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Epidural analgesia

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https://www.readbyqxmd.com/read/29679457/burst-spinal-cord-stimulation-in-peripherally-injured-chronic-neuropathic-rats-a-delayed-effect
#1
Koen P V Meuwissen, Jianwen Wendy Gu, Tianhe C Zhang, Elbert A J Joosten
OBJECTIVE: Two well-known spinal cord stimulation (SCS) paradigms, Conventional (Con) and Burst-SCS, are hypothesized to exert their anti-nociceptive effects through different stimulation-induced mechanisms. We studied the course of the behavioral anti-nociceptive effect during 60 minutes of SCS and 30 minutes post SCS, in a rat model of chronic neuropathic pain. MATERIAL AND METHODS: Animals received a unilateral partial sciatic nerve ligation, after which they were implanted with quadripolar electrodes into the epidural space at vertebral level T13 (n=43 rats)...
April 20, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29664554/extensive-postpartum-urinary-retention-successfully-treated-with-clean-intermittent-catheterization
#2
Paweł Milart, Ewa Beata Wozniakowska, Piotr Czuczwar, Wojciech Wrona, Tomasz Paszkowski
We present a case of extensive urine retention after vaginal delivery. Postpartum urinary retention occurs in 0.7 to 0.9% of vaginal deliveries. In the literature, mediolateral episiotomy, epidural analgesia, perineal lacerations, macrosomic birth and prolonged 2nd stage of labor are suggested as risk factors for postpartum urine retention.
2018: Ginekologia Polska
https://www.readbyqxmd.com/read/29662280/effects-of-epidural-labour-analgesia-in-mother-and-foetus
#3
Varsha Laxmikant Deshmukh, Shaswatee S Ghosh, Kanan A Yelikar, Shreeniwas N Gadappa
Objective: Aim of study was to determine effect of epidural analgesia on progress of labour and mode of delivery, to find out its complications in labour and puerperium and to evaluate neonatal outcome in terms of APGAR score. Method: The present study was conducted in Department of Obstetrics and Gynaecology at Government Medical College Aurangabad over period of 2 years from June 2014 to June 2016 after taking approval from institutional ethical board. Hundred low-risk primigravidas were included in the study, 50 women received epidural analgesia for relief of labour pain at 3-4 cm and 50 women served as control...
April 2018: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/29655592/development-of-a-blunt-chest-injury-care-bundle-an-integrative-review
#4
REVIEW
Sarah Kourouche, Thomas Buckley, Belinda Munroe, Kate Curtis
BACKGROUND: Blunt chest injuries (BCI) are associated with high rates of morbidity and mortality. There are many interventions for BCI which may be able to be combined as a care bundle for improved and more consistent outcomes. OBJECTIVE: To review and integrate the BCI management interventions to inform the development of a BCI care bundle. METHODS: A structured search of the literature was conducted to identify studies evaluating interventions for patients with BCI...
