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Epidural in labor

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https://www.readbyqxmd.com/read/28306579/continuous-epidural-analgesia-using-an-ester-linked-local-anesthetic-agent-2-chloroprocaine-during-labor-a-case-report
#1
Simon C Lee, Vanessa Moll
We report the use of the ester-linked local anesthetic, 2-chloroprocaine, for continuous epidural analgesia in a patient in labor with a history of allergic reaction to amide local anesthetics. The patient gave a reliable history of pruritus, hives, erythema, and swelling on her lower extremity after having received a preservative-free amide local anesthetic. This allergy had been confirmed by a dermatologist by her reports. The patient requested an epidural for labor analgesia that was placed successfully...
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28298752/quality-of-labor-epidural-analgesia-and-maternal-outcome-with-levobupivacaine-and-ropivacaine-a-double-blinded-randomized-trial
#2
T Senthil Kumar, P Rani, V R Hemanth Kumar, Sunita Samal, S Parthasarathy, M Ravishankar
BACKGROUND: Quality of labor analgesia plays a vital role in the maternal outcome. Very few literature are available analyzing the quality of epidural labor analgesia. AIM: The aim of this study was to compare the effectiveness of 0.1% levobupivacaine and 0.1% ropivacaine with fentanyl as an adjuvant for epidural labor analgesia in terms of onset, duration, quality of analgesia, and degree of motor blockade. METHODOLOGY: Sixty nulliparous parturients, with singleton uncomplicated pregnancy, were recruited by continuous sampling...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28284462/an-observational-study-of-agreement-between-percentage-pain-reduction-calculated-from-visual-analog-or-numerical-rating-scales-versus-that-reported-by-parturients-during-labor-epidural-analgesia
#3
E Pratici, S Nebout, N Merbai, J Filippova, D Hajage, H Keita
BACKGROUND: This study aimed to determine the level of agreement between calculated percentage pain reduction, derived from visual analog or numerical rating scales, and patient-reported percentage pain reduction in patients having labor epidural analgesia. METHODS: In a prospective observational study, parturients were asked to rate their pain intensity on a visual analog scale and numerical rating scale, before and 30min after initiation of epidural analgesia...
February 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28283828/risk-factors-and-peripartum-outcomes-of-failed-epidural-a-prospective-cohort-study
#4
Carmen Bucstain, Gali Garmi, Noah Zafran, Sivan Zuarez-Easton, Julia Carmeli, Raed Salim
PURPOSE: Awareness to rate, risk factors, and the associated peripartum outcomes of failed epidural analgesia (FEA) may improve expectations and labor management. We aimed to identify risk factors for FEA and to examine peripartum outcomes associated with failure. METHODS: A prospective cohort study conducted between March 2015 and August 2015, at a single university medical center. Laboring women at ≥34 weeks, receiving epidural analgesia, were eligible. Pain was evaluated using a 0-10 cm visual analogue scale (VAS)...
March 10, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28279445/a-comprehensive-analysis-of-continuous-epidural-analgesia-s-effect-on-labor-and-neonates-in-maternal-hypertensive-disorder-patients
#5
Bin Han, Mingjun Xu
BACKGROUND: Maternal hypertensive disorder is one of the most common and severe medical complications during pregnancy. Epidural analgesia administration is widely used during labor process. AIM: To evaluate the potential advantage or disadvantage of continuous epidural analgesia's on labor and neonates for maternal hypertensive disorder patients comprehensively. METHODS: We have retrospectively analyzed 232 patients who diagnosed as maternal hypertensive disorder in our hospital since 2015...
January 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/28247084/anatomy-of-the-sacral-hiatus-and-its-clinical-relevance-in-caudal-epidural-block
#6
Hassan Bagheri, Figen Govsa
PURPOSE: Caudal epidural anesthesia (CEB) is widely used for the prevention of chronic lower back pain, the control of intraoperative analgesia such as genitourinary surgery and labor pain cases in sacral epidural space approach for the implementation of analgesia. CEB is an anesthetic solution used into the sacral canal via sacral hiatus (SH). For optimal access into the sacral epidural space, detailed anatomical landmarks of SH are required. This study aims at exploring the anatomical structures and differences of the SH by using the sacral bone as a guide point to failure criteria for reviewing the caudal epidural anesthesia and improving the criteria for success in practice...
