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Epidural in labor

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https://www.readbyqxmd.com/read/29971770/anesthetic-approach-to-postdural-puncture-headache-in-the-peripartum-period-an-israeli-national-survey
#1
Alexander Ioscovich, Yaara Giladi, Rivka Leah Fuica, Carolyn F Weiniger, Sharon Orbach-Zinger, Yaacov Gozal, Daniel Shatalin
BACKGROUND: Accidental dural puncture frequency among pregnant women is about 1.5%, while approximately 60% of these women will suffer from post-dural puncture headache (PDPH) that may be debilitating. METHODS: Following IRB approval, we conducted a national survey of the lead anesthesiologist in 23 labor and delivery rooms in Israel. Each survey inquired about medical center annual delivery volume, training program for residents, accidental dural puncture management, processing of information, and PDPH management strategies...
July 3, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29962624/epidural-analgesia-during-labor-attitudes-among-expectant-mothers-and-their-care-providers
#2
Garg Kamakshi, Grewal Anju, Singh Tania, Gupta Priyanka, Bansal Kamya, Pruthi Gegal, Chuttani Priyanka
Introduction: Varying levels of knowledge and attitudes among parturients and physicians toward epidural analgesia result in its low utilization. We aimed to assess the knowledge, attitude, and practice of parturients, obstetricians, and anesthesiologists regarding epidural labor analgesia. Methodology: We surveyed obstetricians, anesthesiologists, and parturients availing care and later delivered at our hospital from July 1, 2017, to December 31, 2017. Knowledge, attitude, and practice regarding epidural analgesia were collected using a semi-structured predesigned questionnaire...
April 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29943508/effects-of-adrenaline-on-maternal-and-fetal-fentanyl-absorption-in-epidural-analgesia-a-randomized-trial
#3
F Haidl, L A Rosseland, O Spigset, V Dahl
BACKGROUND: The combination of low-dose local anesthesia and lipophilic opioids such as fentanyl is established as a standard solution for labor epidural analgesia. Fentanyl increases efficacy, but may have negative effects on the neonate in terms of reduced neonatal neurologic and adaptive capacity scores and breast feeding. We hypothesized that addition of adrenaline 2 μg/mL to a solution of bupivacaine 1 mg/mL and fentanyl 2 μg/mL would reduce the systemic uptake of fentanyl, resulting in reduced serum fentanyl in the fetus at birth...
June 25, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29936072/algorithm-for-automatic-detection-of-spontaneous-seizures-in-rats-with-post-traumatic-epilepsy
#4
Pedro Andrade, Tomi Paananen, Robert Ciszek, Niina Lapinlampi, Asla Pitkänen
BACKGROUND: Labor intensive electroencephalogram (EEG) analysis is a major bottleneck to identifying anti-epileptogenic treatments in experimental models of post-traumatic epilepsy. We aimed to develop an algorithm for automated seizure detection in experimental post-traumatic epilepsy. NEW METHOD: Continuous (24/7) 1-month-long video-EEG monitoring with three epidural screw electrodes was started 154 d after lateral fluid-percussion induced traumatic brain injury (TBI; n = 97) or sham-injury (n = 29) in adult male Sprague-Dawley rats...
