжают испытывать боль;
  • При стремительном течении родовой деятельности применение эпидуральной анестезии исключается, так как для действия препарата нужно некоторое время.
  • Последствиями для мамы после применения эпидуралки, нередко бывают боли в спине, которые могут остаться на всю жизнь, травмы межпозвоночного пространства, занесение инфекции.
  • Для введения катетера в межпозвоночное пространство нужно обладать высоким профессионализмом.
  • Последствием для ребенка могут стать понижение частоты сердечных сокращений, нарушение развития моторики.

Показания к применению эпидуральной анестезии

  • Гипоксия ребенка;
  • Слабая родовая деятельность;
  • Особенно болезненный, изматывающий период схваток;
  • Показания к оперативному вмешательству, например неправильное положение плода, обвитие пуповиной или многоплодная беременность.

Противопоказания к эпидуральной анестезии

  • Нарушенная свертываемость крови;
  • Инфекционное заболевание;
  • Низкое давление;
  • Патологические изменения позвоночника.

Стоимость эпидуральной анестезии

В государственных учреждениях процедура проводится бесплатно. В частных родильных домах стоимость колеблется от 5000 до 10000 рублей.

Спинальная блокада

Эта инъекция вводится в нижний отдел спины. Действует этот способ обезболивания моментально, блокируя боль ниже грудной клетки. Действие препарата длится 2-3 часа. Введение производится в область спинномозговой жидкости тонкой иглой. Этот вид обезболивания могут использовать и для проведения кесарева сечения, однако концентрация препарата будет выше.

Плюсы спинальной блокады

  • Безболезненное введение инъекции;
  • Отсутствие риска для плода;
  • Быстрое действие;
  • Бюджетная стоимость.

Недостатки спинальной анестезии

  • После введения инъекции несколько часов запрещено вставать с постели;
  • Способно вызвать сильные головные боли;
  • Может наблюдаться затрудненность дыхания.

Показания к применению спинальной анестезии

  • Оперативное вмешательство в процесс родов.
  • Изматывающий период схваток.

Противопоказания к спинальной блокаде

  • Нарушения строения позвоночника;
  • Гипертония;
  • Пороки развития плода;
  • Кожные инфекции;
  • Аллергия на препарат.

Стоимость спинальной анестезии

В среднем стоимость спинальной блокады варьируется от 1500 до 5000 рублей в платных родильных домах. В государственных учреждениях эта процедура проводится бесплатно.

Спинально-эпидуральный комплекс

Относительно недавно появившийся метод обезболивания родовой деятельности. Заключается в комбинации двух препаратов. Отличается длительностью блокирования болевых ощущений. Первые несколько часов работает спинальная анестезия, потом срабатывает эпидуральная.

Обезболивание наркотическими препаратами

Как бы странно это не звучало, но в крайне тяжелых случаях доктор может принять решение провести обезболивание наркосодержащими препаратами.

Например:

  • бутофранолом;
  • промедолом;
  • лексиром.

Эти препараты вводятся как внутримышечно, так и через катетер внутривенно. Происходит блокировка боли в среднем на 5-6 часов, что дает женщине возможность набраться сил и отдохнуть. Этот метод используется только по назначению доктора и под его тщательном наблюдением. Так как при использовании этих препаратов может наблюдаться замедление дыхание у роженицы и плода.

Местная анестезия

Используется только для обезболивания влагалища при необходимости эпизиотомии или наложении швов на послеродовые разрывы. Эффект наступает мгновенно, убирая боль в месте инъекции. Никаких побочных эффектов ни у мамы, ни у ребенка это вызвать не может. Местное обезболивание применяется на усмотрение акушерки или врача.

Промежностная (пудендальная) анестезия

Укол делается в стенку влагалища, делая боль при проходе ребенка через родовые пути менее болезненной. Никаких негативных последствий эта инъекция не имеет.

Общий наркоз

Используется только в случае крайней надобности: при операции кесарева сечения, сильном ухудшении состояния роженицы или плода, маточных кровотечениях. Препарат вводится внутривенно, после чего женщина впадает в состояние близкое ко сну. Общий наркоз влияет на кровообращение плода, его ЦНС и отражается на дальнейшем развитии ребенка. Поэтому прибегают к такому методу только в том случае, если другого выхода спасти женщину и ребенка нет.

обезболивание при родах

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