T / F Pain associated with the first stage of labour is visceral pain – dull, poorly localised, and felt in the lower abdomen or back. It is caused by cervical dilation, and increasing pressure in the lower uterine segment.
T / F Nociception in the first stage occurs via A-delta and C fibres that travel with the sympathetic efferents. They eventually enter the neuraxis via the T10 – L1 nerve roots.
T / F Pain associated with the second stage of labour is predominantly somatic pain – localised to the perineum. It is caused by stretching and tearing of the vagina and perineal skin.
T / F Nociception in the second stage is transmitted via the pudendal nerves, which enter the neuraxis via the S2 – S4 nerve roots.
T / F An epidural block to T10 would be adequate for labour, but needs to be extended to T4 for a Caesarian, in order to cover most of the peritoneal contents.
T / F Ice is used to assess an epidural or spinal block, because input from thermoreceptors is transmitted via the same A-delta and C fibres that transmit pain.
1. Macintyre etal. Clinical Pain Management: Acute Pain, 2nd edition 2008, Chapter 26.
2. Guyton 12th edition, Fig 46-6