April 7, 2018: Injury
https://www.readbyqxmd.com/read/29643621/evaluation-of-dexmedetomidine-and-fentanyl-as-additives-to-ropivacaine-for-epidural-anesthesia-and-postoperative-analgesia
#5
S Kiran, Kavita Jinjil, Urvashi Tandon, Soumita Kar
Background and Aims: The synergism between epidural local anesthetic agent and opioids is well established, but evidence for the combination of local anesthetic agent with dexmedetomidine in epidurals is limited. This study evaluates the clinical efficacy of dexmedetomidine versus fentanyl as an additive to ropivacaine for epidural anesthesia. Material and Methods: Patients undergoing infraumbilical surgeries were divided randomly into three groups - Group R (n = 25): received 18 ml of 0...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29643619/comparison-of-continuous-epidural-infusion-of-0-125-ropivacaine-with-1-%C3%AE-g-ml-fentanyl-versus-0-125-bupivacaine-with-1-%C3%AE-g-ml-fentanyl-for-postoperative-analgesia-in-major-abdominal-surgery
#6
Shruti Shrikant Patil, Amala G Kudalkar, Bharati A Tendolkar
Background and Aim: The present study was carried out to compare the efficacy of continuous epidural infusion of two amide local anesthetics, ropivacaine and bupivacaine with fentanyl for postoperative analgesia in major abdominal surgeries. Material and Methods: A total of 60 patients scheduled for major abdominal surgery were randomized into two study Groups B and R with thirty patients in each group. All patients were administered general anesthesia after placing epidural catheter...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29643618/a-randomized-clinical-trial-of-intrathecal-magnesium-sulfate-versus-midazolam-with-epidural-administration-of-0-75-ropivacaine-for-patients-with-preeclampsia-scheduled-for-elective-cesarean-section
#7
Sophia Paleti, P Krishna Prasad, B Sowbhagya Lakshmi
Background and Aims: Magnesium sulfate and midazolam have been used as adjuvants to local anesthetics via intrathecal and epidural routes to augment the quality of block and prolong postoperative analgesia. This study compares addition of intrathecal magnesium sulfate versus intrathecal midazolam to epidurally administered isobaric ropivacaine as a part of combined spinal epidural technique in pre-eclamptic parturients undergoing elective cesarean section. Material and Methods: After institutional ethics committee approval and written informed consent, 50 pre-eclamptic parturients were randomly allocated to one of the two groups of 25 each to either receive intrathecal magnesium sulfate (50 mg) or intrathecal midazolam (1 mg) in combination with epidural ropivacaine (0...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29643617/comparison-of-ropivacaine-0-2-with-or-without-clonidine-1-%C3%AE-g-kg-for-epidural-labor-analgesia-a-randomized-controlled-study
#8
Indira Kumari, Kapil Sharma, Vikram Bedi, Madhan Mohan, Hemraj Tungaria, Manish Kumar Modi
Background and Aims: The aim is to determine the effect of addition of clonidine to ropivacaine for epidural labor analgesia with regard to onset of analgesia, duration of analgesia, neonatal outcome, and quality of analgesia. Material and Methods: A total of 60 term parturients of the American Society of Anesthesiologists Grade I and II with uncomplicated pregnancy, vertex presentation, posted for on-demand epidural labor analgesia after informed consent were divided in two groups...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29643616/labor-analgesia-in-parturients-of-fetal-growth-restriction-having-raised-umbilical-doppler-vascular-indices
#9
Sukhen Samanta, Kajal Jain, Neerja Bhardwaj, Vanita Jain, Preet Mohinder Singh, Sujay Samanta, Veenu Singla, Rini Saha
Background and Aims: Fetuses with abnormal umbilical blood flow are at a higher risk of adverse perinatal outcome than those with normal flow. Epidural analgesia (EA) has shown to decrease villous vascular resistance in preeclamptic women during labor. The present study evaluates the effects of epidural ropivacaine and intramuscular (IM) tramadol on Doppler blood flow in parturients with fetal growth restriction and raised umbilical artery (UmA) blood flow. Material and Methods: In this prospective nonrandomized comparative study, 36 term parturients with sonographic evidence of UmA systolic-diastolic (S-D) ratio ≥3 were enrolled...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29642862/effectiveness-and-safety-of-moderate-intensity-aerobic-water-exercise-during-pregnancy-for-reducing-use-of-epidural-analgesia-during-labor-protocol-for-a-randomized-clinical-trial
#10
Araceli Navas, Catalina Artigues, Alfonso Leiva, Elena Portells, Aina Soler, Antonia Cladera, Silvia Ortas, Margarita Alomar, Marina Gual, Concepción Manzanares, Marina Brunet, Magdalena Julià, Lidia López, Lorena Granda, Miquel Bennasar-Veny, Mari Carmen Carrascosa
BACKGROUND: Epidural analgesia during labor can provide effective pain relief, but can also lead to adverse effects. The practice of moderate exercise during pregnancy is associated with an increased level of endorphins in the blood, and this could also provide pain relief during labor. Aerobic water exercises, rather than other forms of exercise, do not negatively impact articulations, reduce edema, blood pressure, and back pain, and increase diuresis. We propose a randomized controlled trial (RCT) to evaluate the effectiveness and safety of a moderate water exercise program during pregnancy on the need for epidural analgesia during labor...
