Your Anaesthetic for Caesarean Section, 2nd edition, October 2009 BENGALI

wmRvwiqvb Kivi Rb¨ Avcbv‡K G‡bm&‡_wUK ev Aek Kiv

cÖwZ cvuPwUi g‡a¨ GKwU wkï wmRvwiqvb †mKk‡b Rb¥ †bq| wZb fv‡Mi yBfvM Gi †¶‡Î Zv nVvr K‡i nq ev Kvgbv bv K‡iB, m~Zivs Avcwb GB cyw —Kv co‡j nqZ DcKvi †c‡Z cv‡ib,

GgbwK hw` Avcwb Avcbvi Rb¨ wmRvwiqvb bvI Avkv K‡ib|

Your Anaesthetic for Caesarean Section, 2nd edition, October 2009 BENGALI

ev”Pv nIqv bv f~jvi g‡Zv GKwU AwfÁZv wmRvwiqvb Gi gva¨‡g †Wwjfvix mvavib †Wwjfvixi g‡ZvB mš‘wóRbK, Ges hw` g‡b Kiv nq Avcbvi wmRvwiqvb Kiv `iKvi Zvn‡j Avcbvi g‡b Kiv DwPZ bq †h Avcwb wb‡R‡K ev Ab¨ KvD‡K Amnvq fve‡Qb| me‡P‡q ¸i“Z¡c~Y© welq n‡jv †h Bnv‡Z Avcwb I Avcbvi wkï wbivc`| wmRvwiqvb nqZ wbwðš— nIqvi Rb¨ me‡P‡q fv‡jv cš’v| wmRvwiqvb †mKkb Gi Rb¨ bvbv iK‡gi G‡bm&‡_wmqv Av‡Q| GB cyw¯—Kv GB e¨vcv‡i Ges G‡bm‡_wUK Gi mgh wK nq Zv e¨vL¨v Ki‡e| Avcwb Avcbvi G‡bm&‡_wUó (whwb Aek K‡ib) Gi mv‡_ wewfbœ iK‡gi G‡bm‡_wUK wb‡q Av‡jvPbv Ki‡Z cv‡ib| Ae&m‡UwUªK G‡bm‡_wUóiv Wv³vi, hviv Mf©eZx gwnjv‡`i‡K G‡bm‡_wUó †`qvi e¨vcv‡i we‡klÁ| Avcbvi wmRvwiqvb †mKkb nqZ AMÖxg cwiKíbv Kiv †h‡Z cv‡i - Bnv‡K GKwU ÔG‡jKwUf wmRvwiqvb †mKkbÕ ejv nq| Avcbvi Aem&‡UwUªwmqvb (†h Wv³vi wgWIqvBd‡`i mv‡_ KvR K‡i Mf©eZx gwnjv‡`i ev”Pv cÖm‡e hZœ †bb) nqZ Avcbv‡K civgk© w`‡Z cv‡ib wmRvwiqvb Gi Rb¨ hw` Zviv g‡b K‡ib Avcbvi mvavib †Wwjfvix‡Z mgm¨v n‡Z cv‡i| GKwU D`vnib n‡jv hw` †`Lv hvq Mf©Kvjxb mg‡qi †kl ch©v‡q Avcbvi ev”Pv A ^vfvweK Ae¯’vq Av‡Q| ‡Kvb †Kvb †¶‡Î Avcbvi Aem&‡UwUªwkqvb nqZ `ª“Z GKwU wmRvwiqvb Kivi civgk© w`‡Z cv‡ib, mvavibZ: Avcwb hLb †jevi G _v‡Kb| Bnv GKwU Ri“ix wmRvwiqvb †mKkb| Zviv nqZ Avcbv‡K Zv civgk© Ki‡Z cv‡ib Kvib Avcbvi †jevi Lye ax‡i ax‡i n‡”Q, Kvib ev”Pvi Ae¯’v µgvMZ Lvivc n‡”Q A_ev DfqwU n‡”Q| Avcbvi Aem&‡UwUªwkqvb nqZ Avcbvi mv‡_ Av‡jvPbv Ki‡eb †Kb Zviv g‡b K‡ib Avcbvi GKwU wmRvwiqvb nIqv `iKvi Ges Acv‡ik‡bi c~‡e© cÖ_‡g Avcbvi AbygwZ †b‡eb| G‡bm&‡_wUK Gi aib G‡bm&‡_wUK Gi cÖavb yBwU aib Av‡Q| Avcwb nq †R‡M _vK‡Z cv‡ib (AvÂwjK G‡bm&‡_wUK) ev Nygš— _vK‡Z cv‡ib (GKwU mvavib G‡bm&‡_wUK)| mvavibZ: hw` Avcbvi wmRvwiqvb nq Zvn‡j Avcbv‡K wbw ©ó ’v‡b ev H A‡j G‡bm‡_wUK †`Iqv nq| GB †¶‡Î Avcwb †R‡M _vK‡eb Z‡e Avcbvi kix‡ii wbgœ A‡j †Kvb Abyf~wZ cv‡eb bv| Bnv mvavibZ: Avcbvi I Avcbvi wkïi Rb¨ wbivc` Ges Avcbv‡K I Avcbvi m½x Dfq‡K Rb¥ †`qvi AwfÁZv AR©b Ki‡Z †`q|

wZb ai‡bi AvÂwjK G‡bm&‡_wUK Av‡Q : 1. ‡gi“`Û ev ¯úvBbvj – Bnv me‡P‡q e¨vcK e¨eüZ c×wZ| Bnv nqZ cwiKwíZ ev Ri“ix Dfq

wmRvwiqvb †mKk‡b e¨envi Kiv †h‡Z cv‡i| †h bvf© Avcbvi kix‡ii wbgœvÂj †_‡K Abyf~wZ enb K‡i Av‡b Zv‡Z GK e¨vM Zij c`v_© _v‡K hv †gi“`‡Ûi wfZ‡i _v‡K| G‡bm‡_wUó GB Zij c`v‡_©i e¨v‡Mi wfZ‡i ‡jvK¨vj ev ¯’vbxq G‡bm‡_wUK Bb‡RKkb cÖ‡qv‡Mi gva¨‡g cÖ‡ek Kivb, LyeB m~¶è myuB‡qi gva¨‡g| GB c×wZ Lye `ª“Z KvR K‡i, Ges ïaygvÎ GKwU †QvU G‡bm‡_wUK †WvR Gi cÖ‡qvRb nq|

