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obstetric analgesic

Carolyn F Weiniger, Pervez Sultan, Ashley Dunn, Brendan Carvalho
STUDY OBJECTIVE: Neuraxial blockade may increase external cephalic version (ECV) success rates. This survey aimed to assess the frequency and characteristics of neuraxial blockade used to facilitate ECV. SETTING AND DESIGN: We surveyed Society for Obstetric Anesthesia and Perinatology members regarding ECV practice using a 15-item survey developed by 3 obstetric anesthesiologists and tested for face validity. The survey was e-mailed in January 2015 and again in February 2015 to the 1056 Society of Obstetric Anesthesiology and Perinatology members...
November 2016: Journal of Clinical Anesthesia
J Singer, A Jank, S Amara, P D H Stepan, U Kaisers, C Hoehne
Background: Peripartum anesthesia may consist of parenteral opioids and/or regional analgesia. There is only limited data in the literature comparing both methods in daily obstetric practice. This observational study investigated the opioids pethidine and meptazinol as well as regional analgesics with regard to their administration, efficacy, side effects and subjective maternal satisfaction with therapy. The rates of secondary regional analgesia administration after administration of the respective opioid served as a means of evaluating treatment...
September 2016: Geburtshilfe und Frauenheilkunde
Noor Al-Adhami, Karen Whitfield, Angela North
AIM: To eliminate the prescribing of codeine and codeine combination products postpartum to improve safety in breast fed infants.Concerns have been raised over the use of codeine and codeine combination products during breast feeding after the death of a neonate whose mother had been prescribed codeine postpartum. High concentrations of morphine were found in the infant's blood and this was attributed to the mother being a CYP2D6 ultrafast metaboliser.1 METHODS: The evidence surrounding the safety of codeine and codeine combination products in children, during the postpartum period and specifically for breast fed infants was collated...
September 2016: Archives of Disease in Childhood
Melissa Smallwood, Ashley Sareen, Emma Baker, Rachel Hannusch, Eddy Kwessi, Tyisha Williams
Autism spectrum disorder (ASD) is a perplexing and pervasive developmental disorder characterized by social difficulties, communicative deficits, and repetitive behavior. The increased rate of ASD diagnosis has raised questions concerning the genetic and environmental factors contributing to the development of this disorder; meanwhile, the cause of ASD remains unknown. This study surveyed mothers of ASD and non-ASD children to determine possible effects of labor and delivery (L&D) drugs on the development of ASD...
August 2016: ASN Neuro
Marzieh Beigom Khezri, Elham Tahaei, Amir Hossein Atlasbaf
OBJECTIVES: To compare the analgesic efficacy of intrathecal Ketamine and fentanyl added to bupivacaine in patients undergoing cesarean section. METHODS: Ninety patients 18-40 years old were recruited in a prospective double-blinded, randomized way. Spinal anesthesia was performed in the three groups by using bupivacaine 10mg combined with 0.1mg/kg ketamine in group K, bupivacaine 10mg combined with 25 µg fentanyl in group F and bupivacaine 10mg combined 0.5 ml distilled water in group P...
February 2016: Middle East Journal of Anesthesiology
Masahide Fujita, Tsuyoshi Satsumae, Makoto Tanaka
A 24-year-old woman with Marfan syndrome was scheduled for cesarean section in order to avoid progression of heart failure due to severe mitral regurgitation and aortic dissection during labor. Cesarean section was performed under general anesthesia using remifentanil. Anesthesia was induced and maintained with remifentanil (0.1-0.3 μg x kg(-1) x min(-1)) and continuous administration of propofol (target-controlled infusion, 2-3 ng x ml(-1)). The trachea was intubated without a significant hemodynamic change...
May 2016: Masui. the Japanese Journal of Anesthesiology
S Mitra, J Arora, V Ahuja, N Takkar
AIM: To compare the efficacy and safety of combined spinal-epidural (CSE, with the spinal component using low-dose heavy bupivacaine without opioid) with low-dose epidural analgesia in labor. METHODS: Sixty consenting adult parturients requesting epidural were randomly allocated to two equal groups to receive either low-dose epidural or CSE analgesia. The Epidural Group received 10ml of a mixture of 0.1% bupivacaine and 2 µg/ml fentanyl, followed by a 6 ml first bolus after 10 min if needed (not considered as a top-up)...
