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Epidural analgesia

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https://www.readbyqxmd.com/read/28727597/bilateral-continuous-erector-spinae-plane-block-contributes-to-effective-postoperative-analgesia-after-major-open-abdominal-surgery-a-case-report
#1
Carlos Eduardo Restrepo-Garces, Ki Jinn Chin, Patricia Suarez, Alejandro Diaz
The erector spinae plane (ESP) block is a regional anesthetic technique involving local anesthetic injection in a paraspinal plane deep to the erector spinae muscle. Originally described for thoracic analgesia when performed at the T5 transverse process, the ESP block can provide abdominal analgesia if performed at lower thoracic levels because the erector spinae muscles extend to the lumbar spine. A catheter inserted into this plane can extend analgesic duration and can be an alternative to epidural analgesia...
July 19, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28727584/thoracic-epidural-catheter-placement-in-a-preoperative-block-area-improves-operating-room-efficiency-and-decreases-epidural-failure-rate
#2
Yehoshua Gleicher, Oskar Singer, Stephen Choi, Paul McHardy
BACKGROUND AND OBJECTIVES: The primary aim of this study was to review the impact of inserting thoracic epidural catheters in a preoperative block room setting on operating room efficiency. METHODS: We conducted a retrospective preintervention/postintervention review of thoracic epidurals inserted over a 12-month period. The review included 6 months of data prior to implementation of the regional anesthesia block room and 6 months of data following implementation...
July 20, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28727314/transperitoneal-rectus-sheath-block-and-transversus-abdominis-plane-block-for-laparoscopic-inguinal-hernia-repair-a-novel-approach
#3
Jun Nagata, Jun Watanabe, Masato Nagata, Yusuke Sawatsubashi, Masaki Akiyama, Takehide Tajima, Koichi Arase, Noritaka Minagawa, Takayuki Torigoe, Yoshifumi Nakayama, Reiko Horishita, Kentaro Kida, Kotaro Hamada, Keiji Hirata
INTRODUCTION: A laparoscopic approach for inguinal hernia repair is now considered the gold standard. Laparoscopic surgery is associated with a significant reduction in postoperative pain. Epidural analgesia cannot be used in patients with perioperative anticoagulant therapy because of complications such as epidural hematoma. As such, regional anesthetic techniques, such as ultrasound-guided rectus sheath block and transversus abdominis plane block, have become increasingly popular. However, even these anesthetic techniques have potential complications, such as rectus sheath hematoma, if vessels are damaged...
August 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28725244/optimal-perioperative-anesthesia-management-for-gynecologic-interstitial-brachytherapy
#4
Alison A Nielsen, Tehani A Liyanage, Gary S Leiserowitz, Jyoti Mayadev
PURPOSE: To propose an optimal perioperative pain management clinical care pathway for interstitial brachytherapy for gynecologic cancer based on our interdepartmental experience. MATERIAL AND METHODS: We conducted a retrospective review of 23 women who underwent 32 interstitial brachytherapy procedures for gynecological cancers, analyzing patient demographics, type of anesthetic, medications, postoperative pain scores, adverse events, and delays in discharge. We measured the association of postoperative nausea and/or vomiting (PONV) with hydromorphone use, and postoperative pain scores and total narcotic administration with type of anesthesia...
June 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28719524/establishing-obstetric-anesthesiology-practice-guidelines-in-the-republic-of-armenia-a-global-health-collaboration
#5
Gordon Yuill, Ashot Amroyan, Simon Millar, Emil Vardapetyan, Ashraf S Habib, Medge D Owen
BACKGROUND: Disparity exists in anesthesia practices between high- and low-to-middle income countries, and awareness has been raised within the global health community to improve the standards of anesthesia care and patient safety. The establishment of international collaborations and appropriate practice guidelines may help address clinical care deficiencies. This report's aim was to assess the impact of a multiyear collaboration on obstetric anesthesia practices in the Republic of Armenia...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28715964/uterine-and-abdominal-muscle-electromyographic-activities-in-control-and-pcea-treated-nulliparous-women-during-the-second-stage-of-labor
#6
Xueya Qian, Pin Li, Shao-Qing Shi, Robert E Garfield, Huishu Liu
OBJECTIVE: Patient-controlled epidural analgesia (PCEA), used to relieve pain during delivery, delays labor but the mechanism is unknown. The aim was to investigate the effects of PCEA on uterine and abdominal muscles electromyographic (EMG) activity during the second stage of labor. METHODS: This study included 45 nulliparous pregnant women without PCEA, 42 women with standard PCEA treatment given during the first stage of labor and stopped near the end of the first stage, and 22 women with standard PCEA treatment with continued use throughout the first and second stages of labor...
