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https://www.readbyqxmd.com/read/29147776/-pain-therapy-in-obstetrics
#1
J Wallenborn, I Kühnert, D O Chebac, P Kranke
Labor pains can be stronger than pain caused by fractures and as a result of fear and stress can even have a negative effect on the course of parturition. A proportion of 75% of all women in labor use one or more supportive forms of analgesia to relieve labor pains. The procedures used range from supportive non-pharmacological measures, single intramuscular or intravenous analgesics and a prolonged inhalative analgesia up to highly efficient neuraxial blocks. Non-pharmacological interventions are considered to be generally safe but poorly effective...
November 17, 2017: Der Schmerz
https://www.readbyqxmd.com/read/29096283/positions-during-the-first-stage-and-the-passive-second-stage-of-labor-a-survey-of-french-midwives
#2
Chloé Barasinski, Anne Debost-Legrand, Didier Lémery, Françoise Vendittelli
OBJECTIVE: the objective of our study was to describe the practices reported by French midwives during labor (first stage and passive phase of the second stage). DESIGN: this cross-sectional internet questionnaire surveyed French midwives who attended at least one delivery in 2013. SETTING: this open survey was posted on a website from June 15 through December 1, 2014. PARTICIPANTS: 1496 midwives from 377 maternity units participated in the study...
October 17, 2017: Midwifery
https://www.readbyqxmd.com/read/29090268/pudendal-nerve-blocks-in-men-undergoing-urethroplasty-a-case-series
#3
Arun Kalava, Abby M Pribish, Lucas R Wiegand
The pudendal nerve block (PNB) is widely used for regional anesthesia during obstetric and anorectal procedures, but its role in urologic procedures has not been thoroughly studied. While transvaginal PNB is relatively straightforward, PNB in male patients often requires imaging guidance due to difficulty appreciating anatomic landmarks. We review the PNB and relevant sonoanatomy, and describe its analgesic efficacy in three male patients undergoing urethroplasty for urethral stricture. In this procedure, the patient was placed in lithotomy position, the ischial tuberosity was palpated, and the sacrotuberous ligament and pudendal artery were identified using ultrasound...
October 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/29049122/case-series-of-successful-postoperative-pain-management-in-buprenorphine-maintenance-therapy-patients
#4
Barbara L Leighton, Lara W Crock
Buprenorphine maintenance therapy patients frequently have severe postoperative pain due to buprenorphine-induced hyperalgesia and provider use of opioids with limited efficacy in the presence of buprenorphine. The authors report good-to-excellent pain management in 4 obstetric patients using nonopioid analgesics, regional anesthesia, continuation of buprenorphine, and use of opioids with high μ receptor affinity.
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28938298/safety-and-efficacy-of-epidural-analgesia
#5
Elke M E Bos, Markus W Hollmann, Philipp Lirk
PURPOSE OF REVIEW: Epidural analgesia remains a widely used analgesic technique. This article aims to assess the safety of epidural analgesia by balancing efficacy and complications, of epidural analgesia for acute, labor and chronic pain. RECENT FINDINGS: Main indications for epidural analgesia include major open abdominal surgery, thoracotomy and labor analgesia. Past and current literature show that epidural analgesia leads to statistically significant, but possibly clinically less meaningful, reductions in pain scores compared with intravenous analgesia...
December 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28926443/recovery-after-nulliparous-birth-a-detailed-analysis-of-pain-analgesia-and-recovery-of-function
#6
Ryu Komatsu, Brendan Carvalho, Pamela D Flood
BACKGROUND: The majority of parturients in the United States first return for evaluation by their obstetric practitioner 6 weeks after delivery. As such, there is little granular data on the pain experience, analgesic requirements, and functional recovery during the postpartum period. This prospective observational study was performed to evaluate these factors to provide expectations for patients. METHODS: A total of 213 nulliparous women were enrolled and assessed daily until they completed 3 outcomes: (1) pain resolution; (2) opioid cessation; and (3) self-assessed functional recovery from delivery...
October 2017: Anesthesiology
https://www.readbyqxmd.com/read/28884414/effect-of-programmed-intermittent-epidural-boluses-and-continuous-epidural-infusion-on-labor-analgesia-and-obstetric-outcomes-a-randomized-controlled-trial
#7
Leopoldo E Ferrer, David J Romero, Oscar I Vásquez, Ednna C Matute, Marc Van de Velde
PURPOSE: Continuous epidural infusion and programmed intermittent epidural boluses are analgesic techniques routinely used for pain relief in laboring women. We aimed to assess both techniques and compare them with respect to labor analgesia and obstetric outcomes. METHODS: After Institutional Review Board approval, 132 laboring women aged between 18 and 45 years were randomized to epidural analgesia of 10 mL of a mixture of 0.1% bupivacaine plus 2 µg/mL of fentanyl either by programmed intermittent boluses or continuous infusion (66 per group)...