Your Anaesthetic for Caesarean Section, 2nd edition, October 2009 BENGALI

2. GwcWyivj - GKwU nvjKv c −vw÷K wUDe ev K¨v‡_Uvi Avcbvi †gi“`‡Ûi bv‡f©i Kv‡Q ivLv nq Ges

cÖ‡qvR‡b bv‡f©i ga¨ w`‡q Jla †`Iqv nq| GwcWyivj cÖvqB e¨envi Kiv nq †jevi Gi e¨v_v wPwKrmvi Rb¨, ~e©j ev Kg ‡jvK¨vj Gbm‡_wUK Zij e¨env‡ii gva¨‡g| hw` Avcbvi GKwU wmRvwiqvb †mKk‡bi `iKvi nq, Zvn‡j Gbm‡_wUó GwcWyivj c~Y© Ki‡Z cvi‡eb, GKwU kw³kvjx †jvK¨vj G‡bm‡_wUK Zi‡ji gva¨‡g| Avcbvi GKwU †jvK¨vj G‡bm‡_wUK Gi eo †WvR `iKvi GwcWyiv‡ji mv‡_, †gi“`‡Ûi gva¨‡gi †P‡q Ges Bnv KvR Ki‡Z †ekx mgq †bq|

3. mgwš^Z ¯úvBbvj GwcWyivj ev CSE –

Bnv Df‡qi GKwU mgš^q| ¯úvBbvj c×wZ Avcbvi wmRvwiqvb‡K `ª“Z Ki‡e| GwcWyiv‡ji gva¨‡g cÖ‡qvR‡b AwaK Gbm‡_wUK †`qv †h‡Z cv‡i Ges Acv‡ik‡bi ci e¨v_vbvkK Jla †`qv †h‡Z cv‡i|

mvavib G‡bm‡_wUK - hw` Avcbv‡K GKwU mvavib Gbm‡_wUK †`qv nq Zvn‡j hLb Aem&‡UwUªwkqvb wmRvwiqvb †mKkb cwiPvjbv Ki‡eb ZLb Avcwb Nygš— _vK‡eb| eZ©gv‡b mvavib G‡bm‡_wmqv Lye Kg e¨envi Kiv nq, Bnv nqZ wKQz Ri“ix cÖ‡qvR‡b e¨envi Kiv †h‡Z cv‡i, hw` †Kvb Kvi‡b Avcbvi AvÂwjK G‡bm‡_wUK Dc‡hvMx bv nq A_ev Avcwb Nywg‡q _vK‡Z Pvb| cÖwZ ai‡bi G‡bmw_wUK Gi DcKvixZv I AcKvixZv Av‡Q hv GB cyw¯—Kvi †kl ch©v‡q eY©bv Kiv n‡q‡Q| cÖ_‡g Bnv Rvbv cÖ‡qvRb †h hLb GKwU wmRvwihvb †mKkb cwiKíbv Kiv nq ZLb wK N‡U Ges Avcbvi Acv‡ik‡bi ZvwiL †`qv| G‡jKwUf (cwiKwíZ ) wmRvwiqvb †mKkb wbix¶v

Your Anaesthetic for Caesarean Section, 2nd edition, October 2009 BENGALI

mvavibZ: Acv‡ik‡b Avmvi c~‡e© Avcbv‡K nvmcvZv‡j Avm‡Z n‡e| wgWIqvBd Acv‡ik‡bi c~‡e© Avcbv‡K †`L‡eb Ges wKQz i³ †b‡eb cix¶v Kivi Rb¨ | wZwb e¨vL¨v Ki‡eb wK Avkv Kiv hvq| AwaKvsk gwnjvB wbix¶vi ci N‡i P‡j hvb Ges Acv‡ik‡bi w`b nvmcvZv‡j Av‡mb, Z‡e Avcbv‡K nqZ c~‡e©i iv‡Z nvmcvZv‡j _vK‡Z n‡Z cv‡i| wgWIqvBd nqZ Avcbv‡K U¨ve‡jU †`‡eb Avcbvi †c‡Ui GwmW Kgv‡bvi Rb¨ Ges Amy¯’Zv cÖwZ‡iva Kivi Rb¨| Acv‡ik‡bi c~‡e©i iv‡Z Avcbv‡K GKwU U¨ve‡jU MÖnb Kiv `iKvi Ges Acv‡ik‡bi w`b mKv‡j GKwU| Bnv Avcbv‡K e¨vL¨v Kiv n‡e| G‡bm‡_wUó Gi cwi`k©b Avcbvi wmRvwiqvb nIqvi c~‡e© Avcbv‡K GKRb G‡bm&‡_wUó †`L‡eb | G‡bm&‡_wUó Avcbvi †gwWK¨vj BwZnv‡mi e¨vcv‡i Ges AZx‡Z Avcbvi †Kvb G‡bm‡_wUK n‡q _vK‡j Zv wb‡q Avcbvi mv‡_ K_v ej‡eb| Avcbv‡K nqZ GKwU cix¶v ev AviI AwaK cix¶vi Kivi cÖ‡qvRb n‡Z cv‡i| G‡bm‡_wUó wewfbœ ai‡bi G‡bm‡_wUK wb‡q Avcbvi mv‡_ Av‡jvPbv Ki‡eb Ges Avcbvi cÖ‡kœi DËi †`‡eb |

H w`b wgWIqvBd Avcbvi Acv‡ik‡bi mgq wbwðZ Ki‡eb Ges wbix¶v Ki‡eb †h Avcwb U¨ve‡jU MÖnb K‡i‡Qb wKbv| Avcbvi wewKwb jvBb nqZ †kf Kiv n‡Z cv‡i| Avcbvi nv‡Zi Kwâ ev cvu‡qi †Mvovjxi Dci bvghy³ e¨vÛ jvMv‡bv n‡e| wgWIqvBd nqZ Avcbv‡K we‡kl UvBU ÷wKsm (TED ÷wKsm ejv nq) civi Rb¨ mvnvh¨ Ki‡Z cv‡ib, hv‡Z Avcbvi cv‡q i³ RgvU evav eÜ Kiv hvq| Avcbv‡K GKwU Ôw_‡qUvi MvDbÕ †`qv n‡e civi Rb¨ | Avcbvi m½x hw` †_‡K _v‡Kb Avcbvi I wgWIqvBd Gi mv‡_ Acv‡ikb w_‡qUv‡i _vK‡Z cvi‡eb| GKRb wgWIqvBd Avcbv‡K Acv‡ikb w_‡hUv‡ii Rb¨ we‡kl Kvco †`‡eb| Acv‡ikb w_‡qUv‡i wb‡gœ ewY©Z A‡bK †jvKRb KvR K‡ib : • wgWIqvBd †mLv‡b _vK‡eb Avcbv‡K I Avcbvi wkï‡K hZœ †bqvi mvnv‡h¨i Rb¨| • G‡bm‡_wUó Gi GKRb mnKvix _vK‡eb| • Ae&m‡UwUªwmqvb Gi GKRb mnKvix I ¯Œve bvm© _vK‡eb |