April 11, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29629201/anesthesia-and-fast-track-in-video-assisted-thoracic-surgery-vats-from-evidence-to-practice
#11
REVIEW
Marzia Umari, Stefano Falini, Matteo Segat, Michele Zuliani, Marco Crisman, Lucia Comuzzi, Francesco Pagos, Stefano Lovadina, Umberto Lucangelo
In thoracic surgery, the introduction of video-assisted thoracoscopic techniques has allowed the development of fast-track protocols, with shorter hospital lengths of stay and improved outcomes. The perioperative management needs to be optimized accordingly, with the goal of reducing postoperative complications and speeding recovery times. Premedication performed in the operative room should be wisely administered because often linked to late discharge from the post-anesthesia care unit (PACU). Inhalatory anesthesia, when possible, should be preferred based on protective effects on postoperative lung inflammation...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29628834/comparison-of-analgesic-efficacy-and-safety-of-continuous-epidural-infusion-versus-local-infiltration-and-systemic-opioids-in-video-assisted-thoracoscopic-surgery-decortication-in-pediatric-empyema-patients
#12
Priyanka Pradeep Karnik, Nandini Malay Dave, Madhu Garasia
Introduction: The stripping of the densely innervated and inflamed parietal pleura in empyema during video-assisted thoracoscopic surgery (VATS) decortication can lead to significant pain and major postoperative respiratory compromise. Hence, we compared the analgesic efficacy of continuous epidural infusion versus local infiltration and systemic opioids in children undergoing VATS decortications. Methodology: Following ethics approval and informed consent, forty patients from 1 to 12 years of age were randomized into two groups, Group E (epidural) and Group L (local infiltration) after induction of anesthesia...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628829/using-dexamethasone-as-an-adjuvant-to-levobupivacaine-in-epidural-anesthesia-to-change-the-pain-intensity-and-duration-in-painless-labor
#13
Hassan Mohamed Ali, Amr Wahdan
Background and Objective: This is a randomized controlled trial aiming at comparing the effectiveness of levobupivacaine alone versus a levobupivacaine with dexamethasone in the epidural injection for painless labor. Patients and Methods: This is a comparative randomized controlled double-blinded clinical trial with 49 patients were included in this study, all of them were primigravidas and were during vaginal delivery with a cervical dilatation ≥4 cm. Patients were included randomly in one of two groups either Group C (26 cases) with epidural levobupivacaine 0...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628682/perioperative-pain-management-following-total-joint-arthroplasty-a-review-and-update-to-an-institutional-pain-protocol
#14
REVIEW
Kimberly L Stevenson, Alexander L Neuwirth, Neil Sheth
As the rate of total joint arthroplasty increases with the aging population of the United States, new focus on decreasing opioid use through the development of multimodal pain regimens (MPRs) is becoming an important area of research. MPRs use different agents and modes of delivery in order to synergistically address pain at many levels of the pain pathway. MPRs include a combination of acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), gabapentinoids, opioids (short- and long-acting), spinal/epidural analgesia, regional nerve blocks, and local anesthetics...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29628592/magnesium-sulfate-as-a-preemptive-adjuvant-to-levobupivacaine-for-postoperative-analgesia-in-lower-abdominal-and-pelvic-surgeries-under-epidural-anesthesia-randomized-controlled-trial
#15
Heba Omar
Background: Magnesium (Mg) has been evaluated as an adjuvant to local anesthetics for prolongation of postoperative epidural and intrathecal analgesia but not with epidural levobupivacaine in lower abdominal surgeries. Aim of the Study: The aim of the study was to evaluate the preemptive analgesic effect of Mg added to epidural levobupivacaine anesthesia in infraumbilical abdominal surgeries. Settings and Design: This study design was a prospective randomized controlled trial...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628589/clonidine-as-an-adjuvant-to-caudal-epidural-ropivacaine-for-lumbosacral-spine-surgeries