June 21, 2018: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/29924010/effect-of-led-photobiomodulation-on-analgesia-during-labor-study-protocol-for-a-randomized-clinical-trial
#5
Maria Aparecida Dos Santos Traverzim, Sergio Makabe, Daniela Fátima Teixeira Silva, Christiane Pavani, Sandra Kalil Bussadori, Kristianne Santos Porta Fernandes, Lara Jansiski Motta
BACKGROUND: Labor pain is one of the most intense pains experienced by women, which leads to an increase in the number of women opting to undergo a cesarean delivery. Pharmacological and nonpharmacological analgesia methods are used to control labor pain. Epidural analgesia is the most commonly used pharmacological analgesia method. However, it may have side effects on the fetus and the mother. Light-emitting diode (LED) photobiomodulation is an effective and noninvasive alternative to pharmacological methods...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29914785/the-optimal-concentration-of-bupivacaine-and-levobupivacaine-for-labor-pain-management-using-patient-controlled-epidural-analgesia-a-double-blind-randomized-controlled-trial
#6
V Baliuliene, A Macas, K Rimaitis
BACKGROUND: The study aim was to evaluate the efficacy and safety of different low concentrations of two local anesthetics for labor analgesia using patient-controlled epidural analgesia. METHODS: A double-blind, randomized controlled trial recruiting healthy nulliparous women was conducted from 2014 to 2016. Epidural analgesia was provided using local anesthetic and fentanyl. Patients were allocated to six groups, according to the concentration of bupivacaine or levobupivacaine (0...
May 18, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29914784/experimental-validation-of-the-compuflo%C3%A2-epidural-controlled-system-to-identify-the-epidural-space-and-its-clinical-use-in-difficult-obstetric-cases
#7
G Capogna, M Camorcia, A Coccoluto, M Micaglio, M Velardo
BACKGROUND: This prospective study was designed to validate the CompuFlo® device and to assess its use in difficult epidural placement. METHODS: In the first part of the study, 30 parturients requesting labor epidural analgesia were recruited. The block was performed by an expert anesthesiologist, with the Tuohy needle connected to the CompuFlo® device to evaluate the agreement between the anesthesiologist's reported sensation and the variation of pressure recorded by the CompuFlo®...
May 4, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29914232/current-practice-in-obstetric-anesthesia-and-analgesia-in-public-hospitals-of-greece-a-2016-national-survey
#8
Chryssoula Staikou, Alexandros Μakris, Kassiani Theodoraki, Athanasia Τsaroucha, Amalia Doumax, Eleni Μoka, Eleni Αrnaoutoglou, Tilemahos Paraskevopoulos, Ioanna Siafaka, Efi Stavropoulou, Eriphili Αrgyra
Aims: The aim of this nationwide descriptive survey was to assess the use of regional anesthesia in obstetrics in Greek public hospitals. Methods: The survey was conducted between March and August, 2016. A structured questionnaire was sent to 50 Anesthesia Departments in Greek Public Hospitals with obstetric units. Results: The response rate was 94%. Data corresponded to 9475 cesarean and 8155 vaginal deliveries. Regional anesthesia was used in 69...
June 19, 2018: Balkan Medical Journal
https://www.readbyqxmd.com/read/29900579/women-s-experiences-with-water-birth-a-matched-groups-prospective-study
#9
Anthony Lathrop, Carrie F Bonsack, David M Haas
BACKGROUND: Water birth has become an increasingly popular childbirth option, but has also come under scrutiny because of its possible risks and benefits. The primary objective of this study was to explore potential benefits of water birth by comparing the experiences of women who gave birth in water versus conventionally. We also compared maternal and newborn outcomes. METHODS: We performed a prospective study of 66 women who had water births and 132 who had conventional births...
June 13, 2018: Birth
https://www.readbyqxmd.com/read/29900352/lebanese-women-s-awareness-and-attitude-toward-epidural-anesthesia-during-labor
#10
M Fawaz, S Malas
Women׳s choice to use epidural anesthesia (EA) for relief of labor pain varies from one culture to another. A descriptive cross-sectional design was used to gather data from a sample of 200 women in childbearing age. Data was gathered from general population in Lebanon. Demographic data, knowledge and attitudes questionnaires towards EA were used to gather data for this study. The data in this article provides demographic data about Lebanese women and their awareness and attitudes towards epidural anesthesia...