Your Anaesthetic for Caesarean Section, 2nd edition, October 2009 BENGALI

• AviI GKRb bvm© _vK‡eb hvi `vqxZ¡ n‡jv AwZwi³ hš¿cvwZ †`qv| me©‡gvU cÖvq mvZRb Kg©Pvix m`m¨ w_‡hUv‡i _vK‡eb|

w_‡qUv‡i Avcbvi wbKU hš¿cvwZ ivLv n‡e Avcbvi i³ Pvc, nvU© †iBU Ges i‡³ AwK&ª‡R‡bi cwigvb cwigvc Kivi Rb¨ | Bnv‡Z e¨v_v jvM‡e bv| G‡bm‡_wUó GKwU Kvbyjv jvMv‡eb (GKwU nvév c −vw÷K wUDe) Avcbvi nv‡Zi i‡M ev evû‡Z Ges GKwU wWªc Gi ga¨ w`‡q Zij c`v_© cÖevwnZ Kivi Rb¨| Zvici G‡bm‡_wUó G‡bm‡_wUK ïi“ Ki‡eb| GKwU †jvK¨vj ev ¯’vbxq G‡bm‡_wUó cvIqv hw` Avcbvi GKwU AvÂwjK G‡bm‡_wUK Kiv nq Zvn‡j Avcbvi m½x Acv‡iwUs w_‡qUv‡i Avm‡Z cvi‡eb| Zv‡`i‡K emvi Rb¨ ejv n‡e Ges K‡¶i wKQz ¯’vb cwinvi K‡i Pjvi Rb¨ ejv n‡e| Bnv Kiv nq hv‡Z Acv‡ik‡bi hš¿cvwZ‡Z RxevYy msµwgZ nIqvi SzuwK Kgv‡bvi Rb¨| (hw` Avcbv‡K GKwU mvavib G‡bm‡_wUK Kiv nq Zvn‡j Avcbvi ev”Pvi Rb¥`vZv m½x‡K Ab¨ K‡¶ A‡c¶v Kivi Rb¨ ejv n‡e)| Avcbv‡K ejv n‡e nqZ emvi Rb¨ A_ev cvk wd‡i †kvqvi Rb¨ †cQb w`K evuKv K‡i| G‡bm‡_wUó †÷wijvBwRs Zij c`v_© Øviv Avcbvi †cQb w`‡K †cB›U Ki‡eb, hv‡Z VvÛv Abyfe n‡e| ZLb Zviv Avcbvi wbgœv‡½i ga¨eZx© ¯’v‡b GKwU Dchy³ ¯’vb LyuR‡eb Ges GKwU †QvU †jvK¨vj G‡bm‡_wmK Bb‡RKkb †`‡eb Pvgov‡K Aek Kivi Rb¨| Bnvi d‡j wKQz mgq k³ jvM‡Z cv‡i| Zvici, GKwU ¯úvBbvj G‡bm‡_wmó Gi Rb¨GKwU m~¶è m~uB Avcbvi †cQ‡b XyKv‡bv n‡e| KLbI Avcwb g‡b Ki‡Z cv‡ib GKwU k³ wKQz cv‡qi bx‡Pi w`‡K hv‡”Q, m~uB cÖ‡ek Kivi mv‡_ mv‡_| GKwU †QvU ˆe`y¨wZK k‡Ki gZ|

