BLOQUEIO PARAVERTERBRAL TORÁCICO BILATERAL NA ANALGESIA OBSTÉTRICA RELATO DE EXPERIÊNCIA E DESCRIÇÃO DA TÉCNICA ATRAVÉS DE E BOOK
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional Universidade Franciscana |
Texto Completo: | http://www.tede.universidadefranciscana.edu.br:8080/handle/UFN-BDTD/963 |
Resumo: | Introduction The pain of childbirth is often the most striking in the entire life of women, who are entitled to the necessary care during labo r. In Brazil, evidence points to the low supply of pharmacological obstetric analgesia. The World Health Organization makes recommendations that indicate a de medicalization of natural childbirth, with less aggressive techniques and encourages the realizat ion of methods that provide pain relief, safely, both for the parturient and the fetus. Under this focus, the present study arose from the need to think about new or adapted techniques that are useful for increasing the offer of labor analgesia. Thoracic P aravertebral Block is a technique that can be adapted for labor analgesia, due to its potential for effectiveness and safety in the application and monitoring process. The proposal is part of the Research Priorities Agenda of the Ministry of Health: Axis 4 Development of Technologies and Innovation in Health and Axis 14 Maternal and Child Health. Objective To present a technical alternative to the neuro axis approach for local anesthetic injection to provide pharmacological analgesia Bilateral Thorac ic Paravertebral Block, through an experience report on the use of this technique successfully. Therefore, a priori, a wide literature review about the existing labor analgesia techniques was carried out and, finally, the details of the technique in an e b ook. Methodology This is an experience report that deals with the performance of a technique of obstetric analgesia to stimulate natural childbirth that would have an indication for cesarean section due to phobia of the pain of natural childbirth. The rep ort was preceded by an extensive literature review and, finally, with the description of the technique in didactic material in e book format. The project was developed during the year 2020, after approval by the Research Ethics Committee of the Franciscan University (opinion number 4,442,526). Results Bilateral paravertebral thoracic block, the chosen analgesic method, is a technique that does not use neuro axis as an anatomical substrate and does not produce hemodynamic fluctuation in the parturient and w ithout consequencesfor the fetus. The pregnant woman, after receiving analgesia, did not present pain in the first stage of labor and the use of the technique allowed, in this case, that the indication for cesarean section due to phobia of labor pain was r eviewed by the obstetric team and the childbirth developed in a natural way. In this process, the performance of the maternity nursing team was essential to conduct monitoring and care for parturient women. Final considerations This study presents a techn ical alternative with the potential to replace conventional pharmacological obstetric analgesia and contribute to pain relief in the first stage of labor. This technique can make the offer of pharmacological labor analgesia more prevalent in Brazilian mate rnity hospitals and, thus, 16 contribute to the minimization of cesarean rates nationwide, considered much higher than the percentages recommended by the World Health Organization. The benefits of this technique are also associated with its ease of use, mi nimization of complications (less possibility of sympatholysis and less hemodynamic fluctuations), the possibility of carrying it out in patients with blood dyscrasia (no contact with epidural venous plexus), lower cost for patients. health services, poten tial for replicability at the national level, as well as greater comfort for the parturient woman. |
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Naujorks, Alexandre AntonioBulow, Neusa Maria HeinzmannBackes, Dirce SteinMalaguez, Adalgiso Feijó2021-04-09T16:45:06Z2020-12-22Malaguez, Adalgiso Feijó. BLOQUEIO PARAVERTERBRAL TORÁCICO BILATERAL NA ANALGESIA OBSTÉTRICA RELATO DE EXPERIÊNCIA E DESCRIÇÃO DA TÉCNICA ATRAVÉS DE E BOOK. 2020. 