Faculty of Medicine
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Item type:Publication, Obstetric anesthesia: present aspects(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2017-11); ; Ivanov, EmilijaThe study reviews the well-established ways to apply labor analgesia which are practiced widely, with a simultaneous analytical overview of current and influential aspects in the field of obstetric anesthesia. In the introduction, attention is paid to the global morbidity and the morbid- ity trend in the field of obstetric anesthesia, which shows positive changes, primarily as a result of more frequent application of regional obstetric anesthesia in general. The current procedures and methods with their specifics have been analyzed, as well as up-to-date data regarding side effects, which have been duly addressed. Special emphasis on the respiratory depression risk caused by intrathecal opioid route is considered, whose usability is very common today. From that aspect, the study is conceived as an opportunity for better information and understanding of the current aspects of obstetric anesthesia, with the ultimate goal of improving the final outcome of the process of labor, thus implicating better well-being for both mother and newborn. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Intravenous Remifentanil for Labor Analgesia - A Review(Medical Faculty Ss. Cyril and Methodius University in Skopje, 2016); ; ; In modern obstetrics there has been a need for safe, efficient, and easy-to-use systemic analgesia with a rapid and short onset, and without an effect on either mother or fetus. Although epidural analgesia remains the gold standard for labor analgesia, opioids applied intravenously can be very useful in cases when epidural analgesia is contraindicated, refused by the patient, or in the absence of skilled anesthesiologist. Closest to the ideal for systemic analgesia is remifentanil, a potent, ultra short-acting μ-1 agonist, which is rapidly metabolized in both mother and fetus. This article, through a literature review, will present the efficacy of remifentanil, its pharmacokinetics, the most effective dose, the safety for both mother and fetus and satisfaction for the mother. The results available show that remifentanil can be quite a satisfactory alternative to neuroaxial analgesia, hence taking its deserved place in modern obstetrics. A low number of reported side effects from mother and child are enough to open a field for future research.