Your Anaesthetic for Caesarean Section, 2nd edition, October 2009 BENGALI

hw` Bnv nq Zvn‡j Avcbvi DwPZ G‡bm‡_wmó‡K Zv ejv, Z‡e Bnv ¸i“Z¡c~Y© †h Avcwb Zv Pvwj‡q hv‡eb hLb G‡bm‡_wmó ¯úvBbvj Bb‡RKkb w`‡Z _vK‡eb| hLb myuBwU mwVK Ae ’v‡b _v‡K Zv ZLb ‡jvK¨vj G‡bm‡_wmK I GKwU e¨v_vbvkK Jla kix‡i cÖ‡ek K‡i Ges Zvici m~uB mwi‡q Avbv nq| Bnv mvavibZ: K‡qK wgwbU mgq †bq Z‡e hw` KwVb nq mwVK ¯’vb Lyu‡R †c‡Z Zvn‡j †ekx mgq jvM‡Z cv‡i| GKwU GwcWyiv‡ji Rb¨ (A_ev †hŠ_ ¯úvBbvj GwcWyivj), G‡bm‡_wmó GKwU eo myuB e¨envi Ki‡eb Zvn‡j Zv Avcbvi †gi“`‡Ûi bv‡f©i wbKU GwcWyivj K¨v‡_Uv‡ii ’v‡b (wUDe) ivLv hvq| ¯úvBbvj Gi †¶‡Î Bnv gv‡S gv‡S wUswjs Abyf~Z nq A_ev Avcbvi cv‡q †QvU ˆe`y¨wZK k‡Ki g‡Zv| G‡bm‡_wUó hLb GwcWyivj †`‡eb ZLb Zv †bqv Pvwj‡q hvIqv ¸i“Z¡c~Y©, Z‡e GKevi hLb K¨v‡_Uvi h_v¯’v‡b ivLv n‡e ZLb Zviv myuB mwi‡q †b‡eb Ges Zv Avcbv‡K Pvwj‡q †h‡Z n‡e bv| Avcwb Rvb‡eb KLb ¯úvBbvj ev GwcWyivj KvR Ki‡Q, Kvib Avcbvi cv¸wj fvix I Mig g‡b n‡e| G¸wj wUsMjI Kiv ïi“ Ki‡e| Aek nIqv µgvš^‡q Avcbvi kix‡i Qwo‡q co‡e| G‡bm‡_wmó cix¶v K‡i †`L‡eb †h Acv‡ikb ïi“i c~‡e© Bnv Avcbvi ey‡Ki gvSLv‡b †cŠ‡Q‡Q| gv‡S gv‡S Avcbvi Ae ’vb cwieZ©b Kiv `iKvi †h, wbwðZ nIqvi Rb¨ G‡bm‡_wmK fv‡jvfv‡e KR Ki‡Q| wUg cÖvqB Avcbvi i³ Pvc cwigvc Ki‡e| hLb G‡bm&‡_wUK KvR Ki‡e, ZLb GKRb wgWIqvBd GKwU wUDe (GKwU BD‡ibvix K¨v‡_Uvi) Avcbvi e−vWvi G XyKv‡eb, Acv‡ikb PjvKvjxb Zv Lvwj Kivi Rb¨| Bnv AmyweavRbK bvI n‡Z cv‡i| wUDewU c‡ii w`b mKvj ch©š— H ¯’v‡b ivLv n‡e| m~Zivs †ckve Kivi Rb¨ Avcbv‡K `y:wðš—v Ki‡Z n‡e bv| Acv‡ik‡bi Rb¨, Avcbv‡K wPZ K‡i †kvqv‡bv n‡e Ges ev‡g †njv‡bv Ae¯’vq ivLv n‡e| hw` Avcwb †Kvb mgq Amy¯’ †eva K‡ib, Zvn‡j Avcbvi DwPZ G‡bm‡_wmó †K Zv ejv| i³ Pvc Kgvi d‡j cÖvqB Amy¯’Zv Abyfe n‡e| G‡bm‡_wmó Avcbv‡K mvnvh¨ Kivi Rb¨ wPwKrmv †`‡eb| ev”Pv Rb¥ †bqvi c~e© ch©š—, Avcbv‡K nqZ GKwU ¯^”Q c −vw÷K gv‡¯‹i ev gy‡Lv‡ki gva¨‡g AwK&ª‡Rb †`qv n‡Z cv‡i| hv‡Z wbwðZ Kiv hvq R‡b¥i c~‡e© wkï hv‡Z cÖPzi cwigv‡b AwK&ª‡Rb cvq| Acv‡ikb GKwU c`v©i gva¨‡g Avcbv‡K I Avcbvi m½x‡K Avcbvi kix‡ii bx‡Pi As‡ki I mvR©vix †_‡K c„_K ivL‡e| G‡bm‡_wUó memgq Avcbvi mv‡_ _vK‡eb| Avcwb nqZ †cQ‡b A‡bK cÖ¯‘wZi kã ïb‡Z cv‡eb| Bnv nqZ GB Kvi‡b †h, Aem‡UwUªwmqvb wgWIqvBd I Kg©Pvix‡`i `j wb‡q w_‡qUv‡i KvR K‡ib| Avcbvi Pvgov mvavibZ: wewKwb jvB‡bi bx‡P mvgvb¨ KvuUv nq| hLb Avcbvi Acv‡ikb Pj‡e ZLb Avcwb hš¿cvwZi kã ïb‡eb Ges ev”Pvi kixi †_‡K Zij c`v_© Uvbvi kã| Avcwb nqZ Uvbv ev Pvc †eva Ki‡Z cv‡ib, Z‡e Avcwb e¨v_v cv‡eb bv| wKQz wKQz gwnjv Bnv‡K eY©bv K‡ib †h, ÔÔ‡KD †hb †c‡Ui Dci wKQz †avqvi KvR Ki‡QÕÕ, hLb Acv‡ikb Pj‡e ZLb G‡bm‡_wUó Avcbvi mv‡_ K_v ej‡eb Ges cÖ‡qvR‡b Avcbv‡K AviI †e`bvbvkK Jla †`‡eb| KLbI nqZ Avcbv‡K mvavib G‡bm‡_wUK †`qvi cÖ‡qvRb n‡Z cv‡i, Z‡e Bnv A¯^vfvweK| Acv‡ikb ïi“i ci †_‡K Bnv mvavibZ: 10 wgwbU mgh †bq, Avcbvi ev”Pv Rb¥ †bqv ch©š—| Rb¥ †bqvi ciciB wgWIqvBd Avcbvi ev”Pv‡K ïKv‡eb I cix¶v Ki‡eb| GKRb c¨vwWqvwUªwkqvb nqZ wgWIqvBd Gi mv‡_ KvR Ki‡eb| Gi ci, Avcwb I Avcbvi m½x nqZ ev”Pv‡K Rwo‡q ai‡Z cvi‡eb, Ges †Kvb †Kvb †¶‡Î kix‡ii mv‡_ jvMv‡Z cvi‡eb|

Your Anaesthetic for Caesarean Section, 2nd edition, October 2009 BENGALI

R‡b¥i ci GKwU Jla hv‡K wm‡›Uvwmbb ejv nq Zv Avcbvi wWª‡c †`qv nq, Avcbvi BD‡Uivm (I¤^) k³ Ki‡Z mvnv‡h¨i Rb¨ Ges Avcbvi c −v‡m›Uv †ei Kivi Rb¨| GKwU Gw›Uev‡qvwUKI wWª‡c †`qv nq hv‡Z Avcbvi KvuUv ¯’v‡b Bb‡dKkb nIqvi SuywK Kgv‡Z cv‡i| Aem&‡UwUªwmqvb AviI AvavN›Uv mgq †b‡eb Acv‡ikb †kl Kivi Rb¨| Gici, Avcbv‡K nqZ GKwU mv‡cvwmUix (U¨ve‡jU) Avcbvi wbgœv‡½ †`qv n‡e e¨v_vgy³ Ki‡Z hLb G‡bm‡_wUK Gi cÖwZwµqv †kl nq|

Your Anaesthetic for Caesarean Section, 2nd edition, October 2009 BENGALI

hLb Acv‡ikb †kl n‡e Acv‡ik‡bi ci Avcbv‡K wiKfvix K‡¶ wb‡q hvIqv n‡e, †hLv‡b Avcbvi i³ Pvc µgvMZ ch©‡e¶b Kiv n‡e| Avcbvi m½x I ev”Pv mvavibZ: Avcbvi mv‡_ _vK‡eb| Avcbvi ev”Pv‡K IRb Kiv n‡e Ges Zvici hw` Avcwb Pvb Zvn‡j Avcwb ey‡Ki `ya LvIqv‡bv ïi“ Ki‡Z cvi‡eb| wiKfvix K‡¶ Avcbvi G‡bm‡_wUK µgvš^‡q cÖwZwµqv nviv‡e Ges Avcwb nqZ wUswjs Abyfe Ki‡eb Ges PzjKvbx †eva Ki‡eb| K‡qK N›Uvi g‡a¨B Avcwb Avevi Avcbvi cv ¸wj bvovPvov Ki‡Z cvi‡eb| Avcbvi ¯úvBbvj ev GwcWyivj Gi mv‡_ †`qv †e`bv Kgv‡Z †e`bvbvkK Jla AviI K‡qK N›Uv Ae¨vnZ ivLv n‡e| wbqwgZ †e`bvbvkK Jla e¨envi Kiv `iKvi hLb bvm© ev Wv³viiv Avcbv‡K Zv Advi Ki‡eb, e¨v_vi Rb¨ A‡c¶v bv K‡i| †h Jla Zviv Avcbv‡K †`‡e Zv Avcbvi wkï‡K ey‡Ki ya LvIqv‡bv‡Z †Kvb Amyweavi Kvib n‡e bv|

