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Efeitos na mulher e no feto/recém-nascido da utilização do óxido nitroso durante o trabalho de parto: Projeto de estágio de desenvolvimentos de competências clínicas especializadas na área da Enfermagem de Saúde Materna e Obstétrica
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Abstract(s)
O presente relatório de estágio visa descrever criticamente o meu percurso de aprendizagem e as atividades desenvolvidas ao longo dos estágios da Unidade Curricular - Estágio de natureza profissional com relatório, no âmbito do Curso de Mestrado em Enfermagem de Saúde Materna e Obstétrica, que decorreu num centro hospitalar geral e diferenciado entre 12 de setembro de 2023 e 25 de junho de 2024. O objetivo do estágio foi aprimorar o conhecimento e adquirir competências na prestação de cuidados de enfermagem especializados à mulher inserida na família e na comunidade, abrangendo o período pré-natal, o trabalho de parto e o período pós-parto.
No decorrer do estágio, em particular, durante o contexto de estágio de internamento de grávidas com complicações, emergiu a curiosidade de aprofundar uma temática relacionada com a dor durante o trabalho de parto, nomeadamente a utilização do óxido nitroso como uma estratégia farmacológica para o alívio da dor de trabalho de parto. O óxido nitroso associado a 50% de oxigénio, é uma analgesia inalatória amplamente utilizada em alguns países, como Estados Unidos ou Noruega, durante o trabalho de parto. Em Portugal esta via de analgesia é pouco comum e usada em contextos clínicos específicos, mas que tem vindo a despertar curiosidade da sua aplicação na obstetrícia. A possibilidade de oferecer às mulheres a alternativa de utilizar o óxido nitroso, enquanto método para alívio da dor durante o trabalho de parto, pode ter um efeito positivo, no sentido em que promove um sentimento de capacitação, de empoderamento, uma vez que são as próprias que controlam a sua administração. Neste sentido, surgiu a elaboração de uma revisão integrativa da literatura com o objetivo de identificar os efeitos do uso do óxido nitroso durante o trabalho de parto para a mulher e para o feto/recém-nascido. Em suma, o óxido nitroso demonstra ser uma opção analgésica vantajosa durante o trabalho de parto, proporcionando alívio eficaz da dor e redução da ansiedade, o que contribui para uma experiência de parto mais positiva e empoderadora para as mulheres. Embora os estudos revisados não apontem efeitos adversos significativos para o feto ou recém-nascido, permanece a necessidade de mais pesquisas que avaliem a sua segurança a longo prazo. Além disso, é essencial continuar a explorar formas de otimizar a administração do óxido nitroso, garantindo maior segurança e conforto materno.
This internship report aims to critically describe my learning path and the activities developed throughout the internships of the Curricular Unit - Professional internship with report, within the scope of the Master's Degree in Maternal and Obstetric Health Nursing, which took place in a general and differentiated hospital center between September 12, 2023 and June 25, 2024. The objective of the internship was to improve knowledge and acquire skills in the provision of specialized nursing care to women inserted in the family and in the community, covering the prenatal period, labor and postpartum period. During the internship, particularly during the internship involving pregnant women with complications, I became interested in exploring a topic related to pain during labor, namely the use of nitrous oxide as a pharmacological strategy for relieving labor pain. Nitrous oxide combined with 50% oxygen is an inhaled analgesic widely used in some countries, such as the United States and Norway, during labor. In Portugal, this analgesic route is uncommon and used in specific clinical contexts, but it has been arousing curiosity about its application in obstetrics. The possibility of offering women the alternative of using nitrous oxide as a method for pain relief during labor can have a positive effect, in the sense that it promotes a feeling of empowerment, since they themselves are the ones who control its administration. In this sense, an integrative literature review was developed with the aim of identifying the effects of the use of nitrous oxide during labor for the woman and the fetus/newborn. In summary, nitrous oxide proves to be an advantageous analgesic option during labor, providing effective pain relief and reducing anxiety, which contributes to a more positive and empowering childbirth experience for women. Although the reviewed studies do not indicate significant adverse effects for the fetus or newborn, there remains a need for further research to assess its long-term safety. Additionally, it is essential to continue exploring ways to optimize the administration of nitrous oxide, ensuring greater maternal safety and comfort.
This internship report aims to critically describe my learning path and the activities developed throughout the internships of the Curricular Unit - Professional internship with report, within the scope of the Master's Degree in Maternal and Obstetric Health Nursing, which took place in a general and differentiated hospital center between September 12, 2023 and June 25, 2024. The objective of the internship was to improve knowledge and acquire skills in the provision of specialized nursing care to women inserted in the family and in the community, covering the prenatal period, labor and postpartum period. During the internship, particularly during the internship involving pregnant women with complications, I became interested in exploring a topic related to pain during labor, namely the use of nitrous oxide as a pharmacological strategy for relieving labor pain. Nitrous oxide combined with 50% oxygen is an inhaled analgesic widely used in some countries, such as the United States and Norway, during labor. In Portugal, this analgesic route is uncommon and used in specific clinical contexts, but it has been arousing curiosity about its application in obstetrics. The possibility of offering women the alternative of using nitrous oxide as a method for pain relief during labor can have a positive effect, in the sense that it promotes a feeling of empowerment, since they themselves are the ones who control its administration. In this sense, an integrative literature review was developed with the aim of identifying the effects of the use of nitrous oxide during labor for the woman and the fetus/newborn. In summary, nitrous oxide proves to be an advantageous analgesic option during labor, providing effective pain relief and reducing anxiety, which contributes to a more positive and empowering childbirth experience for women. Although the reviewed studies do not indicate significant adverse effects for the fetus or newborn, there remains a need for further research to assess its long-term safety. Additionally, it is essential to continue exploring ways to optimize the administration of nitrous oxide, ensuring greater maternal safety and comfort.
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Keywords
Óxido nitroso Trabalho de parto Enfermagem de Saúde Materna e Obstétrica