Managing Complications in Pregnancy and Childbirth: - IAWG

C-38 Anaesthesia and analgesia- If the infant has adequate peripheral circulation aftersuccessful resuscitation, naloxone can be given IM. Repeateddoses may be required to prevent recurrent respiratorydepression.• If there are no signs of respiratory depression in the newborn, butpethidine or morphine was given within 4 hours of delivery,observe the baby expectantly for signs of respiratory depressionand treat as above if they occur.LOCAL ANAESTHESIALocal anaesthesia (lignocaine with or without adrenaline) is used toinfiltrate tissue and block the sensory nerves.• Because a woman with local anaesthesia remains awake and alertduring the procedure, it is especially important to ensure:- counselling to increase cooperation and minimize her fears;- good communication throughout the procedure as well asphysical reassurance from the provider, if necessary;- time and patience as local anaesthetics do not take effectimmediately.• The following conditions are required for the safe use of localanaesthesia:- All members of the operating team must be knowledgeable andexperienced in the use of local anaesthetics;- Emergency drugs and equipment (suction, oxygen,resuscitation equipment) should be readily available, andshould be in usable condition and all members of the operatingteam trained in their use.PREMEDICATION WITH PROMETHAZINE AND DIAZEPAMPremedication is required for procedures that last longer than 30minutes. The dose must be adjusted to the weight and condition of thewoman and to the condition of the fetus (when present).A popular combination is pethidine and diazepam: