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574 PARTE II, SECCIÓN 9 OBSTETRICIA/GINECOLOGÍA

®
■ Selección del parto con medicación Fentanilo (Sublimaze ): de 50-100 μg i.v.
cada 30-60 min. Se puede administrar
• Reconsiderar los riesgos y los beneficios de
como una dosis de carga de hasta 200 μg
los medicamentos analgésicos. Si una B B 2 2 en la primera hora si es necesario.
mujer elige esta opción, se le ofrecerá
apoyo y aliento. La tutoría durante la
segunda etapa del parto se convierte en ■ Analgesia regional
algo mucho más importante.
• Bloqueos paracervicales.
B B 2 2
• Para la sedación:
• Bloqueo del pudendo.
®
Difenhidramina (Benadryl ): B B 2 2
comprimido/cápsula v.o., 25 a 50 mg; se • Bloqueo epidural.
repite cada 4-6 h según sea necesario A A 3 3
• Raquídeo/epidural combinado.
Prometazina (Phenergan ): 25 mg v.o. B B 3 3
®
o 12,5 mg i.v. cada 6 h.
• Para aliviar el dolor: ■ Tratamiento posparto
• Es indispensable una charla abierta acerca
Sulfato de morfina: 2 a 5 mg i.v. o 10 mg i.m. del parto y el alumbramiento.
cada 4 h.
• Se ayuda a la mujer a la lactancia natural y
®
Nalbufina (Nubain ): 10 mg i.v. o i.m. cada a los primeros cuidados neonatales.
3 h.

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