65f. Dissertação( Mestrado Profissional em Saúde Materno Infantil) - Universidade Franciscana, Santa Maria - RS .http://www.tede.universidadefranciscana.edu.br:8080/handle/UFN-BDTD/963Introduction The pain of childbirth is often the most striking in the entire life of women, who are entitled to the necessary care during labo r. In Brazil, evidence points to the low supply of pharmacological obstetric analgesia. The World Health Organization makes recommendations that indicate a de medicalization of natural childbirth, with less aggressive techniques and encourages the realizat ion of methods that provide pain relief, safely, both for the parturient and the fetus. Under this focus, the present study arose from the need to think about new or adapted techniques that are useful for increasing the offer of labor analgesia. Thoracic P aravertebral Block is a technique that can be adapted for labor analgesia, due to its potential for effectiveness and safety in the application and monitoring process. The proposal is part of the Research Priorities Agenda of the Ministry of Health: Axis 4 Development of Technologies and Innovation in Health and Axis 14 Maternal and Child Health. Objective To present a technical alternative to the neuro axis approach for local anesthetic injection to provide pharmacological analgesia Bilateral Thorac ic Paravertebral Block, through an experience report on the use of this technique successfully. Therefore, a priori, a wide literature review about the existing labor analgesia techniques was carried out and, finally, the details of the technique in an e b ook. Methodology This is an experience report that deals with the performance of a technique of obstetric analgesia to stimulate natural childbirth that would have an indication for cesarean section due to phobia of the pain of natural childbirth. The rep ort was preceded by an extensive literature review and, finally, with the description of the technique in didactic material in e book format. The project was developed during the year 2020, after approval by the Research Ethics Committee of the Franciscan University (opinion number 4,442,526). Results Bilateral paravertebral thoracic block, the chosen analgesic method, is a technique that does not use neuro axis as an anatomical substrate and does not produce hemodynamic fluctuation in the parturient and w ithout consequencesfor the fetus. The pregnant woman, after receiving analgesia, did not present pain in the first stage of labor and the use of the technique allowed, in this case, that the indication for cesarean section due to phobia of labor pain was r eviewed by the obstetric team and the childbirth developed in a natural way. In this process, the performance of the maternity nursing team was essential to conduct monitoring and care for parturient women. Final considerations This study presents a techn ical alternative with the potential to replace conventional pharmacological obstetric analgesia and contribute to pain relief in the first stage of labor. This technique can make the offer of pharmacological labor analgesia more prevalent in Brazilian mate rnity hospitals and, thus, 16 contribute to the minimization of cesarean rates nationwide, considered much higher than the percentages recommended by the World Health Organization. The benefits of this technique are also associated with its ease of use, mi nimization of complications (less possibility of sympatholysis and less hemodynamic fluctuations), the possibility of carrying it out in patients with blood dyscrasia (no contact with epidural venous plexus), lower cost for patients. health services, poten tial for replicability at the national level, as well as greater comfort for the parturient woman.Introdu çã o A dor do parto é, muitas vezes, a mais contundente em toda a vida das mulheres, as quais tem direito aos cuidado s necessários durante o trabalho de parto. No Brasil, evidências apontam a baixa oferta de analgesia obstétrica farmacológica. A O rganização M undial da S aúde faz recomendações que indicam uma desmedicalização do parto natural, com técnicas menos agressivas e incentiva a realização de métodos que propiciem o alívio da dor, com segurança, tanto pa ra a parturiente quanto para o feto. Sob esse enfoque, o presente estudo surgiu da necessidade de se pensar técnicas novas ou adaptadas que sejam úteis para o aumento da oferta de analgesia de parto. O Bloqueio Paravertebral Torá cico é uma técnica que pode ser adaptada para a analgesia de parto, pelo seu potencial de efetividade e segurança no processo de aplicação e monitoramento. A proposta se insere na Agenda de Prioridades de Pesquisa do Ministério da Saúde: Eixo 4 Desenvolvimento de Tecnologias e Ino vação em Saúde e Eixo 14 Saúde Materno Infantil. Objetivo Apresentar uma alternativa técnica à abordagem do neuro eixo para injeção de anestésico local para prover analgesia farmacológica Bloqueio Paravertebral Torácico Bilateral, por meio de um relat o de experiência da utilização desta técnica com sucesso. Para tanto, realizou se, a priori, ampla revisão de literatura acerca das técnicas de analgesia de parto existentes e, por fim, o detalhamento da técnica em um e book. Metodologia: Trata se de um relato de experiência que versa sobre a realização de uma técnica de analgesia obstétrica de estimulo ao parto natural de uma gestante que teria indicação de cesárea por fobia à dor do parto natural. O relato foi precedido por ampla revisão de literatura e, por fim, com a descrição da técnica em material didático em formato e book. O projeto