Obstetric analgesia using a bilateral thoracic paravertebral block technique: An experience report in a usual risk maternity
DOI:
https://doi.org/10.33448/rsd-v10i6.15712Keywords:
Natural childbirth; Analgesia, Obstetrical; Epidural block; Paravertebral block.Abstract
Objective: To report an experience of using thoracic paravertebral block as an alternative to obstetric analgesia. Method: Experience report on the performance of an analgesia technique that was used to contribute to obstetric analgesia and natural childbirth of a pregnant woman with indication for cesarean section due to phobia of the pain of natural childbirth. The experience was in a maternity ward of a medium-sized philanthropic hospital, in the countryside, in the state of Rio Grande do Sul. Results: Bilateral paravertebral thoracic block was the analgesic method chosen for not using the neuro-axis as an anatomical substrate and do not produce hemodynamic fluctuation in the patient and consequences in the fetus. After receiving analgesia, the pregnant woman did not experience pain in the first stage of labor. This technique, in this case, allowed the indication of cesarean section due to phobia of labor pain to be reviewed by the obstetric team and the childbirth developed in a natural way. The maternity nursing team is central to the use of this technique, to conduct monitoring and care for the parturient. Conclusion: Obstetric analgesia contributes to the humanization of natural childbirth. It is necessary to encourage this practice, since it alone tends to increase the number of natural births, considering that in the first prenatal consultation, some pregnant women have the desire to perform cesarean delivery for fear of pain.
References
Anim-Somuah, M., Smyth, R. M., & Jones, L. (2011). Epidural versus non-epidural or no analgesia in labour. The Cochrane database of systematic reviews, (12), CD000331. https://doi.org/10.1002/14651858.CD000331.pub3
Antipin, É. É., Uvarov, D. N., Nedashkovskiĭ, É. V., & Kushev, I. P. (2014). Epidural analgesia in the first stage of labor--is there an alternative? Anesteziologiia i reanimatologiia, (1), 18–22.
Batista Filho, M., & Rissin, A. (2018). A OMS e a epidemia de cesarianas. Revista Brasileira de Saúde Materno Infantil, 18(1),3-4. https://doi.org/10.1590/1806-93042018000100001
Bouman, E., Sieben, J. M., Balthasar, A., Joosten, E. A., Gramke, H. F., van Kleef, M., & Lataster, A. (2017). Boundaries of the thoracic paravertebral space: potential risks and benefits of the thoracic paravertebral block from an anatomical perspective. Surgical and radiologic anatomy: SRA, 39(10), 1117–1125. https://doi.org/10.1007/s00276-017-1857-4
Brasil, Ministério da Saúde. (2017) Diretrizes Nacionais de Assistência ao Parto Normal. Brasília – DF.
Brasil. Ministério da Saúde. Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher – PNDS (2006) dimensões do processo reprodutivo e da saúde da criança/ Ministério da Saúde, Centro Brasileiro de Análise e Planejamento. – Brasília: Ministério da Saúde.
Chau, A., & Tsen, L. C. (2018). Update on Modalities and Techniques for Labor Epidural Analgesia and Anesthesia. Advances in anesthesia, 36(1), 139–162. https://doi.org/10.1016/j.aan.2018.07.006
Fiocruz. (2014) Nascer no Brasil – Inquérito Nacional sobre Parto e Nascimento. http://www6.ensp.fiocruz.br/nascerbrasil/.
Gayeski, M. E. & Brüggemann, O. Maria. (2010). Métodos não farmacológicos para alívio da dor no trabalho de parto: uma revisão sistemática. Texto & Contexto - Enfermagem, 19(4), 774-782. https://doi.org/10.1590/S0104-07072010000400022
Maia, M. B. (2010). Humanização do parto: política pública, comportamento organizacional e ethos profissional. Rio de Janeiro: Editora Fiocruz.
Morgan, G. E. & Mikhail, M.S., (2018). Clinical Anesthesiology. 6 ed. LANGE.
Okutomi, T., Taguchi, M., Amano, K., & Hoka, S. (2002). Paravertebral block for labor analgesia in a parturient with idiopathic thrombocytopenia.Masui. The Japanese journal of anesthesiology, 51(10), 1123–1126.
Penuela, I., Isasi-nebreda, P., Almeida, H., López, M., Gomez-Sanchez, E. & Tamayo, E. (2019). Epidural analgesia and its implications in the maternal health in a low parity comunity. BMC Pregnancy Childbirth, 19(1):52. https://doi.org/10.1186/s12884-019-2191-0
Dodd, M., Hunsley, J. (2011). Thoracic paravertebral block: landmark techniques anaesthesia tutorial of the week 224. Disponível em: https://resources.wfsahq.org/atotw/thoracic-paravertebral-block-landmark-techniques/
Silva, A. D. V., Cunha, E. A. & Araújo, R. V. (2020). The benefits of integrative and complementary practices in childbirth work. Research, Society and Development, 9(7): 1-16, e614974468. doi: http://dx.doi.org/10.33448/rsd-v9i7.4468
Montenegro, C. A. B. (2012). Operação cesária. In: Montenegro, C. A. B., Rezende Filho, J. Rezende obstetrícia fundamental. 12ª ed. Rio de Janeiro: Guanabara Koogan; p. 634-46.
Novo, J., Pellicciari, C., Camargo, L., Bálsamo, S., & Novo, N. (2017). Indicações de partos cesáreos em hospitais de atendimento ao Sistema Único de Saúde: baixo e alto riscos. Revista da Faculdade de Ciências Médicas de Sorocaba, 19(2), 67-71. https://doi.org/10.23925/1984-4840.2017v19i2a4
Fernandes, R. L.V., Damasceno, A. K. C., Herculano, M. M. S., Martins, R. S. T, Oriá M. O. B. (2017). Analgesia obstétrica farmacológica: um estudo sobre os desfechos obstétricos e neonatais. Revista Rene. 18(5):687-94. doi: 10.15253/2175-6783.2017000500017
Silva, Y. A. P., Araújo, F. G., Amorim, T., Francisca Martins, E., & Felisbino-Mendes, M. S. (2020). Analgesia obstétrica no trabalho de parto e sua associação com desfechos neonatais. Revista Brasileira de Enfermagem, 73(2), e20180757. doi: https://dx.doi.org/10.1590/0034-7167-2018-0757
Oliveira, J., Campos, T., Souza, F., Davim, R., & Dantas, J. (2016). Percepção de enfermeiros obstetras na assistência à parturiente. Revista de Enfermagem UFPE on line. 10(10, 3868-3875. doi: 10.5205/reuol.9667-87805-1-ED1010201619
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