peridural obstetr

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BACKGROUND: Peridural blockade with lidocaine, bupivacaine, and fentanyl is an anesthetic procedure extensively used in obstetrics, justifying the pharmacokinetic study of these drugs during labor. OBJECTIVE: To investigate the influence of the physiopathological changes of gestational diabetes mellitus (GDM) on the pharmacokinetics of lidocaine and its metabolite monoethylglycinexylidide (MEGX) in pregnant women subjected to peridural anesthesia. PATIENTS AND METHODS: Ten normal pregnant women (group 1) and six pregnant women with GDM (group 2) were studied, all of them at term...

We report on an exceptional therapy with epidural anesthesia and tunnelling of the peridural catheter over a time period of 2-14 days in patients with threatening early preterm labor, intact membranes and vaginal engagement of the infants (4 singleton, 8 twin and 2 triplet pregnancies). A combination of bupivacaine (0.125%) and fentanyl (2 microg/mL) was used up to a maximum of 20 mL/h during the treatment period. Long-term follow-up of the infants was normal in 19/20 infants. The advantages, such as prolongation of pregnancy without maternal pain and disadvantages such as the risk of fetal and maternal infection and of sudden delivery are discussed...

Pudendal nerve block may be indicated during instrumental delivery in situations where peridural anesthesia is unavailable. We report three cases of neonatal lidocaine intoxication following maternal pudendal block during delivery. Clinical features were hypotonia, pupillary mydriasis fixed to light, apnea, cyanosis and seizures. Two neonates required mechanical ventilation. Lidocaine was found in the serum of two babies. In all three cases, recovery was complete. The pharmacokinetics of lidocaine in a highly vascularized perineum during labor increase the risk of neonatal intoxication...

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The purpose of this study was to evaluate knowledge and acceptance of obstetric peridural analgesia among pregnant women in Togo. A prospective, descriptive survey was carried out over a period of one month. A standardized survey form was used to collect data. A total of 303 pregnant women with a mean age of 27 +/- 6 years were interviewed. A proportion of primiparous and multiparous was the same, i.e., 50%. Among multiparous women, 83.5% described labor pain during previous deliveries as severe. Twelve percent of the pregnant women interviewed claimed knowledge of techniques to control labor pain...

AIM: The aim of our study was to prove that by using sequential combined spinal-epidural (CSE) anesthesia it is possible to overcome the limits connected to the use of spinal anesthesia (SA) alone for elective cesarean section. METHODS: We examined 100 women submitted to cesarean section; SA was administered to 50 patients and sequential CSE technique to the other 50. In every woman before execution of the anesthesia we infused 500 mL of a plasma expander and a previous administration of 5 mg of ephedrine...

OBJECTIVE: Comparison between particular methods of obstetrics analgesia, their analgetic efects and influence on the progress of delivery and postpartum adaptation of fetus. DESIGN OF THE STUDY: Prospective study. SETTING: The Department of Gynecology and Obstetrics of the Teaching Hospital and the 2nd Medical Faculty of the Charles University in Prague. METHODS: A prospective study of 92 patients who received intravenous infusion nalbuphine (28 women) or epidural analgesia (31 women) or pethidin (33 women)...

OBJECTIVE: Drug use in birth delivery has not been enough explored in the literature. It is a significant issue to be discussed on the theme of rational drug use. The objective was to study drug use during birth delivery stay in maternity hospitals. METHODS: A cross-sectional study was carried out using medical records of two private and public maternity hospitals of Belo Horizonte, Brazil. Data were collected on pregnant women's identification, pregnancy, delivery and drug prescribed from medical records of public hospitals and medical records and billing invoice of private maternity hospitals...

OBJECTIVE: Anal sphincter injury and its sequelae are a recognized complication of vaginal childbirth. The aim of the present study was to identify risk factors for third- and fourth-degree perineal tears in patients undergoing either spontaneous or vaginal-assisted delivery by forceps routinely combined with mediolateral episiotomy. STUDY DESIGN: We retrospectively reviewed 5377 vaginal deliveries based on the analysis of the obstetric database and patient records of our department during a 5-year period from 1999 to 2003...

Pain control during labor is a primary objective of antalgic therapy. The use of the peridural as an elective procedure for labor analgesia is now corroborated by the international scientific community. Sometimes a combined spinal-peridural procedure is used together with the intrathecal administration of opioids to also cover the first stage of labor. Unfortunately, patients and/or gynecologists often request analgesia in a late stage of labor. The aim of our study was to evaluate the possibility of using a subarachnoid block alone for labor analgesia when this is requested at a late stage, that is, in advanced labor with cervical dilation greater than 7 cm...

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BACKGROUND: Obstetrical analgesia continues to be challenging to science in the search for safe and effective methods that will permit the use of these procedures allied to improved obstetrical and perinatal results. OBJECTIVE: The objective of the present study was to investigate the pharmacokinetics and the placental transfer of lidocaine and its metabolite in parturients whose pregnancies were resolved by the vaginal route under perineal analgesia. PATIENTS AND METHODS: The study was conducted on 23 pregnant women who received perineal analgesia with 20 ml 2% lidocaine (400 mg) during the expulsive period of labor...

Two series of labour trial were compared in a forward-looking study. The first series of 24 parturient women (series I) to whom the labour trial took place under peridural analgesy. The second series of 80 parturient women (series II) to whom the labour trial took place without peridural analgesy. The rate of caesarean section is significantly less important in the series I (33.3% versus 58%) P = 0.37. The average duration of the labour trial is significantly prolonged under peridural analgesy but without bared effects for the newborn children...

OBJECTIVES: To compare obstetrical practices between level 1 ( community hospital) and level 3 (university hospital) maternities in a low risk nulliparous population. MATERIALS AND METHODS: 1532 low risk nulliparas were included in a retrospective study conducted in the setting of two maternities in the Ile-de-France area. Cesarean delivery and forceps rates, management of labor, analgesia, maternal and neonatal outcomes were compared. RESULTS: Cesarean delivery rates were not significantly different (11...

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No abstract text is available yet for this article.