Primórdios da analgesia de parto: a força das mulheres

Abstract

Este artigo é parte da Dissertação defendida pelo autor na Faculdade de Farmácia da Universidade de Coimbra, para obtenção do título de Mestre em Farmacologia Aplicada. RESUMOObjetivos: Ao longo do tempo, as crenças, as posições religiosas e a comunidade médica marcaram a evolução da analgesia de parto. As mulheres, direta ou indiretamente, foram as grandes impulsionadoras deste importante marcador de igualdade social. O objetivo deste estudo é fazer uma revisão história sobre a evolução da analgesia de parto e determinar o papel da comunidade feminina nessa evolução. Métodos: Revisão da literatura através da base de dados Pubmed e pesquisa de livros históricos sobre o tema. Resultados: A analgesia de parto apresenta-se nos nossos dias como uma técnica segura e eficaz, tendo vindo a evoluir significativamente ao longo dos últimos 100 anos. As técnicas iniciais de anestesia/analgesia inalatória apresentavam riscos para a mãe e o feto, mas foram o início de um progresso demorado e necessário. Esta revisão faz uma síntese sobre os avanços e recuos da analgesia de parto e o papel da mulher nessa mudança. Conclusões: A comunidade feminina teve um papel ativo e de pioneirismo no desenvolvimento da analgesia de parto. Instigadoras como a Rainha Victória ou investigadoras como Virginia Apgar, as mulheres são indissociáveis desse desenvolvimento. ABSTRACTAims: Over time, beliefs, religious views and the medical community marked the evolution of labor analgesia. Women, directly or indirectly, were major instigators of this important marker of social equality. The aim of this study is to make a historic revision on the evolution of labor analgesia and to determine the role of the female community on that evolution. Methods: A review of literature through Pubmed database and research of historical books on the subject. Results: Epidural analgesia is nowadays a safe and effective technique, having evolved significantly over the last hundred years. The initial inhalatory anesthesia / analgesia presented risks to the mother and fetus, but they were the beginning of a long and necessary evolution. This review provides an overview on the advances and retreats of labor analgesia and the role of women in these changes. Conclusions: The female community had an active and pioneering role in labor analgesia development. Instigators like Queen Victoria or researchers as Virginia Apgar, women are inseparable from this development.

Pharmacological obstetric analgesia: a study of obstetric and neonatal outcomes

“…Given the retrospective and documentary nature of this study, it was not possible to identify the technique, the dosage, and the drug used to perform analgesia. These variables have been essential to identify their possible benefits and complications (5)(6)(7)(8)(9)(10)13) .…”

“…Obstetric analgesia is understood as the suppression of the physical pain demanded especially by the uterine contraction and cervical dilation. This analgesia can be obtained through non-pharmacological procedures (massages, immersion in warm water, music therapy, aromatherapy, and acupuncture); administration of drugs with systemic action (inhalation, intramuscular, and intravenous); and local phar-macological analgesia (spinal, epidural, or combined spinal-epidural) (4)(5) . According to the Ministry of Health, all possibilities must be explained to the pregnant woman in the prenatal period and the non-pharmacological methods available should be offered before starting pharmacological analgesia (4) .…”

“…Epidural analgesia is the gold standard in pharmacological analgesic practices during labor, which allows free maternal movement and has minimal side effects for the mother and fetus (4)(5)(6)(7)(8) . Inappropriate doses or techniques of pharmacological analgesia may expose the mother-child binomial to iatrogeneses, side effects, and mild to severe adverse reactions (3) .…”