foi desenvolvido ao longo do ano de 2020, após aprovação pelo Comitê de Ética em Pesquisa da Universidade Franciscana (parecer número 4.442.526). Resultados: O bloquei o paravertebral torácico bilateral, método analgésico escolhido, se trata de uma técnica que não utiliza neuro eixo como substrato anatômico e não produz flutuação hemodinâmica na parturiente e sem consequências para o feto. A gestante, após receber a anal gesia, não apresentou dor no primeiro estágio do trabalho de parto e o uso da técnica permitiu, neste caso, que a indicação de cesárea por fobia à dor do parto fosse revista pela equipe obstétrica e o parto desenvolveu se de maneira natural. Nesse processo a atuação da equipe de enfermagem da maternidade foi fundamental para conduzir a monitorização e os cuidados a parturiente. Considerações finais: Este estudo apresenta uma alternativa técnica com potencial para substituir a analgesia obstétrica farmacoló gica convencional e contribuir para o alívio da dor no primeiro estágio do trabalho de parto. Esta técnica pode fazer com que a oferta de analgesia de parto farmacológica seja mais prevalente nas maternidades brasileiras e, dessa forma, contribuir para a m inimização das taxas de cesáreas em âmbito nacional, consideradas muito superiores aos percentuais recomendados pela Organização Mundial da Saúde. Os benefícios desta técnica estão associados, também, à facilidade de sua utilização, minimização das complic ações (menor possibilidade de simpatólise e menos flutuações hemodinâmicas), a possibilidade de realização em pacientes com discrasia sanguínea (não tem contato com plexo venoso peridural), menor custo para os serviços de saúde, potencial de replicabilidad e em âmbito nacional, além de maior conforto para a parturiente.Submitted by MARCIA ROVADOSCHI (marciar@unifra.br) on 2021-04-09T16:45:06Z No. of bitstreams: 3 Dissertacao_AdalgisoFeijoMalaguez.pdf: 4324904 bytes, checksum: ead78350f1ec7427b9aadaf1dd56bc5f (MD5) ProdutoTecnico_AdalgisoFeijoMalaguez.pdf: 1567369 bytes, checksum: 45ada55a6fbc22d19d6de3d4aed5306b (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2021-04-09T16:45:06Z (GMT). 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dc.title.por.fl_str_mv |
BLOQUEIO PARAVERTERBRAL TORÁCICO BILATERAL NA ANALGESIA OBSTÉTRICA RELATO DE EXPERIÊNCIA E DESCRIÇÃO DA TÉCNICA ATRAVÉS DE E BOOK |
title |
BLOQUEIO PARAVERTERBRAL TORÁCICO BILATERAL NA ANALGESIA OBSTÉTRICA RELATO DE EXPERIÊNCIA E DESCRIÇÃO DA TÉCNICA ATRAVÉS DE E BOOK |
spellingShingle |
BLOQUEIO PARAVERTERBRAL TORÁCICO BILATERAL NA ANALGESIA OBSTÉTRICA RELATO DE EXPERIÊNCIA E DESCRIÇÃO DA TÉCNICA ATRAVÉS DE E BOOK Malaguez, Adalgiso Feijó Dor do parto. Parto Natural. Analgesia Obstétrica. Bloqueio Paravertebral Torácico. Obstetrical Analgesia. Natural Childbirth. Paravertebral Thoracic Block. Saúde Materno Infantil |
title_short |
BLOQUEIO PARAVERTERBRAL TORÁCICO BILATERAL NA ANALGESIA OBSTÉTRICA RELATO DE EXPERIÊNCIA E DESCRIÇÃO DA TÉCNICA ATRAVÉS DE E BOOK |
title_full |
BLOQUEIO PARAVERTERBRAL TORÁCICO BILATERAL NA ANALGESIA OBSTÉTRICA RELATO DE EXPERIÊNCIA E DESCRIÇÃO DA TÉCNICA ATRAVÉS DE E BOOK |
title_fullStr |
BLOQUEIO PARAVERTERBRAL TORÁCICO BILATERAL NA ANALGESIA OBSTÉTRICA RELATO DE EXPERIÊNCIA E DESCRIÇÃO DA TÉCNICA ATRAVÉS DE E BOOK |
title_full_unstemmed |
BLOQUEIO PARAVERTERBRAL TORÁCICO BILATERAL NA ANALGESIA OBSTÉTRICA RELATO DE EXPERIÊNCIA E DESCRIÇÃO DA TÉCNICA ATRAVÉS DE E BOOK |
title_sort |
BLOQUEIO PARAVERTERBRAL TORÁCICO BILATERAL NA ANALGESIA OBSTÉTRICA RELATO DE EXPERIÊNCIA E DESCRIÇÃO DA TÉCNICA ATRAVÉS DE E BOOK |
author |
Malaguez, Adalgiso Feijó |
author_facet |
Malaguez, Adalgiso Feijó |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Naujorks, Alexandre Antonio |
dc.contributor.referee1.fl_str_mv |
Bulow, Neusa Maria Heinzmann |
dc.contributor.referee2.fl_str_mv |
Backes, Dirce Stein |
dc.contributor.author.fl_str_mv |
Malaguez, Adalgiso Feijó |
contributor_str_mv |
Naujorks, Alexandre Antonio Bulow, Neusa Maria Heinzmann Backes, Dirce Stein |
dc.subject.por.fl_str_mv |
Dor do parto. Parto Natural. Analgesia Obstétrica. Bloqueio Paravertebral Torácico. |
topic |
Dor do parto. Parto Natural. Analgesia Obstétrica. Bloqueio Paravertebral Torácico. Obstetrical Analgesia. Natural Childbirth. Paravertebral Thoracic Block. Saúde Materno Infantil |
dc.subject.eng.fl_str_mv |
Obstetrical Analgesia. Natural Childbirth. Paravertebral Thoracic Block. |
dc.subject.cnpq.fl_str_mv |
Saúde Materno Infantil |
description |