August 2018: Data in Brief
https://www.readbyqxmd.com/read/29888832/perinatal-outcome-of-vaginal-delivery-with-epidural-analgesia-initiated-at-the-early-or-late-phase-of-labor-period-a-retrospective-cohort-study-in-the-japanese-population
#11
Michihisa Shiro, Katsutoshi Nakahata, Sawako Minami, Tomoyuki Kawamata, Kazuhiko Ino
AIM: We compared the perinatal outcomes of vaginal delivery with epidural analgesia initiated at the early versus late phase in a Japanese population. METHODS: Women enrolled in this retrospective cohort study received intrapartum analgesia via combined spinal epidural analgesia after labor onset between May 2010 and August 2015. We compared the perinatal outcomes between two different timings of epidural analgesia: at the early phase (≤3 cm cervical dilatation) and the late phase (≥4 cm) or at the new definition-based early phase (≤5 cm) and late phase (≥6 cm)...
June 11, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29887886/anesthesiologists-preferences-regarding-visitor-presence-during-placement-of-neuraxial-labor-analgesia
#12
Sangeeta Kumaraswami, Suryanarayana Pothula, Mario Anthony Inchiosa, Keshar Paul Kubal, Micah Alexander Burns
Introduction: Neuraxial labor analgesia has become an integral part of modern obstetric anesthetic practice. Presence of a familiar person during its placement may be beneficial to the patient. A survey was sent to anesthesiologists practicing obstetric anesthesia in the USA to determine their views. Methods: The survey queried the following: existence of a written policy; would they allow a visitor; visitor's view, sitting or standing; reasons to allow or not allow a visitor; and influence by other staff on the decision...
2018: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/29883521/formulating-and-answering-high-impact-causal-questions-in-physiologic-childbirth-science-concepts-and-assumptions
#13
REVIEW
Jonathan M Snowden, Ellen L Tilden, Michelle C Odden
In this article, we conclude our 3-part series by focusing on several concepts that have proven useful for formulating causal questions and inferring causal effects. The process of causal inference is of key importance for physiologic childbirth science, so each concept is grounded in content related to women at low risk for perinatal complications. A prerequisite to causal inference is determining that the question of interest is causal rather than descriptive or predictive. Another critical step in defining a high-impact causal question is assessing the state of existing research for evidence of causality...
June 8, 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29862280/the-efficacy-of-programmed-intermittent-epidural-bolus-for-postoperative-analgesia-after-open-gynecological-surgery-a-randomized-double-blinded-study
#14
Shiho Satomi, Nami Kakuta, Chiaki Murakami, Yoko Sakai, Katsuya Tanaka, Yasuo M Tsutsumi
Background: It is well known that the programmed intermittent epidural bolus (PIEB) technique effectively provides epidural anesthesia in labor. This randomized double-blind trial compared the postoperative analgesic efficacy of PIEB with that of continuous epidural infusion (CEI) in patients undergoing gynecological surgery under combined general-epidural anesthesia. Methods: Patients undergoing open gynecological surgery under combined general-epidural anesthesia were randomized at a 1 : 1 ratio to receive PIEB or CEI...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29847969/postdural-puncture-headache-and-epidural-blood-patch-in-a-large-obstetric-anaesthesia-population
#15
Blanca Martínez, Enrique Canser, Alberto Alonso, Eduardo Alonso, Elena Gredilla, Jesús Díez, Fernando Gilsanz
OBJECTIVE: Postdural puncture headache (PDPH) is the most common serious complication in obstetric anesthesia. We show the incidence of accidental dural puncture (ADP), PDPH, epidural blood patch (EBP) and associated morbidity following a protocol established in an obstetric anesthesia department. METHODS: An observational, prospective, analytical study performed in 66,540 epidural labor analgesia procedures. The objective is to describe the incidence of ADP, PDPH and EBP in a large obstetric anesthesia population, as well as morbidity associated with ADP and EBP...