February 28, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28238320/-oxytocin-administration-during-spontaneous-labour-guidelines-for-clinical-practice-guidelines-short-text
#7
C Dupont, M Carayol, C Le Ray, C Barasinski, R Beranger, A Burguet, A Chantry, C Chiesa, B Coulm, A Evrard, C Fischer, L Gaucher, C Guillou, F Leroy, E Phan, A Rousseau, V Tessier, F Vendittelli, C Deneux-Tharaux, D Riethmuller
OBJECTIVES: To define the different stages of spontaneous labour. To determine the indications, modalities of use and the effects of administering synthetic oxytocin. And to describe undesirable maternal and perinatal outcomes associated with the use of synthetic oxytocin. METHOD: A systematic review was carried out by searching Medline database and websites of obstetrics learned societies until March 2016. RESULTS: The 1st stage of labor is divided in a latence phase and an active phase, which switch at 5cm of cervical dilatation...
January 2017: Gynecol Obstet Fertil Senol
https://www.readbyqxmd.com/read/28235535/the-effect-of-second-stage-pushing-and-body-mass-index-on-postdural-puncture-headache
#8
Amber M Franz, Shawn Y Jia, Henry T Bahnson, Akash Goel, Ashraf S Habib
STUDY OBJECTIVE: To explore how pushing during labor and body mass index affect the development of postdural puncture headache in parturients who experienced dural puncture with Tuohy needles. DESIGN: Retrospective cohort. SETTING: Obstetric ward and operating rooms at a university-affiliated hospital. PATIENTS: One hundred ninety parturients who had witnessed dural puncture with 17 or 18 gauge Tuohy needles from 1999-2014...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235511/increasing-body-mass-index-predicts-increasing-difficulty-failure-rate-and-time-to-discovery-of-failure-of-epidural-anesthesia-in-laboring-patients
#9
Ayse O Kula, Matthias L Riess, Elizabeth H Ellinas
STUDY OBJECTIVE: Obese parturients both greatly benefit from neuraxial techniques, and may represent a technical challenge to obstetric anesthesiologists. Several studies address the topic of obesity and neuraxial analgesia in general, but few offer well described definitions or rates of "difficulty" and "failure" of labor epidural analgesia. Providing those definitions, we hypothesized that increasing body mass index (BMI) is associated with negative outcomes in both categories and increased time needed for epidural placement...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28217071/difficulty-in-the-removal-of-epidural-catheter-for-labor-analgesia
#10
Mohamed S Hajnour, Rashid Saeed Khokhar, Abdul Aziz Ahmed Ejaz, Tariq Al Zahrani, Naveed Uddin Kanchi
For labor pain management epidural analgesia is a popular and an effective method. Difficult removal of epidural catheters occasionally occurs, and several maneuvers have been recommended. The purpose of this article is to raise awareness of the problem of retained epidural catheter fragments and identify the potential impact of complications.
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28215984/the-cost-of-nurse-midwifery-care-use-of-interventions-resources-and-associated-costs-in-the-hospital-setting
#11
Molly R Altman, Sean M Murphy, Cynthia E Fitzgerald, H Frank Andersen, Kenn B Daratha
INTRODUCTION: Obstetrical care often involves multiple expensive, and often elective, interventions that may increase costs to patients, payers and the health care system with little effect on patient outcomes. The objectives of this study were to examine the following hospital related outcomes: 1) use of labor and birth interventions, 2) inpatient duration of stay, and 3) total direct health care costs for patients attended by a certified nurse-midwife (CNM) compared with those attended by an obstetrician-gynecologist (OB-GYN), within an environment of safe and high-quality care...
February 15, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28210635/combined-spinal-epidural-for-vaginal-delivery-in-a-parturient-with-takayasu-s-arteritis
#12
Sean Patrick Clifford, Paul Brian Mick, Brian Matthew Derhake
Takayasu's arteritis is a rare, progressive panendarteritis involving all layers of the arterial wall. This disease includes variable involvement of the aorta and its major branches. The most common complication with this condition is severe, uncontrolled hypertension, often leading to end organ dysfunction. We describe the management of a 27-year-old woman diagnosed with Takayasu's arteritis that presented in labor with intense pain and underwent a combined spinal-epidural for anesthetic management. Per literature review, a combined spinal-epidural technique for planned vaginal delivery has not been described for a laboring Takayasu patient...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28207645/hazards-of-standard-epidural-test-dose-in-laboring-parturients
#13
Michael G Richardson
No abstract text is available yet for this article.