Your Anaesthetic for Caesarean Section, 2nd edition, October 2009 BENGALI

GKwU mvavib G‡bm‡_wUK †bqv wbgœwjwLZ Kvi‡b Avcbvi nqZ GKwU mvavib Gbm‡_wUK Gi cÖ‡qvRb n‡Z cv‡i :

• hw` Avcbvi †Kvb wbw`©ó Ae¯’v _v‡K hLb i³ wVKfv‡e RgvU n‡Z cv‡i bv, ZLb GKwU AvÂwjK G‡bm‡_wUK bv n‡j fv‡jv|

• hw` Avcbvi nVvr K‡i wmRvwiqvb Gi cÖ‡qvRb nq, ZLb nqZ GKwU AvÂwjK G‡bm‡_wUK KvR Kivi Rb¨ h‡_ó mgq bvI _vK‡Z cv‡i|

• Avcbvi †cQb w`‡Ki A ^vfvweKZv nqZ GKwU AvÂwjK G‡bm‡_wU‡K mgm¨v g~jK ev Am¤¢e K‡i Zzj‡Z cv‡i|

• ‡Kvb ‡Kvb mgq, GKwU ¯úvBbvj ev GwcWyivj G‡bm‡_wUK h_v¯’v‡b †`qv hvq bv, A_ev fv‡jvfv‡e KvR K‡i bv|

GKwU AvÂwjK G‡bm‡_wmó Gi g‡ZvB AwaKvsk cÖ¯‘wZi welq GKB iKg| hvB‡nvK Avcbvi m½x Acv‡ikb w_‡qUv‡i Avcbvi mv‡_ _vK‡Z cvi‡eb bv| Avcbv‡K GKwU G›UvwmW cvb Kivi Rb¨ †`Iqv n‡e (Avcbvi †c‡U GwmW Kgv‡bvi Rb¨) Ges GKwU mvavib G‡bm‡_wUK ïi“i c~‡e© GKRb wgWIqvBd nqZ Avcbvi e −vWvi G GKwU K¨v‡_Uvi XyKv‡eb| G‡bm‡_wmó GKwU gy‡Lv‡ki gva¨‡g K‡qK wgwbU AwK&ª‡R‡b k¦vm cÖk¦vm †bqvi Rb¨ ‡`‡eb| GKevi hLb Aem&‡UwUªwmhvb Ges mKj wUg ˆZix _vK‡eb ZLb G‡bm‡_wmó Gi mnKvix Avcbvi Nv‡o nvjKvfv‡e Pvc †`‡eb| Bnv‡Z †c‡Ui Zij c`v_© jvs‡m †h‡Z evavcÖvß n‡e| G‡bm‡_wUK Lye `ª“Z KvR Ki‡e|

Your Anaesthetic for Caesarean Section, 2nd edition, October 2009 BENGALI

hLb Avcwb Nygš— _v‡Kb, ZLb G‡bm‡_wUó GKwU wUDe DBÛ cvB‡c ivL‡eb hv‡Z Avcbvi †cU †_‡K Zij c`v_© jvs‡m cÖ‡ek Ki‡Z bv cv‡i Ges GKwU †gwk‡bi gva¨‡g k¦vm †bqvi Rb¨| G‡bm‡_wUó Ae¨vnZfv‡e G‡bm‡_wUK cÖ`vb Ki‡eb hv‡Z Avcbv‡K Nyg cvwo‡q ivLv hvq Ges Aem&‡UwUªwkqvb‡K Avcbvi ev”Pv wbivc‡` cÖm‡e mnvqZv Kiv hvq| Z‡e GB wel‡qi †KvbwUB Avcwb Rvb‡eb bv | hLb Avcwb †R‡M DV‡eb, Avcbvi Mjvq nqZ A¯^w¯— jvM‡Z cv‡i wUDe †_‡K, Ges Avcwb Acv‡ik‡bi d‡j PzjKvwb ev Mjvfv½v †eva Ki‡eb| Avcwb nqZ Nyg Nyg †evaI Ki‡Z cv‡ib Ges m¤¢eZ wKQz mg‡qi Rb¨ mvgvb¨ Amy ’ n‡Z cv‡ib| Z‡e kxNÖB Avcwb ¯^vfvweK n‡q hv‡eb| Avcbv‡K wiKfvix GjvKvq wb‡q hvIqv n‡Z cv‡i, †hLv‡b Avcwb Avcbvi ev”Pv I m½xi mv‡_ †hvM w`‡Z cvi‡eb| Ri“ix wmRvwiqvb †mKkb GKwU Ri“ix Acv‡ikb n‡jv Zv hvi Rb¨ GK ev `yB w`‡bi AwaK cwiKíbv Kiv nq bvB| Bnv KZUv Ri“ix Zv A‡bK ZviZ‡g¨i e¨vcvi| hLb †Kvb GKwU Kg Ri“ix nq ZLb †mwU‡K cwiKwíZ Acv‡ik‡bi gZB Acv‡ikb Kiv hvq| hw`I Avcbvi kyaygvÎ GKwU G›UvwmW U¨ve‡j‡Ui Rb¨B mgq _vK‡e †ekxifvM †¶‡Î c~e© †_‡K| Ab¨w`‡K wKQz Acv‡ikb nqZ Lye `ª“Z m¤úv`b Kiv `iKvi| Bnv nqZ wm×vš— †bqvi GK N›Uvi g‡a¨ ev Lye †¶‡Î hZ ZvovZvwo m¤¢e nq| Lye Ri“ix wmRvwiqvb Acv‡ik‡bi Lye mvavib Kvib n‡jv hLb Avcbvi ev”Pvi nVvr †Kvb Amyweav nq(hv‡K gv‡S gv‡S d¨vUvj wWm‡Uªm ejv nq)| hw` Avcbvi Lye Ri“ix wmRvwiqvb Gi `iKvi nq, ZLb mvavibZ: Avgiv †h cÖ¯‘wZ MÖnb Kwi Zv nqZ cwieZ©b n‡Z cv‡i A_ev evwZj n‡Z cv‡i| Avcbvi GKwU K¨vbyjvi `iKvi n‡e (GKwU c−vw÷K wUDe) hv Avcbvi nv‡Zi i‡M ¯’vcb Kiv n‡e ev evû‡Z, hw` BwZg‡a¨ Zv bv Kiv nq| wUg nqZ Avcbv‡K G›UvwmU Jla w`‡Z cv‡i hv‡Z Avcbvi †c‡U GwmW Kgv‡bv hvq| K¨vbyjvi gva¨‡g U¨ve‡jU AvKv‡i bv w`‡q| Avcbv‡K nqZ GKwU UvBU wdwUs gy‡Lvk w`‡q AwK&ª‡Rb †`qv n‡Z cv‡i| hw` BwZg‡a¨ Avcbv‡K GKwU GwcWyivj †`qv n‡q _v‡K e¨v_vbvkK cÖ vb Kivi Rb¨ Avcbvi †jev‡ii mgq Ges Zv hw` fv‡jvfv‡e KvR K‡i, Zvn‡j G‡bm‡_wUó nqZ Avcbv‡K h‡_ó G‡bm‡_wUK Bnvi gva¨‡g †`qvi †Póv Ki‡eb hv‡Z GKwU Ri“ix wmRvwiqvb Kiv †h‡Z cv‡i| Zviv GKwU ‡jvK¨vj G‡bm‡_wUK Gi eo †WvR †`‡eb| Zvn‡j Acv‡ik‡bi Rb¨ e¨v_vi e −K kw³kvjx _vK‡e|

