'In
other cultures around the globe, and for thousands of years, people
have stayed in their homes to die, looked after by their family and
local community. We want to see a return to this' (via Guardian Life & style)
People
often seek support to bring a new life into the world, but what about
when we are preparing to leave it? Eleanor Tucker speaks to death doula
Rebecca Green
The Guardian
對於術後止痛，主要仍為藥物控制。而給藥的方法越來越多樣化。概述如下：
1.傳統的口服或皮下、靜脈注射給藥。
2.硬脊膜止痛：
如果手術是下半身手術、是採用脊椎硬脊膜上麻醉（epidural anesthesia），那麼可以考慮手術完成時把脊椎上的給藥管留下來個幾天，當作注射止痛藥到腰椎硬脊膜上的管道。這種方式對下半身的術後止痛，效果很好，也可避免靜脈注射後藥物全身循環，造成系統性及中樞神經的副作用。
3.病人自控式給藥（Patient-controlled analgesia, PCA）：
由
於疼痛是一種很主觀的感受，相似的病情與手術規模，在不同人身上可能有相當不同的疼痛感。因此如果以一種規律性方式給藥，恐怕有過與不及的狀況；有些人疼
痛不堪、有些人卻莫名接受過多不必要的止痛藥物。因此把藥物放在機器裡，連接注射管線到病人身上，病人視需要自行按鈕給藥，似乎是個不錯的方式。注射的途
徑，以靜脈注射最多；對下半身的手術，也可以採用前述的硬脊膜上留存管線給藥。為了防止藥物過量，機器當然有防護設計：在某設定時間間隔（例如1小時）內，劑量上限可設定為一定值。到達這個上限，病人再按鈕，機器也不會給藥；而要到下一個時間間隔，機器才會繼續運作。
4.周邊神經阻斷注射：
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The Brooklyn Cyclones offered a Lamaze class in center field before Sunday night’s game. It was one of the activities as part of the "Bellies and Baseball： A Salute to Pregnancy" event. 「布魯克林旋風」隊在週日晚間的比賽之前，在球場中外野上拉梅茲課程。這是「肚皮與棒球：向懷孕致敬」活動的多項節目之一。belly：名詞，肚皮。諺語，A growing youth has a wolf in his belly，成長中的年輕人肚裡有匹狼，形容發育中的年輕人食量大。◎ 張沛元翻譯
The Lamaze Technique is a prepared childbirth technique developed in the 1940s by French obstetrician Dr. Fernand Lamaze as an alternative to the use of medical intervention during childbirth. Dr. Lamaze was influenced by Soviet childbirth practices, which involved breathing and relaxation techniques under the supervision of a "monitrice" or midwife. The Lamaze method gained popularity in the United States after Marjorie Karmel wrote about her experiences in her 1959 book Thank You, Dr. Lamaze.
The rise of the epidural by 1980 and the widespread use of continuous electronic fetal monitoring as standard care practices changed the nature and purpose of the Lamaze method. Today, Lamaze International is an organization which promotes a philosophy of personal empowerment while providing general childbirth education. Modern Lamaze childbirth classes teach expectant mothers many ways to work with the labor process to reduce the pain associated with childbirth, and to promote normal (physiological) birth and the first moments after birth. Techniques include allowing labor to begin on its own, movement and positions, massage, aromatherapy, hot and cold packs, informed consent and informed refusal, breathing techniques, the use of a "birth ball" (yoga or exercise ball), spontaneous pushing, upright positions for labor and birth, breastfeeding techniques, and keeping mother and baby together after childbirth.
Contents[hide] |
Lamaze Approach to Birth
Birth is normal, natural and healthy.The experience of birth profoundly affects women and their families.
Women's inner wisdom guides them through birth.
Women's confidence and ability to give birth is either enhanced or diminished by the care provider and place of birth.
Women have the right to give birth free from routine medical interventions.
Birth can safely take place in homes, birth centers and hospitals.
Childbirth education empowers women to make informed choices in health care, to assume responsibility for their health and to trust their inner wisdom.
Lamaze Healthy Birth Practices
Lamaze healthy birth practices are based on the best medical evidence available, and are designed to promote a safe and healthy pregnancy and birth• Let labor begin on its own Letting the body go into labor on its own is almost always the best way to know that the baby is ready to be born and the body is ready for labor.
• Walk, move around and change positions throughout labor Moving in labor (not confined to a bed) helps women cope with strong and painful contractions, while gently moving the baby into the pelvis and through the birth canal.
• Bring a loved one, friend or doula for continuous support In childbirth, a woman feels better when supported by people she trusts and those who use encouragement.
• Avoid interventions that are not medically necessary When interventions (e.g., induction, epidural, continuous monitoring) are used in a routine manner, women and babies are exposed to unnecessary risks.
• Avoid giving birth on back and follow the body’s urges to push Upright positions are safe during pushing and can make it easier to push the baby out. This could mean squatting, sitting or lying on the side
• Keep mother and baby together – it’s best for mother, baby and breastfeeding Mother and baby share a natural instinct to be close after birth, and experts recommend that a healthy newborn be placed and cared for skin-to-skin on the mother’s abdomen or chest.
See also
External links
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interfold
出典:『Wiktionary』 (2011/09/20 06:11 UTC 版)
interleaved
あい紙入り
[名][U]《医学》無痛覚（症）.
analgesia
- an • al • ge • si • a
- 発音
- æ`nəldʒíːziə
doula
Syllabification: dou·la
Pronunciation: /ˈdo͞olə
/
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