2015: Acta Anaesthesiologica Belgica
David Sommerfield, Anoop Ramgolam, Andrew Barker, Ric Bergesio, Britta S von Ungern-Sternberg
BACKGROUND: Surgical correction of vesicoureteric reflux through ureteric reimplantation is a common, highly successful treatment. Postoperative pain can be severe and may relate to somatic wound pain from the lower abdominal incision or from visceral bladder spasm pain. AIM: To conduct a prospective quality improvement audit to compare four perioperative analgesic techniques. METHODS: Observational data were collected on 217 patients following open ureteroneocystostomy over 5 days...
October 2016: Paediatric Anaesthesia
Lucía Mosquera Pan, Maialen Onandia Garate, Ana María Luces Lago, Eva Tizón Bouza
INTRODUCTION: The pain during the birth process is the result of a pile of physiological, psychological and socio-cultural stimulus. In our society, epidural analgesia is the most common technique used in obstetrics to relieve this pain, despite not being harmless. However, there are other complementary techniques based on methods that have demonstrated analgesic effects and they benefit of lacking adverse effects either on the mother or on the fetus. Among these methods is the immersion in warm water (WI)...
January 2016: Revista de Enfermería
Xiaohui Liu, Lingling Wu, Wei Yi
OBJECTIVE: To explore a safe and effective scheme of analgesic for labor. METHODS: Eighty-four primiparas without contraindication of vaginal delivery were divided into an observation group and a control group, 42 cases in each one. In the observation group, the acupoint injection was given at Zusanli (ST 36) combined with electroacupuncture (EA) at Hegu (LI 4) and Sanyinjiao (SP 6) till the cervical opening at the end of first stage labor. In the control group, the routine respiratory instruction was applied...
November 2015: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
J N Njiru, M A Esiromo, H O Omari
OBJECTIVE: To find out the knowledge, attitude and practice of pain relief methods during labour among mothers attending antenatal clinics at Shalom Community Hospital, Athi River, Kenya. DESIGN: Cross Sectional study. SETTING: Shalom Community Hospital, Athi River, Kenya. SUBJECTS: Two hundred and seven participants attending antenatal clinics at the facility were recruited. RESULTS: The median age of the participants was 28 years and a median parity of one...
July 2014: East African Medical Journal
P N Tshibuyl, P O R Olang, Omondi Ogutu, T M Chokwe
BACKGROUND: Most women experience moderate to severe pain during labour and delivery, often requiring some form of pharmacologic analgesia. The lack of proper psychological preparation combined with fear and anxiety can greatly enhance the patient's sensitivity to pain and further add to the discomfort. Skillfully conducted obstetric analgesia, in addition to relieving pain and anxiety, may benefit the mother by increasing self esteem and improving bonding with the baby. OBJECTIVE: To assess and compare the satisfaction and efficacy of two regimens of single-shot spinal blocks for the relief of labor pain in women who present in active phase of labour...
January 2013: East African Medical Journal
Michael Tien, Dionne F Peacher, Amber M Franz, Shawn Y Jia, Ashraf S Habib
Objective To report on the failure rate of spinal catheters placed following inadvertent dural puncture (IDP) compared with re-sited epidural catheters in the obstetric population. Research design and methods Patients who experienced IDP during epidural or combined spinal epidural placement with 17 or 18 gauge Tuohy needles for labor analgesia between 2003 and 2014 were identified using our post-dural puncture headache (PDPH) database. Patients were categorized into two groups: those who had spinal catheters inserted and those who had epidural catheters re-sited...