August 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28713495/awareness-of-epidural-analgesia-among-pregnant-women-in-jeddah-saudi-arabia
#7
Abdulrahim Gari, Ala Aziz, Nourah ALSaleh, Yosra Hamour, Hanaa Abdelal, Raed Sayed Ahmed
BACKGROUND AND OBJECTIVE: Labor pain is one of the most severe forms of pain that women experience throughout their lifetime. Many pregnant women decide to have an epidural anesthesia to cope with labor pain. This study has focused on general awareness about epidural anesthesia among pregnant women in Jeddah, Saudi Arabia. METHODS: This was a cross-sectional hospital-based study using a self-administered questionnaire, conducted in King Faisal Specialist Hospital and Research Center and International Medical Centre...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28711635/a-new-pupillary-measure-to-assess-pain-a-prospective-study
#8
David J Charier, Daniel Zantour, Vincent Pichot, Florian Chouchou, Jean-Claude M Barthelemy, Frederic Roche, Serge B Molliex
Pupillary diameter (PD) varies under the influence of both the sympathetic and parasympathetic systems, increasing proportionally to pain intensity. Such variations however should not be confused with pupillary fluctuations, which refer to the fast and permanent PD fluctuations induced by the ongoing interplay between the sympathetic and parasympathetic systems, which we propose to measure using the Variation Coefficient of Pupillary Diameter (VCPD). This study aimed first at correlating both PD, PD increase during a contraction, and VCPD, with pain as rated with the Numerical Rating Scale (NRS) during obstetrical labor, and then at comparing such correlations with one another...
July 12, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28709410/identification-of-barriers-and-facilitators-for-optimal-cesarean-section-care-perspective-of-professionals
#9
Sonja Melman, Rachel Hellen Petra Schreurs, Carmen Desiree Dirksen, Anneke Kwee, Jan Gerrit Nijhuis, Nicol Anna Cornelia Smeets, Hubertina Catharina Johanna Scheepers, Rosella Petronella Maria Gemma Hermens
BACKGROUND: The cesarean section (CS) rate has increased over recent decades with poor guideline adherence as a possible cause. The objective of this study was to explore barriers and facilitators for delivering optimal care as described in clinical practice guidelines. METHODS: Key recommendations from evidence-based guidelines were used as a base to explore barriers and facilitators for delivering optimal CS care in The Netherlands. Both focus group and telephone interviews among 29 different obstetrical professionals were performed...
July 14, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28707454/interventions-for-postoperative-pain-in-children-an-overview-of-systematic-reviews
#10
REVIEW
Krste Boric, Svjetlana Dosenovic, Antonia Jelicic Kadic, Marijan Batinic, Marija Cavar, Marjan Urlic, Nikolina Markovina, Livia Puljak
The aim of this study was to conduct an overview of systematic reviews that summarizes the results about efficacy and safety from randomized controlled trials involving the various strategies used for postoperative pain management in children. We searched the Cochrane Database of Systematic Reviews, CINAHL, Database of Reviews of Effect, Embase, MEDLINE, and PsycINFO from the earliest date to January 24, 2016. This overview included 45 systematic reviews that evaluated interventions for postoperative pain in children...
July 14, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28706102/a-method-to-assess-obstetric-outcomes-using-the-10-group-classification-system-a-quantitative-descriptive-study
#11
Janne Rossen, Miha Lucovnik, Torbjørn Moe Eggebø, Natasa Tul, Martina Murphy, Ingvild Vistad, Michael Robson
OBJECTIVES: Internationally, the 10-Group Classification System (TGCS) has been used to report caesarean section rates, but analysis of other outcomes is also recommended. We now aim to present the TGCS as a method to assess outcomes of labour and delivery using routine collection of perinatal information. DESIGN: This research is a methodological study to describe the use of the TGCS. SETTING: Stavanger University Hospital (SUH), Norway, National Maternity Hospital Dublin, Ireland and Slovenian National Perinatal Database (SLO), Slovenia...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28701185/case-report-perioperative-management-of-caesarean-section-for-a-parturient-with-mitochondrial-myopathy
#12
Qiang Zheng, Penghui Wei, Jinfeng Zhou, Haipeng Zhou, Fucheng Ji, Wenxi Tang, Jianjun Li
BACKGROUND: Mitochondrial myopathies represent a group of disorders caused by mitochondrial defects that disrupt energy production. Most patients have issues from infancy to early childhood. Pregnancy in women with mitochondrial myopathy is uncommon and the management for these parturients is full of challenges. CASE PRESENTATION: A 36-year-old woman with mitochondrial myopathy was scheduled for caesarean section under a combined spinal-epidural anaesthesia and multi-model analgesia...
July 12, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28698953/what-can-we-do-to-reduce-the-associated-costs-in-induction-of-labour-of-intrauterine-growth-restriction-foetuses-at-term-a-cost-analysis-study
#13
Jorge Duro-Gómez, María Fernanda Garrido-Oyarzún, Ana Belén Rodríguez-Marín, Antonio Jesús de la Torre González, José Eduardo Arjona-Berral, Camil Castelo-Branco
OBJECTIVE: To evaluate the costs associated with induction of labour in intrauterine growth restriction fetuses comparing different procedures. STUDY DESIGN: 150 pregnancies at term diagnosed with intrauterine growth restriction and indication for induction of labour were included. 24 were ripened with misoprostol 25 μg tablets, 24 with dinoprostone 10 mg vaginal insert, and 77 with Cook(®) cervical ripening balloon. To determine the costs of induction of labour, method of induction, intrapartum medication, epidural analgesia, type of delivery, and maternal and neonatal admissions were considered...