November 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28734732/perinatal-and-neonatal-use-of-sedation-and-analgesia
#8
REVIEW
Christopher McPherson, Terrie Inder
Optimal obstetric and neonatal care requires the provision of adequate analgesia for painful procedures. However, anesthetic and analgesic agents have the potential to adversely impact the developing fetal/neonatal brain. In this setting, clinicians must assess the risks and benefits of pharmacologic anesthesia and analgesia for specific indications in this population. General anesthesia is required for non-obstetric surgery and cesarean section in the absence of neuraxial anesthesia for the health of the mother and fetus...
October 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28663623/comparison-of-epidural-butorphanol-with-neostigmine-and-epidural-sufentanyl-with-neostigmine-for-first-stage-of-labor-analgesia-a-randomized-controlled-trial
#9
Manoj Chaurasia, Ashok Kumar Saxena, Geetanjali T Chilkoti
BACKGROUND: Epidural administration of neostigmine appears to be safe in the obstetric population. Recently, few studies have concluded 10 μg sufentanil to be an effective adjuvant with epidural neostigmine in providing labor analgesia. However, no study has evaluated the analgesic effect of epidural butorphanol with neostigmine for the same. MATERIALS AND METHODS: The parturients were randomly allocated to one of the three study groups - Group A (n = 30) received butorphanol 1 mg and neostigmine 7 μg/kg...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28625302/pharmacogenetics-in-obstetric-anesthesia
#10
REVIEW
Ruth Landau, Richard Smiley
The 21st century has been billed as the era of "precision/personalized medicine." Genetic investigation of clinical syndromes may guide therapy as well as reveal previously unknown biological or pharmacological pathways that may result in novel drug therapies. Several clinical issues in obstetrics and obstetric anesthesiology have been targets for genetic investigations. These include evaluation of the genetic effects on preterm labor and the progression of labor, spinal anesthesia-induced hypotension and the response to medications used to treat hypotension, and the effect of gene variants on pain and analgesic responses...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28494909/remifentanil-as-an-alternative-to-epidural-analgesia-for-vaginal-delivery-a-meta-analysis-of-randomized-trials
#11
Myeongjong Lee, Fang Zhu, Jessica Moodie, Zhe Zhang, Davy Cheng, Janet Martin
OBJECTIVES: Although epidural analgesia is considered the gold standard for labor pain management, its use may be restricted in some conditions due to clinical contraindications or availability, and suitable alternatives may be required. The objective of this meta-analysis was to determine whether evidence from randomized trials suggests remifentanil PCA (R-PCA) results in significant differences in maternal satisfaction, analgesic efficacy, and safety compared with conventional epidural analgesia (EA)...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28474356/patients-preferences-for-labor-analgesic-counseling-a-qualitative-analysis
#12
Paloma Toledo, Javiera Pumarino, William A Grobman, Cynthia A Wong, Jane L Holl, Romana Hasnain-Wynia
BACKGROUND: The decision to use, or not use, neuraxial labor analgesia is complex, with both maternal and fetal considerations. Fears and concerns about neuraxial analgesia may influence analgesic decision-making. Little is known about patients' preferences for analgesic counseling. Therefore, the objectives of this qualitative study were to evaluate the sources of information used by patients, the timing and content of antepartum counseling about labor analgesia, and patients' preferences for such counseling...
May 5, 2017: Birth
https://www.readbyqxmd.com/read/28367293/thoracic-interfascial-nerve-block-for-breast-surgery-in-a-pregnant-woman-a-case-report
#13
Boohwi Hong, Seok-Hwa Yoon, Ann Misun Youn, Bum June Kim, Seunghyun Song, Yeomyung Yoon
Regional anesthesia for non-obstetric surgery in parturients is a method to decrease patient and fetal risk during general anesthesia. Thoracic interfascial nerve block can be used as an analgesic technique for surgical procedures of the thorax. The Pecs II block is an interfascial block that targets not only the medial and lateral pectoral nerves, but also the lateral cutaneous branch of the intercostal nerve. Pecto-intercostal fascial block (PIFB) targets the anterior cutaneous branch of the intercostal nerve...