Introduction The pain of childbirth is often the most striking in the entire life of women, who are entitled to the necessary care during labo r. In Brazil, evidence points to the low supply of pharmacological obstetric analgesia. The World Health Organization makes recommendations that indicate a de medicalization of natural childbirth, with less aggressive techniques and encourages the realizat ion of methods that provide pain relief, safely, both for the parturient and the fetus. Under this focus, the present study arose from the need to think about new or adapted techniques that are useful for increasing the offer of labor analgesia. Thoracic P aravertebral Block is a technique that can be adapted for labor analgesia, due to its potential for effectiveness and safety in the application and monitoring process. The proposal is part of the Research Priorities Agenda of the Ministry of Health: Axis 4 Development of Technologies and Innovation in Health and Axis 14 Maternal and Child Health. Objective To present a technical alternative to the neuro axis approach for local anesthetic injection to provide pharmacological analgesia Bilateral Thorac ic Paravertebral Block, through an experience report on the use of this technique successfully. Therefore, a priori, a wide literature review about the existing labor analgesia techniques was carried out and, finally, the details of the technique in an e b ook. Methodology This is an experience report that deals with the performance of a technique of obstetric analgesia to stimulate natural childbirth that would have an indication for cesarean section due to phobia of the pain of natural childbirth. The rep ort was preceded by an extensive literature review and, finally, with the description of the technique in didactic material in e book format. The project was developed during the year 2020, after approval by the Research Ethics Committee of the Franciscan University (opinion number 4,442,526). Results Bilateral paravertebral thoracic block, the chosen analgesic method, is a technique that does not use neuro axis as an anatomical substrate and does not produce hemodynamic fluctuation in the parturient and w ithout consequencesfor the fetus. The pregnant woman, after receiving analgesia, did not present pain in the first stage of labor and the use of the technique allowed, in this case, that the indication for cesarean section due to phobia of labor pain was r eviewed by the obstetric team and the childbirth developed in a natural way. In this process, the performance of the maternity nursing team was essential to conduct monitoring and care for parturient women. Final considerations This study presents a techn ical alternative with the potential to replace conventional pharmacological obstetric analgesia and contribute to pain relief in the first stage of labor. This technique can make the offer of pharmacological labor analgesia more prevalent in Brazilian mate rnity hospitals and, thus, 16 contribute to the minimization of cesarean rates nationwide, considered much higher than the percentages recommended by the World Health Organization. The benefits of this technique are also associated with its ease of use, mi nimization of complications (less possibility of sympatholysis and less hemodynamic fluctuations), the possibility of carrying it out in patients with blood dyscrasia (no contact with epidural venous plexus), lower cost for patients. health services, poten tial for replicability at the national level, as well as greater comfort for the parturient woman. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020-12-22 |
dc.date.accessioned.fl_str_mv |
2021-04-09T16:45:06Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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Malaguez, Adalgiso Feijó. BLOQUEIO PARAVERTERBRAL TORÁCICO BILATERAL NA ANALGESIA OBSTÉTRICA RELATO DE EXPERIÊNCIA E DESCRIÇÃO DA TÉCNICA ATRAVÉS DE E BOOK. 2020. 65f. Dissertação( Mestrado Profissional em Saúde Materno Infantil) - Universidade Franciscana, Santa Maria - RS . |
dc.identifier.uri.fl_str_mv |
http://www.tede.universidadefranciscana.edu.br:8080/handle/UFN-BDTD/963 |
identifier_str_mv |
Malaguez, Adalgiso Feijó. BLOQUEIO PARAVERTERBRAL TORÁCICO BILATERAL NA ANALGESIA OBSTÉTRICA RELATO DE EXPERIÊNCIA E DESCRIÇÃO DA TÉCNICA ATRAVÉS DE E BOOK. 2020. 65f. Dissertação( Mestrado Profissional em Saúde Materno Infantil) - Universidade Franciscana, Santa Maria - RS . |
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http://www.tede.universidadefranciscana.edu.br:8080/handle/UFN-BDTD/963 |
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por |
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Universidade Franciscana |
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UFN |
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Brasil |
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Saúde Materno Infantil |
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Universidade Franciscana |
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Repositório Institucional Universidade Franciscana |
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Repositório Institucional Universidade Franciscana - Universidade Franciscana (UFN) |
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