G‡bm‡_wUó‡K wm×vš— MÖnb Ki‡Z n‡e †h, GwcWyivj c~Y© Kivi Rb¨ h‡_ó mgq Av‡Q wKbv ev Avcbv‡K GKwU ¯úvBbvj †`qv n‡e wKbv| hw` Avcbvi GwcWyivj bv _v‡K A_ev hw` Avcbvi GwcWyivj h‡_ó e¨v_vbvkK cÖ vb bv K‡i| hw` GKwU AvÂwjK G‡bm‡_wUK Kivi Rb¨ Avcbvi h‡_ó mgq bv _v‡K A_ev Lye fv‡jvfv‡e Zv Kivi Rb¨ h‡_ó mgq bv _v‡K Zvn‡j Avcbv‡K GKwU mvavib G‡bm‡_wUK †`qv n‡e| hw` Avcwb G‡bm‡_wUó †K e‡j _v‡Kb †h Avcwb GKwU AvÂwjK G‡bm‡_wUK cQ›` K‡ib Zvn‡j mvavib G‡bm‡_wUK nevi m¤¢vebv wmRvwiqvb Gi †¶‡Î †ekxifvM gwnjv‡`i Rb¨ Lye Kg| ïaygvÎ cÖwZ 10wU wmRvwiqvb Gi GKwU Lye Ri“ix|

gv‡S gv‡S hw` Lye Zvovûov Kivi `iKvi nq, ZLb wU‡gi ch©vß mgq _v‡K bv cy‡ivcywi welqwU Avcbv‡K I Avcbvi m½x‡K eb©bv Kivi †h wK NU‡Q| Avcbvi m½x‡K nqZ †Wwjfvix K‡¶ A‡c¶vi Rb¨ ejv n‡Z cv‡i hLb Avcbvi Acv‡ikb nq| Bnv nqZ Avcbv‡K fxZ ev gg©vnZ Ki‡Z cv‡i| hvB‡nvK, Kg©Pvixiv me© v Avcbvi mv‡_ K_v ej‡eb I e¨vL¨v Ki‡eb wK n‡q‡Q Ges †Kb|

Your Anaesthetic for Caesarean Section, 2nd edition, October 2009 BENGALI

Acv‡ik‡bi ci †e`bvbvkK GKwU wmRvwiqvb Acv‡ikb nIqvi ci ‡e`bvbvkK cÖ`vb Kivi bvbv iK‡gi cš’v Av‡Q, hv wb‡gœ †`Iqv n‡jv :

• Avcbv‡K nqZ ¯úvBbvj ev GwcWyiv‡j GKwU `xN©¶b KvR K‡i Ggb †e`bv bvkK †`Iqv n‡Z cv‡i| • ‡Kvb †Kvb nvmcvZv‡ji wUg GwcWyivj K¨v‡_Uvi h_v¯’v‡b †i‡L †`q Zvn‡j Zviv Gi gva¨‡g AviI AwaK

Jla w`‡Z cv‡ib| • GKRb wgWIqvBd nqZ Avcbv‡K Ômv‡cvwmUwimÕ hv‡Z e¨v_vbvkK Jla _v‡K †`‡eb, Acv‡ik‡bi †k‡l| • GKRb wgWIqvBd nqZ giwdb ev GKB iKg †e`bv bvkK Bb‡R± Ki‡Z cv‡ib| • wUg nqZ giwdb Av‡Q Ggb wWªc Avcbv‡K w`‡Z cv‡i A_ev GKB iK‡gi Jla| Avcwb PvB‡j KZUzKz

†e`bvbvkK Jla †b‡eb Zv wbqš¿b Ki‡Z cv‡ib| Bnv‡K ejv nq Ôc¨v‡k›U K‡›UªvjW Gbvj‡mwmqv ev PCA’

• GKRb wgWIqvBd Avcbv‡K U¨ve‡jU †`‡eb †hgb diclofinac, paracetamol ev codeine AvÂwjK G‡bm‡_wUK Gi myweav hw` Zv mvavib G‡bm‡_wUK Gi mv‡_ Zzjbv Kiv nq :

• ¯úvBbvj I GwcWyivj mvavibZ: Avcbvi I ev”Pvi Rb¨ wbivc`| • G‡Z Avcwb I Avcbvi m½x Rb¥ nIqv †`Lv fvMvfvwM Ki‡Z cvi‡eb| • Gici Avcbvi Nyg Nyg cv‡e bv| • Zviv Avcbv‡K LvIqv‡e I ev”Pv‡K a‡i ivL‡e, hZ ZvovZvwo m¤¢e| • Gici Avcbv‡K Lye fv‡jv †e`bvbvkK Jla †`qv n‡e| • Avcbvi wkï hLb Rb¥ †b‡e ZLb †m Aw_K m‡PZb _vK‡e|

AvÂwjK G‡bm‡_wUK Gi Amyweav hw` Zv mvavib G‡bm‡_wUK Gi mv‡_ Zzjbv Kiv nq :