April 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28360907/aspirin-the-mechanism-of-action-revisited-in-the-context-of-pregnancy-complications
#14
REVIEW
Angela P Cadavid
Aspirin is one of the most frequently used and cheapest drugs in medicine. It belongs to the non-steroidal anti-inflammatory drugs with a wide range of pharmacological activities, including analgesic, antipyretic, and antiplatelet properties. Currently, it is accepted to prescribe a low dose of aspirin to pregnant women who are at high risk of preeclampsia (PE) because it reduces the onset of this complication. Another pregnancy alteration in which a low dose of aspirin is recommended is the obstetric antiphospholipid syndrome (APS)...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28245192/the-effect-of-attending-a-prenatal-childbirth-preparedness-course-on-labor-duration-and-outcomes
#15
David Yohai, Debi Alharar, Ruthi Cohen, Zohar Kaltian, Barak Aricha-Tamir, Saviona Ben Aion, Zehava Yohai, Adi Y Weintraub
OBJECTIVE: To evaluate the effect of attending a prenatal childbirth preparation course (CPC) on labor duration and outcomes. METHODS: A cross sectional study of 53 primiparous women who attended and 54 women who did not attend a CPC was conducted. The state-trait anxiety inventory (STAI) score was used to diagnose anxiety. Clinical and obstetrical data were collected from the perinatal database of our center. Through post-partum interviews, coping strategies were assessed, patients graded their childbirth experience and breastfeeding was evaluated...
February 28, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28215514/robotic-single-site-myomectomy-clinical-analysis-of-61-consecutive-cases
#16
Eun Ji Choi, A Mi Rho, Sa Ra Lee, Kyungah Jeong, Hye-Sung Moon
STUDY OBJECTIVES: To report 61 consecutive cases of successful robotic single-site myomectomy (RSSM), and to evaluate the feasibility and safety of RSSM. DESIGN: Retrospective analysis of 61 cases involving RSSM (Canadian Task Force classification III). SETTING: Department of Obstetrics and Gynecology, College of Medicine, Robot Surgery Center, Ewha Womans University, Seoul, Republic of Korea. PATIENTS: Sixty-one patients who underwent RSSM performed by 3 gynecologic surgeons at Ewha Womans University between December 2014 and May 2016...
February 12, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28178769/improving-post-caesarean-analgesia-where-to-next
#17
A Butwick
No abstract text is available yet for this article.
June 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28163844/effect-of-entonox-on-reducing-the-need-for-pethidine-and-the-relevant-fetal-and-maternal-complications-for-painless-labor
#18
Alireza Sharifian Attar, Atefe Shirinzadeh Feizabadi, Lida Jarahi, Laya Shirinzadeh Feizabadi, Shima Sheybani
BACKGROUND: Pain relief during labour is one of the major concerns in obstetrics; severe labor pain causes fear of the next pregnancy, and interferes with the mother's family relationship. OBJECTIVE: The aim of this study was to evaluate the analgesic effects of Entonox during labor on reducing the need for pethidine (Meperidine) and fetal-maternal complications. METHODS: This double-blind randomized clinical trial was conducted on pregnant women who were candidates for vaginal delivery in Educational Hospitals of Mashhad University of Medical Sciences, Iran between January 2014 and November 2015...
December 2016: Electronic Physician
https://www.readbyqxmd.com/read/28099701/a-systematic-review-of-implementation-strategies-to-deliver-guidelines-on-obstetric-care-practice-in-low-and-middle-income-countries
#19
REVIEW
Mari Imamura, Lovney Kanguru, Suzanne Penfold, Tim Stokes, Janette Camosso-Stefinovic, Beth Shaw, Julia Hussein
BACKGROUND: Healthcare measures to prevent maternal deaths are well known. However, effective implementation of this knowledge to change practice remains a challenge. OBJECTIVES: To assess whether strategies to promote the use of guidelines can improve obstetric practices in low- and middle-income countries (LMICs). SEARCH STRATEGY: Electronic databases were searched up to February 7, 2014, using relevant terms for implementation strategies (e...
January 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/27959349/an-unusual-cause-of-falls-in-a-young-woman
#20
I Sleeman, L Wiblin, D Burn
Nitrous oxide is commonly used as an analgesic and anaesthetic agent. Nitrous oxide is also in use in industry as an aerosol propellant and is now recognised as a recreational drug whose use is growing, especially among the young. Nitrous oxide from whipped cream canisters is inhaled to produce a dissociative, intoxicated state. Nitrous oxide is known to inactivate vitamin B12 via oxidation, which can precipitate a demyelinating myelopathy akin to the classical B12 deficiency syndrome, subacute combined degeneration of the spinal cord...
September 2016: Journal of the Royal College of Physicians of Edinburgh
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