Obstetrical Nursing: A Text-Book on the Nursing Care of the Expectant Mother, the Woman in Labor, the Young Mother and Her BabyVan Blarcom, Carolyn Conant
Science
Obstetrical Nursing: A Text-Book on the Nursing Care of the Expectant Mother, the Woman in Labor, the Young Mother and Her Baby
Van Blarcom, Carolyn Conant
Infants -- Care; Maternity nursing; Pregnancy
The agents used are chloroform, ether and nitrous oxid gas, while what
is popularly called “twilight sleep” is produced, completely or in a
modified degree, by the hypodermic administration of scopolamin and
morphine.
=Chloroform.= Of these various drugs chloroform is apparently the
anesthetic most widely used in normal obstetrics. Its advantages are
that it is easy to give; quick in its action and is followed by little
or no nausea or other ill effects. For some reason, as yet not
explained, the woman in labor enjoys a certain amount of immunity
against chloroform poisoning, but this tolerance exists only during
labor as the puerperal woman is subject to the same dangers as any other
individual.
Chloroform is not usually administered until the patient is well along
in the second stage, or until the head may be felt through the perineum,
or is in sight. The patient’s face should be oiled and protected with a
towel or gauze folded across her brow, mouth and chin to prevent burns
that might follow the inadvertent dropping of chloroform on her face.
With the beginning of a pain, a few drops are poured on the inhaler
which is held about an inch from the face to give a free admixture of
air, and the patient is told to breathe in deeply. (Fig. 103.) The
inhaler is removed as soon as the pain subsides, but reapplied as soon
as another pain begins. The patient retains consciousness and is able to
talk under this degree of anesthesia, but her suffering is greatly
relieved. It has the advantage, also, of lessening the danger of
perineal tears, as the accoucheur has better control of the delivery
when the patient lies quietly than when she tosses violently about the
bed, and a tear resulting from the sudden delivery of the head at the
height of a pain may in this way be averted.
This light, intermittent anesthesia, now so widely used, is called
obstetrical anesthesia or anesthesia _à la reine_, after Queen Victoria,
upon whom it was first employed at the birth of her seventh child, in
1853.
When the perineum is distended to its maximum, obstetrical anesthesia is
not always sufficient, and complete anesthesia may be employed; but even
this requires very little chloroform. Under ordinary conditions, the
anesthesia is discontinued as soon as the child is born, for unless
there is an extensive tear, the patient is sufficiently anesthetized to
permit of a perineal repair and the delivery of the placenta.
Chloroform is not often given early in labor because of the general
belief that its free or prolonged use lessens the force and frequency of
uterine contractions, thus prolonging labor, and also may unfavorably
affect the child. But small doses seem to stimulate rather than retard
contractions, and by having her pain relieved, the patient is prompted
to make greater effort to use her abdominal muscles, an end greatly to
be desired.
Public-domain text, read in full here on John Shaqi.
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