• ¯úvBbvj I GwcWyivj Avcbvi i³Pvc Kgv‡Z cv‡i, hw`I Bnv wPwKrmv Kiv mnR| • mvavibZ: G¸wj Kvh©Kix n‡Z `xN© mgq jv‡M, myZivs Avcbv‡K Acv‡ik‡bi Rb¨ cÖ ‘Z Ki‡Z `xN© mgq

jv‡M mvavib G‡bm‡_wUK Gi †P‡q| • KLbI KLbI Bnv nqZ Avcbv‡K SuvKv‡bvi gZ Ab~f~wZ w`‡Z cv‡i| • Lye Kg †¶‡Î G¸wj h‡_ó fv‡jvfv‡e KvR K‡i bv, m~Zivs wUg‡K nqZ GKwU mvavib G‡bm‡_wUK w`‡Z

nq| • cÖwZ 10 Rb gwnjvi g‡a¨ Pvi R‡bi hv‡`i GwcWyivj n‡q‡Q Ges 10 Rb gwnjvi g‡a¨ `yBR‡bi ¯úvBbvj

n‡q‡Q hviv †cQ‡bi ’v‡b big †eva Ki‡Z cv‡ib, †hLv‡b m~uB cÖ‡ek K‡i‡Q GB big ¯’vb nqZ K‡qK mßvn ev gvm ch©š— _vK‡Z cv‡i,Z‡e Zv Lye Kg †¶‡Î nq|

wmRvwiqvb †mKk‡bi gva¨‡g ev”Pv cÖme Ki‡j Zv wbivc` Ges Dcnvi¯^i“c AwfÁZv| †ekxifvM gwnjvB GB c×wZi mgq †R‡M _vK‡Z Pvb| Ab¨vb¨iv nqZ Dc‡ii Av‡jvP¨ Kvi‡b Nywg‡q _vK‡Z Pvb| Avgiv AvkvKwi GB cyw¯—Kv Avcbv‡K mvnvh¨ Ki‡e, hv‡Z Avcwb me‡P‡q fv‡jv cš’v cQ›` Ki‡Z cv‡ib, hw` Avcbvi wmRvwiqvb Acv‡ik‡bi cÖ‡qvRb g‡b K‡ib|

Your Anaesthetic for Caesarean Section, 2nd edition, October 2009 BENGALI

GKwU AvÂwjK G‡bm‡_wUK Gi SzuwK mg~n wb‡gœi †Uwe‡j †`Lv‡bv n‡q‡Q| Gi †_‡K cÖvß Z_¨ WKz‡g›U AvKv‡i cÖKvk Kiv nq| †Uwe‡ji wdMvi ev msL¨v AvbygvwbK Ges Bnv nqZ wewfbœ nvmcvZv‡j wfbœ wfbœ n‡Z cv‡i :

• Holdcroft A, Gibberd FB, Hargrove RL, Hawkins DF, Dellaportas CI.

Neurological complications associated with pregnancy. British Journal of Anaesthesia 1995 – chapter 75, pages 522–526.

• Jenkins K, Baker AB. Consent and anaesthetic risk. Anaesthesia 2003 – chapter 58, pages 962–984.

• Jenkins JG, Khan MM. Anaesthesia for Caesarean section: a survey in a UK region from 1992 to 2002. Anaesthesia 2003 – chapter 58, pages 1114–1118.

• Jenkins JG, Some immediate serious complications of obstetric epidural analgesia and anaesthesia: a prospective study of 145,550 epidurals. International Journal of Obstetric Anesthesia 2005 – chapter 14, pages 37–42.

• Reynolds F, Infection a complication of neuraxial blockade. International Journal of Obstetric Anesthesia 2005 – chapter 14, pages 183–188.

‡jevi Gi e¨v_v Kgvevi Rb¨ GwcWyivj ev ¯úvBbvj Gi SuywK SzuwKi aib

KZ Nb Nb Bnv N‡U ? Bnv KZ mvavib ?

i³Pv‡c D‡j−L‡hvM¨ KgwZ

cÖwZ 5Rb gwnjvi g‡a¨ 1 R‡b (¯úvBbvj) cÖwZ 50Rb gwnjvi g‡a¨ 1 R‡b (GwcWyivj)

mvavib gv‡S gv‡S

wmRvwiqvb †mKkb fv‡jvfv‡e KvR Ki‡Q bv ZvB Avcbvi GKwU mvavib G‡bm‡_wUK `iKvi

cÖwZ 20Rb gwnjvi g‡a¨ 1 R‡b (GwcWyivj) cÖwZ 100 Rb gwnjvi g‡a¨ 1 R‡b (¯úvBbvj)

mvavib gv‡S gv‡S

AZ¨waK gv_ve¨v_v

cÖwZ 100 Rb gwnjvi g‡a¨ 1 R‡b (GwcWyivj) cÖwZ 500 Rb gwnjvi g‡a¨ 1 R‡b (¯úvBbvj)

mvavib bq mvavib bq

bvf© ¶wZMÖ ’ (cv‡q ev cv‡qi cvZv Aek ev ~e©j cv) cÖfve Qqgv‡mi AwaK _vK‡Z cv‡i|

A ’vqx cÖwZ 1,000 Rb gwnjvi g‡a¨ 1 R‡b ¯’vqx cÖwZ 13,000Rb gwnjvi g‡a¨ 1 R‡b

Kg Kg

GwcWyivj ÔGe‡m‡mm&Õ (Bb‡dKkb)

cÖwZ 50,000 Rb gwnjvi g‡a¨ 1 R‡b

Lye Kg

Your Anaesthetic for Caesarean Section, 2nd edition, October 2009 BENGALI

‡gwbb&RvBwUm

cÖwZ 100,000 Rb gwnjvi g‡a¨ 1 R‡b

Lye Kg

GwcWyivj n¨vgv‡Uvgv (i³ RgvU)

cÖwZ 170,000Rb gwnjvi g‡a¨ 1 R‡b

Lye Kg

`~NUbvq AÁvb nIqv

cÖwZ 5,000Rb gwnjvi g‡a¨ 1 R‡b

Kg

gvivZœK RLg, c¨vivjvBmmn

cÖwZ 250,000Rb gwnjvi g‡a¨ 1 R‡b

LyeB Kg

cÖKvwkZ MÖš’ †_‡K †Kvb mwVK msL¨v cvIqv hvq bvB, GB mKj SzuwKi †¶‡Î| msL¨v¸wj AvbygvwbK, Ges nvmcvZvj †_‡K nvmcvZv‡j ZviZg¨ n‡Z cv‡i|