March 2018: Asian journal of anesthesiology
https://www.readbyqxmd.com/read/29847386/the-effect-of-labor-epidural-analgesia-on-breastfeeding-outcomes-a-prospective-observational-cohort-study-in-a-mixed-parity-cohort
#16
Sharon Orbach-Zinger, Ruth Landau, Atara Davis, Oren Oved, Liron Caspi, Shlomo Fireman, Shai Fein, Alexander Ioscovich, Danielle Bracco, Moshe Hoshen, Leonid A Eidelman
BACKGROUND: The effect of labor epidural analgesia (LEA) on successful breastfeeding has been evaluated in several studies with divergent results. We hypothesized that LEA would not influence breastfeeding status 6 weeks postpartum in women who intended to breastfeed in an environment that encourages breastfeeding. METHODS: In this prospective observational cohort study, a total of 1204 women intending to breastfeed, delivering vaginally with or without LEA, were included; breastfeeding was recorded at 3 days and 6 weeks postpartum...
May 25, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29793365/the-association-between-neonatal-head-circumference-and-second-stage-duration
#17
Lina Salman, Anat Shmueli, Amir Aviram, Liran Hiersch, Rony Chen, Rinat Gabbay-Benziv
PURPOSE: To determine if head circumference (HC) is an independent factor influencing second stage duration stratified by parity and epidural use. MATERIALS AND METHODS: A retrospective cohort analysis of all live, singleton, term (37-42 weeks) vaginal deliveries in one university affiliated medical center (2012-2014). Exclusion criteria included operative deliveries due to fetal distress, major fetal anomalies/chromosomal abnormalities or cases with missing anthropometric data...
June 13, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29790194/the-impact-of-epidural-analgesia-on-the-duration-of-the-second-stage-of-labor
#18
Anat Shmueli, Lina Salman, Sharon Orbach-Zinger, Amir Aviram, Liran Hiersch, Rony Chen, Rinat Gabbay-Benziv
BACKGROUND: We aimed to describe the length of second stage of labor in a contemporary cohort. We calculated the 5th, 50th, and 95th percentiles for second-stage length stratified by parity and epidural analgesia use and evaluated the effect of labor induction and oxytocin augmentation in our cohort. METHODS: We did a retrospective analysis of all live, singleton, term vaginal deliveries in one tertiary hospital. Multivariate linear regression was used to evaluate second-stage duration confounders...
May 22, 2018: Birth
https://www.readbyqxmd.com/read/29782398/benefit-and-harm-of-adding-epinephrine-to-a-local-anesthetic-for-neuraxial-and-locoregional-anesthesia-a-meta-analysis-of-randomized-controlled-trials-with-trial-sequential-analyses
#19
Clément Tschopp, Martin R Tramèr, Alexis Schneider, Maroun Zaarour, Nadia Elia
BACKGROUND: This systematic review examines the benefit and harm of adding epinephrine to local anesthetics for epidural, intrathecal, or locoregional anesthesia. METHODS: We searched electronic databases to October 2017 for randomized trials comparing any local anesthetic regimen combined with epinephrine, with the same local anesthetic regimen without epinephrine, reporting on duration of analgesia, time to 2 segments regression, or any adverse effects. Trial quality was assessed using the Cochrane risk of bias tool and a random-effects model was used...
July 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29777348/the-effect-of-labor-epidural-analgesia-on-maternal-fetal-outcomes-a-retrospective-cohort-study
#20
Qian Wang, Sheng-Xing Zheng, Yu-Fei Ni, Yuan-Yuan Lu, Bing Zhang, Qing-Quan Lian, Ming-Pin Hu
PURPOSE: To evaluate the impact of labor epidural analgesia on maternal-fetal safety outcomes in a signal Chinese academic medical center. METHODS: A single-intervention impact study was conducted at The Second Affiliated Hospital, Wenzhou Medical University. The study period was divided into three phases: (1) baseline phase: from January 1 and June 30, 2009 when no analgesic method was routinely employed during labor; (2) phase-in period: the epidural analgesia was implemented 8 a...
July 2018: Archives of Gynecology and Obstetrics
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