July 11, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28698694/efficiency-of-medetomidine-for-epidural-analgesia-effects-on-isoflurane-requirement-and-mean-systemic-arterial-blood-pressure-in-dogs
#14
Ryota Watanabe, Yukihiro Fujita
Five healthy beagle dogs anesthetized with isoflurane were administered medetomidine (α-2 adrenoceptor agonist) by the epidural route. Mean arterial pressure (MAP) and end-tidal concentration of isoflurane (ISO) were measured 1, 2.5, and 4 h after administration. Epidural administration of medetomidine reduced the isoflurane dose required to prevent changes in vital parameters following mechanical stimulation and maintained the MAP at a higher level compared to the control.
July 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/28695584/patient-controlled-analgesia-with-remifentanil-vs-alternative-parenteral-methods-for-pain-management-in-labour-a-cochrane-systematic-review
#15
REVIEW
Y Jelting, S Weibel, A Afshari, N L Pace, J Jokinen, T Artmann, L H J Eberhart, P Kranke
We aimed to assess the effectiveness of remifentanil used as intravenous patient-controlled analgesia for the pain of labour. We performed a systematic literature search in December 2015 (updated in December 2016). We included randomised, controlled and cluster-randomised trials of women in labour with planned vaginal delivery receiving patient-controlled remifentanil compared principally with other parenteral and patient-controlled opioids, epidural analgesia and continuous remifentanil infusion or placebo...
August 2017: Anaesthesia
https://www.readbyqxmd.com/read/28691979/perioperative-management-for-abdominal-surgery-in-bilateral-diaphragmatic-paralysis-a-case-report-and-literature-review
#16
Glenio B Mizubuti, Louie Wang, Anthony M-H Ho, Robert C Tanzola, Jordan Leitch
The optimal approach to postoperative analgesia in patients with bilateral diaphragmatic paralysis undergoing abdominal surgery remains unclear. We report a 69-year-old woman with bilateral diaphragmatic paralysis who underwent a laparoscopic hernia repair and an open laparotomy for reversal of a Hartmann procedure under general anesthesia. Postoperative analgesia was provided by intravenous opioid and epidural local anesthetic and opioid, respectively. The patient's trachea was successfully extubated at the end of both surgical procedures...
July 6, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28689621/intrathecal-hematoma-and-arachnoiditis-mimicking-bacterial-meningitis-after-an-epidural-blood-patch
#17
F Roy-Gash, N Engrand, E Lecarpentier, M P Bonnet
We present a case of arachnoiditis and an intrathecal hematoma after an epidural blood patch. A 24-year-old parturient underwent an epidural blood patch three days after an accidental dural puncture during epidural labor analgesia. Four days later, the patient developed severe lower back pain, bilateral leg pain, persistent headache and fever. Bacterial meningitis was initially suspected and antibiotics started. Lumbar magnetic resonance imaging was performed and showed an intrathecal hematoma, with no blood in the epidural space...
June 1, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28688514/pain-control-with-continuous-infusion-preperitoneal-wound-catheters-versus-continuous-epidural-analgesia-in-colon-and-rectal-surgery-a-randomized-controlled-trial
#18
Nicolas J Mouawad, Stefan W Leichtle, Christodoulos Kaoutzanis, Kathleen Welch, Suzanne Winter, Richard Lampman, Matt McCord, Kimberly A Hoskins, Robert K Cleary
OBJECTIVE: To compare continuous infusion preperitoneal wound catheters (CPA) versus continuous epidural analgesia (CEA) after elective colorectal surgery. METHODS: An open-label equivalence trial randomizing patients to CPA or CEA. Primary outcomes were postoperative pain as determined by numeric pain scores and supplemental narcotic analgesia requirements. Secondary outcomes included incidence of complications and patient health status measured with the SF-36 Health Survey (Acute Form)...
July 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28684143/what-s-new-in-clinical-obstetric-anesthesia-in-2015
#19
REVIEW
P E Hess
Each calendar year the Society for Obstetric Anesthesia and Perinatology invites an individual to conduct a review of the medical literature, identifying clinically relevant publications of interest to the obstetric anesthesia provider. This report of that effort covers the publications from 2015 and includes the categories of anesthesia and analgesia, complications of neuraxial procedures, and the effects of anesthesia on the fetus. Neuraxial procedures represent the foundation of obstetric anesthesia; advances in anesthesia and analgesia include novel modes of administration, and refinements in care of the medically complex patient...
March 18, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28681500/continuous-support-for-women-during-childbirth
#20
REVIEW
Meghan A Bohren, G Justus Hofmeyr, Carol Sakala, Rieko K Fukuzawa, Anna Cuthbert
BACKGROUND: Historically, women have generally been attended and supported by other women during labour. However, in hospitals worldwide, continuous support during labour has often become the exception rather than the routine. OBJECTIVES: The primary objective was to assess the effects, on women and their babies, of continuous, one-to-one intrapartum support compared with usual care, in any setting. Secondary objectives were to determine whether the effects of continuous support are influenced by:1...
July 6, 2017: Cochrane Database of Systematic Reviews
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