Your Anaesthetic for Caesarean Section, 2nd edition, October 2009 BENGALI

• Ruppen W, Derry S, McQuay H, Moore RA. Incidence of epidural hematoma,

infection, and neurologic injury in obstetric patients with epidural analgesia/ anesthesia. Anesthesiology 2006 – chapter 105, pages 394–399. GKwU RvZxq Rwi‡c †`Lv †M‡Q †h AvÂwjK G‡bm‡_wmqv hv Mf©eZx gwnjv‡`i Rb¨ e¨envi Kiv nq Zv‡Z Mf©Kvjxb ¶wZi SzuwK Kg _v‡K, Ab¨ MÖ“‡ci †ivMxi †P‡q (Cook TM, Counsell D, Wildsmith JAW. Major complications of cenral neuraxial block: report on the third National Audit Project of the Royal College of Anaesthetists. British Journal of Anaesthesia 2009; 102: 179-190) G‡bm‡_wUK&ª I G‡bm‡_wUK Gi SzuwK m¤ú‡K© Avcwb AviI Z_¨ Ôiqvj K‡jR Ad G‡bm‡_wUóÕ www.youranaesthetic.info †_‡K †c‡Z cv‡ib ev OAA †_‡K www.oaaformothers.info Avcwb wmRvwiqvb †mKk‡bi h‡Zœi gv‡bi e¨vcv‡i AviI Z_¨ wb‡gœi eB‡q †c‡Z cv‡ib : Caesarean section: clinical guideline (National Collaborating Centre for Women’s and Children’s Health; commissioned by the National Institute for Clinical Excellence. London: Royal College of Obstetricians & Gynaecologists Press, 2004). mvavib G‡bm‡_wUK Gi SzuwK SzuwKi aib KZ Nb Nb Bnv N‡U ? Bnv KZ mvavib ? ey‡Ki Bb‡dKkb cÖwZ 5 R‡b 1 Rb gwnjvi mvavib (†ekxifvMB gvivZœK bq) Mjv fv½v cÖwZ 5 R‡b 1 Rb gwnjvi mvavib Amy¯’ †eva Kiv cÖwZ 10 R‡b 1 Rb gwnjvi mvavib Kg AwK&ª‡Rb _vKvq k¦vm cÖk¦v‡m mgm¨v

cÖwZ 300 R‡b 1 Rb gwnjvi mvavib bq

‡cU †_‡K Zij c`v_© jvs‡m cÖ‡ek cÖwZ 300 R‡b 1 Rb gwnjvi mvavib bq KwY©qvj ÔA¨e‡ikbÕ (†Pv‡L PzjKvwb)

cÖwZ 600 R‡b 1 Rb gwnjvi mvavib bq

`vu‡Z ¶wZ cÖwZ 4,500R‡b 1 Rb gwnjvi Kg m‡PZbZv (Avcbvi G‡bm‡_wUó Gi mgq wKQz mgq †R‡M _vKv)

cÖwZ 250 †_‡K 1,000 R‡b 1 Rb gwnjvi

Kg

A¨vbvwdj¨vwK&ªm (GKwU AwZwi³ GjvwR©K cÖwZwµqv)

cÖwZ 10,000 †_‡K 20,000 R‡b 1 Rb gwnjvi

Lye Kg

g„Zz ev †eªb ¶wZMÖ¯’ g„Zz : cÖwZ 100,000 R‡b 1 R‡bi Kg gwnjv

Lye Kg (hy³iv‡R¨ eQ‡i 1 ev 2Rb)Lye Kg (mwVK msL¨v bvB)

Your Anaesthetic for Caesarean Section, 2nd edition, October 2009 BENGALI

GB cyw¯—Kv wj‡L‡Qb ÔBbdi‡gkb di gv`vim& mveKwgwU Ad `¨ Aem&U¨vwUªK G‡bm‡_wUó G‡mvwm‡qkbÕ| mveKwgwU wbgœwjwLZ †jvKR‡bi mgš^‡q MwVZ n‡q‡Q: Dr Rosie Jones (‡Pqvig¨vb) Charis Beynon (b¨vkbvj PvBì ev_© Uªvó, cÖwZwbwa) Shaheen Chaudry (‡fv³v cÖwZwbwa) Dr Rachel Collis (KbmvjU¨v›U G‡bm‡_wUó) Dr Rhona Hughes (Ôiqvj K‡jR Ad Aem‡UwUªwkqvb GÛ MvB‡bvKjwRóÕ cÖwZwbwa) Gail Johnson (Ôiqvj K‡jR Ad wgWIqvBd&mÕ cÖwZwbwa) Dr Michael Kinsella(KbmvjU¨v›U G‡bm‡_wUó) Dr Makani Purva (KbmvjU¨v›U G‡bm‡_wUó) Dr Ratnasabapathy Sashidharan(KbmvjU¨v›U G‡bm‡_wUó) Avgiv Dr Michael Wee (mv‡eK †Pqvig¨vb, ÔBbdi‡gkb di gv`vim& mveKwgwUÕ) †K, Dr Roshan Fernando Ges cÖ‡dmi Felicity Reynolds †K Zv‡`i c~‡e©i ms¯‹i‡bi Kv‡Ri Rb¨ ab¨ev` Rvbv‡Z PvB| • Avgiv gv‡q‡`i Rb¨ GKwU cyw¯—KvI ˆZix K‡iwQ Pain Relief in Labour bvgK Ges ˆØZ DVD †Z

`yBwU Qwe Coping with labour pain Ges Your anaesthetic for Caesarean section

• Avcwb Dfq cyw¯—Kv Avgv‡`i I‡qe mvB‡U cv‡eb, GKB mv‡_ wewfbœ fvlvq Abyevw`Z Gi g‡a¨ Av‡Q Aviex,

evsjv, K¨vbUwbR, †µv‡qwkqvb, †PK, †d«Â, Rvg©vb, MÖxK, ¸RivwU, wnw›`, AvBmj¨vwÛK, BUvwjqvb, RvcvwbR, g¨vÛvwib, †cvwjk, cZ…ywMR, cvÄvex, †ivgvwbqvb, ivwkqvb, mvwe©qvb, †mvgvjx, ¯ú¨vwbk, Zvwgj, D`©y Ges I‡qj&m|

Avcwb PvB‡j Dfq cyw¯—Kvi AwZwi³ Kwc †c‡Z cv‡ib (50 A_ev 750 wUi c¨vK) Ges ˆØZ DVD, www.oaaformthers.info ‡Z dg© c~ib Kiv gva¨‡g| OAA Secretariat Phone: +44 (0)020 8741 1311 E-mail: secretariat@oaa-anaes.ac.uk Website: www.oaaformothers.info Registered Charity No 1111382 © Obstetric Anaesthetists’ Association 2009 Second Edition, October 2009