Tkachenko R. Choice of rational labor analgesia

The thesis is devoted to analysis of the influence of different methods of anesthesia during labor on cardio-vascular, nervous , endocrine systems and the oxygen - metabolic status, also their regulatory mechanisms, integrated clinical characteristics of 491 postpartum and neonates, 113 babies in their first year of life. The main predictors of painful syndrome during labor was discovered.A comparative study of 15 different methods of analgesia and pain management during labor on the basis of the clinical-statistical analysis was conducted. The author has proved that the optimal methods of anesthesia among all others, which are compared, is fractional epidural analgesia lidocaine in a combination with fentanyl and clonidine. Using lidocaine as the "basic" anesthetic drug for epidural analgesia is accompanied by the greatest frequency (31,7 %) physiological labor. Retrospective study of 100 558 postpartum cases in 6 clinics of Kiev has proved that application epidural analgesia during labor reduces frequency of operation cesarean section in 1,71 times.