#16
Saraswathi Nagappa, Sandhya Kalappa, Raghavendra Biligiri Sridhara
Background: Caudal epidural analgesia is a proven technique for providing analgesia for spinal surgeries. Prolonged pain relief with no motor blockade is desired for early mobilization. Objective: The objective of this study is to compare the effect of adding 1 μg/kg of clonidine to injection ropivacaine 0.2% with respect to duration of analgesia, hemodynamic effects, and associated side effects. Methodology: In this prospective double-blind study, a total of 60 patients undergoing lumbosacral spine surgery were randomized to receive 25 cc caudal epidural injection of either injection ropivacaine 0...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628563/postoperative-analgesia-with-epidural-dexmedetomidine-compared-with-clonidine-following-total-abdominal-hysterectomies-a-prospective-double-blind-randomized-trial
#17
Sunil Chiruvella, Balaji Donthu, Srinivasa Rao Nallam, Dora Babu Salla
Background and Aims: Anesthesia for total abdominal hysterectomies is not only concerned with relieving pain during intraoperative period but also during the postoperative period. We compared clonidine and dexmedetomidine as an adjuvant to levobupivacaine for epidural analgesia with respect to onset and duration of sensory block, duration of analgesia, and adverse effects. Materials and Methods: A total of 80 individuals between the age of 45 and 65 years of American Society of Anesthesiologists (ASA) physical status Classes I and II who underwent total abdominal hysterectomies were randomly allocated into two groups, comprising 40 patients in each group...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628556/comparison-of-three-different-concentrations-of-levobupivacaine-for-epidural-labor-analgesia-clinical-effect-and-pharmacokinetic-profile
#18
Ahmed Mostafa El-Shaarawy, Mohamed S Asfour, Doaa A Rashwan, Mahmoud M Amer, Shahira F El-Menshawe, Mohammed H Elkomy
Background: The aim is to compare the clinical effect of three different concentrations of levobupivacaine (0.25%, 0.125%, and 0.0625%) on the sensory and motor block characteristics and mode of delivery during epidural labor analgesia. We also studied the pharmacokinetic profile of the three concentrations during labor. Materials and Methods: Sixty pregnant females undergoing normal vaginal delivery under epidural analgesia were divided into three groups according to the concentration of levobupivacaine used...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628549/comparison-of-efficacy-of-epidural-ropivacaine-versus-bupivacaine-for-postoperative-pain-relief-in-total-knee-replacement-surgeries
#19
Sidharth Bhasin, Mridul Dhar, Deepak Kumar Sreevastava, Rajiv Nair, Saurabh Chandrakar
Background: Epidural analgesia has become the standard of care for knee replacement surgeries worldwide. Bupivacaine has been used successfully for many years. Epidural ropivacaine is now being used increasingly and seems to have benefits other than just pain relief, in terms of a better safety profile. Aim: To compare the efficacy of bupivacaine 0.125% (Group B) versus two concentrations of ropivacaine 0.1% (Group R1) and 0.2% (Group R2), in terms of pain scores, requirement of rescue analgesia, related adverse effects, and duration of postoperative (PO) hospital stay...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29627812/role-of-maternal-characteristics-and-epidural-analgesia-on-caesarean-section-rate-in-groups-1-and-3-according-to-robson-s-classification-a-cohort-study-in-an-italian-university-hospital-setting
#20
Stefania Triunfo, Sergio Ferrazzani, Gaetano Draisci, Bruno Antonio Zanfini, Giovanni Scambia, Antonio Lanzone
OBJECTIVE: To investigate the role of maternal characteristics and epidural analgesia (EA) on caesarean section (CS) rates in selected groups by using the Robson 10-Group Classification System (RTGCS). DESIGN: Cohort study. SETTING: Department of Obstetrics and Gynaecology, Fondazione Policlinico Universitario 'A. Gemelli', Rome, Italy. PATIENTS: A total of 12 098 deliveries in periods I (1998-1999) and II (2010-2011)...
April 7, 2018: BMJ Open
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