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28202311/anesthetic-considerations-for-labor-and-delivery-in-women-with-cerebrospinal-fluid-shunts
#14
S Rajagopalan, S Gopinath, V T Trinh, S Chandrasekhar
BACKGROUND: The anesthetic management of labor and delivery in pregnant women with cerebrospinal fluid shunts can be challenging. We conducted a literature review to understand the anesthetic implications in pregnant women with cerebrospinal fluid shunts. METHODS: We searched PubMed, EMBASE, and Medline databases to identify reports of pregnant women with cerebrospinal fluid shunts during the 30-year period from 1985 to 2015. Twenty-four studies reporting anesthetic techniques for labor and delivery were included in the analyses...
January 16, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28183557/parturient-recall-of-neuraxial-analgesia-risks-impact-of-labor-pain-vs-no-labor-pain
#15
Christopher M Burkle, David A Olsen, Hans P Sviggum, Adam K Jacob
STUDY OBJECTIVE: Information exchange between anesthesia providers and parturients about neuraxial analgesia risks often occurs in the presence of labor pain. This study examined whether the presence of pain impacted the level of recall of information provided to parturients regarding risks of neuraxial techniques. DESIGN: Single-center, nonrandomized study. SETTING: Labor and delivery suite and postpartum patient rooms in a large academic medical center...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28140423/obstetrisk-nervp%C3%A3-verkan-%C3%A3-r-oftast-inte-ryggbed%C3%A3-vningens-fel
#16
Lovisa Brehmer, Johan Rutfors
Postpartum nerve injury is usually not caused by neuroaxial anesthesia - a case report In this case report we describe a woman who after giving birth had numbness and could not support her weight on the right leg. Three attempts of epidural anesthesia had been made during labor. MRI imaging of the spinal cord showed no pathology. She was treated conservatively by a physiotherapist and recovered gradually. After six months all symptoms had resolved. Postpartum nerve injury is often thought to be due to neuroaxial anesthesia, although in most cases it is caused by labor itself...
January 27, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28131124/anesthesiologists-in-obstetric-care-beyond-labor-epidurals-and-c-section-care
#17
EDITORIAL
Lee A Fleisher
No abstract text is available yet for this article.
March 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28131113/epidural-analgesia-for-labor-continuous-infusion-versus-programmed-intermittent-bolus
#18
REVIEW
Onyi C Onuoha
Despite the traditional practice to maintain labor analgesia with a combination of continuous epidural infusion and patient-controlled epidural analgesia using an automated epidural pump; compelling data now shows that bolus injection through the epidural catheter may result in better distribution of anesthetic solution in the epidural space. The programmed intermittent epidural bolus technique is proposed as a better maintenance mode and may represent a more effective mode of maintaining epidural analgesia for labor, especially prolonged labor...
March 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28121831/committee-opinion-no-687-approaches-to-limit-intervention-during-labor-and-birth
#19
(no author information available yet)
Obstetrician-gynecologists, in collaboration with midwives, nurses, patients, and those who support them in labor, can help women meet their goals for labor and birth by using techniques that are associated with minimal interventions and high rates of patient satisfaction. Many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor. For women who are in latent labor and are not admitted, a process of shared decision making is recommended. Admission during the latent phase of labor may be necessary for a variety of reasons...
February 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28121830/committee-opinion-no-687-summary-approaches-to-limit-intervention-during-labor-and-birth
#20
(no author information available yet)
Obstetrician-gynecologists, in collaboration with midwives, nurses, patients, and those who support them in labor, can help women meet their goals for labor and birth by using techniques that are associated with minimal interventions and high rates of patient satisfaction. Many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor. For women who are in latent labor and are not admitted, a process of shared decision making is recommended. Admission during the latent phase of labor may be necessary for a variety of reasons...
February 2017: Obstetrics and Gynecology
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