DR SAMI TRAD'S ORIGINAL
"PROGRAMMED METHOD OF PAINLESS CHILBIRTH"
BY INJECTION OF TAC (TRAD ANALGESIC COCKTAIL).

I - HISTORICAL BACKGROUND - why was this method necessary

This Method was created in 1960 at a time when the psychological methods of Painless Childbirth, mainly those of Lamaze in France, Velvovsky in Russia and Read in England, were very much à la mode. Although their theoretical basis was different, their techniques were more or less similar, based on hypno- suggestion and relaxation exercises. Many variations from these methods also existed, some relying more or less openly on pure hypno-suggestive techniques or even to pure hypnosis in limited number of cases.

The results of these so called psychological methods were obviously proportional to the extent that their hypno-suggestive component could play an important role.

Nonetheless, these methods had at the time a widespread success since the various other medical or pharmacological methods available had only achieved limited analgesia results. At this time the epidural anesthesia was in the beginning stage of development and there was a definite loophole in the analgesic obstetrical armamentarium which the Trad Method endeavored to fill. This loophole still exists nowadays though to a lesser extent because of the progress achieved by epidural anesthesia during this long periodof time.

Yet the historically linked Trad Method of Obstetrical Analgesia which made childbirth painless 45 years ago, and Trad Hospital which started as a small Maternity - and remains today the biggest Maternity in Lebanon by the number of its deliveries - , are still in the minds of women an indissoluble entity.

II - PRINCIPLE OF THE TRAD METHOD AND OF ITS ACTION

The method consists of the injection at various intervals and in various doses by the intramuscular and intravenous routes of an original lytic cocktail.

The formula of this Trad Analgesic Cocktail (TAC) was the synthesis of fragmentary results achieved in various countries and was experimentally and progressively worked out by Dr. Sami Trad in Trad Hospital.

This cocktail is the successful combination of analgesic components potentiating each other and respiratory analeptic components working at different levels.An original and essential part of the cocktail is the vehicle used for the first intramuscular injection of TAC. This vehicle is an enzyme that is isolated from a testicular extract of the bull which quickens the intercellular permeability and the resorbtion rate in the area surrounding the IM Injection. This allows a quicker and greater concentration of the injection product in the blood thus creating a third intermediate route between the intramuscular and the intravenous ones. Following this injection, other successive doses of TAC are given by the intravenous route (injections and drip). The patients' pains in labor subside quickly as she falls peacefully and progressively asleep. She wakes up after delivery is completed but can be awakened at any moment by an injection , whenever needed or wished.

• EXCELLENT RESULTS OBTAINED WITH TRAD OBSTETRICAL ANALGESIA AND PROOFS OF ITS TOTAL EFFICIENCY.

The excellent results obtained have been shown and the total efficiency has been proven :

• by the long period of time this method has been successfully used until today : over 45 years . During this long period TAC helped about 10.000 womento deliver without pain, without fear, and without any problem.Trad Hospital statistics have shown no maternal nor fetal damage (and of course no death) attributable to the method, and a Cesarian section rate of approximately 1% as compared to 30-50% in all Hospitals at large.

• by the International acknowledgment of scientific authorities in countries where this method was tested and practiced. For instance testing the Method in 1970 at Kiel University in Germany on a series of 50 deliveries was followed by a letter of thanks of Professor Kurt Semm Chairman of the Ob-gyn department and a further invitation for a 2 nd visit to Kiel University in order to teach them the method.

- by the many Invitations received to expose the method in international congresses

• Berlin Perinatology International Congress in 1972

This conference was then printed in PERINATALE MEDIZIN BAND III 1972. Georg Thieme Verlag Stuttgart
• Saarbruck All German congress in 1973
• Beirut Middle East Medical Symposium in 1974

All the results achieved, the International acknowledgment, the advantages of this method and all answers to your questions may be found in the :

"Explanatory Booklet for the use of my patients"
to be found in annex of this site with English, French and Arabiceditions.

A book about "painless programmed childbirth" was edited in 1980 by Barker Publications Limited, Richmond, England. A new revised and completed edition is now in preparation .

IV- CONTRAST AND COMPARISON BETWEEN TAC ANALGESIA AND EPIDURAL ANESTHESIA

• TAC gives the possibility of immediate analgesia when a woman is admitted to the Hospital in the last stage of labor with no time left to call the anesthetist who may be absent or busy, the TAC injection can be given by the responsible midwife immediately

• TAC analgesia is always successful if properly given, while epidural analgesia fails statistically in about 20% of patients to whom it is given and hence must be replaced by TAC .

• TAC analgesia can be started as soon as needed, even before any progress in labor, as in the case of a hypertonic uterus, and/or during an induction. Contrarily, Epidural analgesia is not normally given in these early stages.

• TAC analgesia reduces progressively the patient's state of consciousness as labor proceeds and pain increases, so that at the time of delivery, she is practically unconscious (unless she prefers to have only a limited analgesia).

This may be considered as a disadvantage by women who cannot follow in this case the course of events ending up in delivery and the delivery itself, since they have been taught to consider it as a gratifying experience

On the other hand, even granted a successful epidural given at the right time and covering the whole course of labor, which is not evident, many women resent, to various degrees, theanxietyof being a witness of the whole labor process with its frightening atmosphere, the disturbing injection in the spine, the numerous vaginal examinations and manual interventions to facilitate or activate the Delivery process (including a forceps extraction most often present and the episiotomy with repair). Although during the epidural delivery these women may not feel actually pain (in only 80% of cases) they do feel an enormous disturbing pressure and for many of them, a severe anxiety, sometimes unbearable, especially to those suffering from anxiety neurosis (and sometimes even of vaginismus).

• There are definite contra-indicationsfor the use of EpiduralAnalgesia in the following cases:

- very obese women
- women with spinal problems
- women with skin infections in the back
- and finally women with coagulation problems.

These contra-indications do not exist with TAC analgesia.

• Epidural analgesia may have side effects such as chronic back pain for a given duration as well as urinary bladder paresis for a small period of time. These problems are reduced in our Hospital due to the high technical level of our anesthetists but do not exist after giving TAC analgesia.

• For all the above mentioned reasons, it is clear that properly informed women should prefer TAC Analgesia to Epidural unless they are keen on being conscious during labor and are confident they have no anxiety problem. Yet, they should keep in mind most important statistics concerning Cesarian Section incidence. While Trad Hospitals' statistics between year 1985 and 1996 show that only 1% of the 1137 patients that received TAC, ended with a Cesarian Section, statistics in all hospitals (including Trad Hospital) concerning women who received Epidural Analgesia (or other kinds of analgesia) show a Cesarian Section incidence of at least 30% and up to 50% !

Download Trad Method of Painless Childbirth Booklet