Experts and professional associations criticize lack of anesthesia delivery in the SUS in Brazil

22/06/2010 - 07:30 / Updated 22/06/2010 - 07:30

Arthur Guimaraes
UOL News
In Sao Paulo

Experts and representatives of professional associations confirmed that they are critical data on humanization of deliveries made in state, municipal and philanthropic organizations that operate by the Unified Health System (SUS). As a report published yesterday showed the UOL News, a document produced by the Department of Health, based on feedback from users of SUS, indicates that 24% of respondents experienced labor taking anesthesia (spinal or epidural) on the back, 18 , 6% local anesthesia, 14% and 42.8% warm bath remedies.

Desiré Callegari, chairman of the Anesthesiology Society of São Paulo State, believes that the number (24%) of patients who took the anesthesia on the back is low, even considering that a large proportion of births in SUS is performed without abdominal surgery. "Today, all women should have the right not to feel pain, even in childbirth. If one takes anesthesia to pull a tooth, you should not have that option when having a child? It is a medical consensus. And we all know that there is a lower percentage of correct choice of anesthesia in the SUS, "says the expert who is a member of state and federal Medicine.


For him, there are two main causes for the problem. "First, even in the absence of guidance, pregnant women often arrive at the hospital already in an advanced stage to have the baby. Thus, they do not allow the anesthesiologist to study the case with the necessary discretion. "The main obstacle, however, is the lack of network structure of Health" The number of women who go on a drive SUS daily is too large . And missing features, missing drives, so doctors are missing. With the volume of patients is very high, it is not possible to account for running the hospitals and get the time to indicate the anesthesia, "he says.

Callegari argues that, contrary to what happens in some other specialties, the anesthesiologist must always be accompanying the patient. "It's like giving a pill and go to another room to see the next person. Need to be together and follow the proceedings. That is, if I have a four anesthesiologists on duty, they will meet the first four pregnant women who arrive. The other, unfortunately, will receive a call that is not ideal, "he says.

Monica Maria Siaulys, Ph.D. Anesthesia, University of São Paulo (USP), explains that the option for the elimination of pain must come firstly to the patient. "She is going to say to what extent the pain became unbearable and deserves to be medicated," he explains.

It judges as "shameful" the fact that 42.8% of patients interviewed for the survey only took medicine to ease the pain (in the case of normal births). "The drugs injected intravenously or intramuscularly reach the circulation rapidly, which may increase exposure by maternal and fetal medicine," she says, who is chief of Anesthesia Santa Joana Hospital and head of the Maternity Obstetric Anesthesia Pro-Matre .

As she points out, take drugs and not an anesthetic (spinal or epidural) should be limited to a very small group of women, such as those with coagulation problems. "It should be the exception rather than the technical routine. Private institutions, 95% of women give birth with anesthesia in the back. Every woman has the right to have a painless childbirth. And today the techniques allow the pain of childbirth are reduced without any detriment to the contractions, "he says. Below is excerpt from the report of the State Department of Health

Professor Antonio Carneiro, Professor of Gynecology and Obstetrics, Federal University of Rio de Janeiro (UFRJ), explains that another kind of instrument of pain relief used in the SUS network in Sao Paulo - the warm bath, cited by 14% of respondents - , can be used by mothers who opt for a less invasive method of containing the pain in childbirth. "But in my analysis, no indication of a medical standpoint. The modern trend is to make anesthesia back in all surgeries. There is, rather, cases in which anesthesia is not stated. But overall, the recommendation is to be applied to spinal or epidural call, "he says.

Analyses official
The report itself on the care in the SUS states verbatim that "the SUS services, improving access and coverage, must continue its improvement with the review of internal procedures for services in the quest for humanization of care, yet rather imperfect item in emergency childbirth. "

In a statement, the State Health Secretariat of São Paulo, responsible for the report that diagnosed the care of pregnant women in the state, says that "100% of users who responded to question 7, regarding the procedure to relieve pain during labor, had some type of analgesia to relieve pain. "

It said that, contrary to expert opinion, "the anesthesia (spinal or peridual) on the back is only applied in cases of caesarean deliveries and in a few normal births, as indicated by the doctor." The statement further explains that "since the vast majority of deliveries performed by SUS is normal procedures were applied as local anesthetic, analgesic and warm bath, massage or exercise are not always required the use of epidural anesthesia.

Finally, the court stated that "87% of women who responded to the survey rated the care from health professionals (doctors, nurses and others) as excellent or good."
(GO TO A DESK FOR HEALTH TREAT FOR SOME TEETH, and without anesthesia, be amazed! WHEN YOU NEED ASSISTANCE IN THE PS HC, find a HUGE DOOR CLOSED AND A SAFETY ORDINANCE "MAKING THE SCREENING" QUESTION WHAT IS YOUR PROBLEM AND WITH A FACE thesediment, CONTEMPT OF QUESTION WHERE YOU RESIDE AND IF THERE HAS NOT HOSPITAL, IN AN ATTEMPT TO BAR IN YOUR HOME READY PUBLIC HELP! IS ONE HEALTH CARE WASTE, not enough medicines for chronic patients OR NOT TO DEPEND ON THE Pharmacies HC AND INCOR, MONEY BECAUSE TAXES ARE NOT BEING USED IN PUBLIC HEALTH? is MUCH MONEY FOR A RETURN PRE-HISTORY, ONE ABSURD! OH, AND YES THEY ARE HAVING Parturients CHILDBIRTH WITHOUT ANY ANESTHESIA WITHOUT EVEN NOTHING! THAT IS INHUMANE CRIMINAL, FOR ALL HAVE THAT RIGHT!)

WHERE IS THE MONEY FROM CPMF??

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