May 2016: Current Medical Research and Opinion
Allyson Kreshak, Janna Villano, Alexander Clark, Pamela Deak, Richard Clark, Christine Miller
BACKGROUND: Patterns of drug use during pregnancy may be changing. Identifying changes in pregnant women's drug use may help to target prevention and treatment. OBJECTIVE: To determine the regional prevalence of drug and alcohol use among pregnant women in Southern California. METHODS: This was a prospective, descriptive study conducted at a university health system's urban and suburban ambulatory obstetric offices. Included were pregnant women of all ages and trimesters...
March 2016: American Journal of Drug and Alcohol Abuse
M Rezk, E S El-Shamy, A Massod, R Dawood, R Habeeb
OBJECTIVES: This trial aimed to ascertain the relative efficacy, adverse effects, and acceptability of fentanyl versus pethidine for pain relief during labour. MATERIALS AND METHODS: Parturients (n=80) in the active phase who requested analgesia were randomly assigned to receive either intravenous fentanyl (n=40) or intramuscular pethidine (n=40). Pain scores hourly, maternal and fetal adverse effects, neonatal outcome, and maternal acceptability were assessed. RESULTS: Pain scores decreased in both groups, the decrease varying from mild to moderate, average pain scores remaining above 3...
2015: Clinical and Experimental Obstetrics & Gynecology
Nada Bilić, Ivka Djaković, Katarina Kličan-Jaić, Senka Sabolović Rudman, Željko Ivanec
Labor pain is one of the most severe pains. Labor is a complex and individual process with varying maternal requesting analgesia. Labor analgesia must be safe and accompanied by minimal amount of unwanted consequences for both the mother and the child, as well as for the delivery procedure. Epidural analgesia is the treatment that best meets these demands. According to the American Congress of Obstetrics and Gynecology and American Society of Anesthesiologists, mother's demand is a reason enough for the introduction of epidural analgesia in labor, providing that no contraindications exist...
September 2015: Acta Clinica Croatica
Paloma Toledo, Stanley T Eosakul, William A Grobman, Joe Feinglass, Romana Hasnain-Wynia
BACKGROUND: Hispanic women are less likely than non-Hispanic Caucasian women to use neuraxial labor analgesia. It is unknown whether there is a disparity in anticipated or actual use of neuraxial labor analgesia among Hispanic women based on primary language (English versus Spanish). METHODS: In this 3-year retrospective, single-institution, cross-sectional study, we extracted electronic medical record data on Hispanic nulliparous with vaginal deliveries who were insured by Medicaid...
January 2016: Anesthesia and Analgesia
Namtip Triyasunant, Thitima Chinachoti, Sirikan Duangburong
OBJECTIVE: To investigate the effect of direct field block with 40 ml of 0.125% bupivacaine on the top of intrathecal morphine on postoperative pain free period. MATERIAL AND METHOD: The present prospective randomized controlled trial was undertaken in 56 pregnant patients that underwent elective cesarean delivery at Siriraj Hospital. All patients were randomized into two groups to receive spinal block with intrathecal morphine as a control group, or direct field block on the top of spinal block with intrathecal morphine as a study group...
October 2015: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
A A Messmer, J M Potts, C E Orlikowski
Numerous studies of remifentanil patient-controlled analgesia during labour have shown high levels of maternal satisfaction, but concerns remain, especially over the side-effects of sedation and respiratory depression. We conducted a prospective observational study of maternal oxygen desaturation during remifentanil patient-controlled analgesia. Pulse oximetry values were recorded every eight s and later downloaded for analysis. A desaturation episode was defined as oxygen saturation < 90%. We collected 148 h of data in 61 women, during which we observed 176 desaturation episodes...
February 2016: Anaesthesia
F Fuchs, D Benhamou
OBJECTIVE: To determine guidelines for post-partum management after cesarean delivery regarding patient monitoring, organization, postoperative analgesia, time of urinary catheter removal, resumption of feeding and drinking, timing of ambulation, indication and modalities of thromboprophylaxis. METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: Immediate postoperative monitoring after caesarean delivery should be performed in the recovery room, but in exceptional circumstances, it may be performed in the delivery unit provided safety rules are maintained and regulatory authorities are informed (professional consensus)...
December 2015: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
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