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Labor anesthesia

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https://www.readbyqxmd.com/read/30095659/prophylactic-infusion-of-phenylephrine-increases-the-median-effective-dose-of-intrathecal-hyperbaric-bupivacaine-in-cesarean-section-a-prospective-randomized-study
#1
Yin-Fa Zhang, Fei Xiao, Wen-Ping Xu, Lin Liu
BACKGROUND: Phenylephrine infusion to prevent spinal-induced hypotension can attenuate cephalic spread of intrathecal bupivacaine. Therefore, we suspected the intrathecal dose requirement for bupivacaine may differ when using phenylephrine infusion to prevent spinal-induced hypotension in cesarean section. We designed a prospective, randomized study to determine the ED50 of hyperbaric bupivacaine for cesarean section under combined spinal-epidural anesthesia in healthy parturients with and without prophylactic phenylephrine infusion to prevent spinal-induced hypotension...
August 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/30055810/-universalization-parity-and-evolution-of-the-demand-of-epidural-analgesia-in-labor-in-andalusia-spain
#2
José María García-de-Diego, Rafael Serrano-Del-Rosal
OBJECTIVE: Assess whether the universalization of epidural analgesia supplied in hospitals of the Andalusia Public Health Service (SSPA) has ended up with the inequalities shown in previous studies regarding to their demand: the percentage of women who rejected epidural analgesia was higher among the users having low educational level, lower income and working as housekeeper. METHOD: The data are based on satisfaction surveys conducted by the Institute for Advanced Social Studies amongst of SSPA users...
July 25, 2018: Gaceta Sanitaria
https://www.readbyqxmd.com/read/30047260/obstetric-anesthesia-analgesia-does-not-affect-disease-course-in-multiple-sclerosis-10-year-retrospective-cohort-study
#3
Hana Harazim, Pavel Štourač, Petr Janků, Hana Zelinková, Kamil Frank, Michal Dufek, Petr Štourač
OBJECTIVES: Multiple sclerosis (MS) often occurs in young women and the effect of obstetric anesthesia/analgesia on the disease is poorly understood. No previous study has investigated the course of the disease in women in labor in the Czech Republic. The aim of this study was to evaluate the occurrence or absence of relapses in the 6-month postpartum period in MS parturients with and without obstetric anesthesia/analgesia. MATERIALS AND METHODS: We retrospectively studied all deliveries (n = 58,455) at the University Hospital Brno from 2004 to 2013 and identified those of the women with an ICD-10 code G35 (MS) recorded anytime in their medical history (n = 428)...
July 25, 2018: Brain and Behavior
https://www.readbyqxmd.com/read/30039233/management-of-venous-thromboembolism-in-pregnancy
#4
REVIEW
Annemarie E Fogerty
PURPOSE OF REVIEW: This manuscript addresses the risks for venous thromboembolism (VTE) during pregnancy and the associated challenges of both diagnosis and treatment. RECENT FINDINGS: The obstacles to diagnosis given lack of specificity of typical biomarkers to predict VTE in pregnancy, as well as the unique fetal and bleeding risks introduced by managing massive pulmonary embolism (PE) with thrombolytics or thrombectomy are highlighted. VTE during pregnancy and the postpartum window occurs at a 6-10-fold higher rate compared with age-matched peers and is a major cause of morbidity and mortality...
July 23, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/30023142/pregnancy-and-breastfeeding-during-intrathecal-baclofen-therapy-a-case-study-and-review
#5
Takeshi Hara, Madoka Nakajima, Hidenori Sugano, Kostadin Karagiozov, Emiko Hirose, Keiko Goto, Hajime Arai
We report the case of a young woman who received intrathecal baclofen therapy (ITB) and subsequently became pregnant and had a normal delivery. A 28-year-old woman with flexion myelopathy had anterior decompression with fusion at C4/5 and C5/6 levels. Clinical symptoms improved after surgery. However, when she was 29 years old, her symptoms steadily advanced to Modified Ashworth Scale 3 spasticity level in the lower legs, with pain in both of them and urinary retention tendency. Since a 25 μg intrathecal baclofen injection improved her symptoms, an ITB pump system was implanted...
July 2018: NMC Case Report Journal
https://www.readbyqxmd.com/read/30019160/anesthetic-treatment-of-cardiac-disease-during-pregnancy
#6
REVIEW
Kate M Cohen, Rebecca D Minehart, Lisa R Leffert
PURPOSE OF REVIEW: This review summarizes the pathophysiology, peripartum treatment, and anesthetic management of parturients with cardiac disease. Valvular disease, coronary disease, and cardiomyopathy are specifically addressed in the context of the normal physiologic changes of pregnancy. We offer recommendations for anesthetic approaches, hemodynamic goals with an emphasis on interdisciplinary planning between anesthesiologists, cardiologists, cardiothoracic surgeons, obstetricians, maternal fetal medicine specialists, and neonatologists...
July 18, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29962624/epidural-analgesia-during-labor-attitudes-among-expectant-mothers-and-their-care-providers
#7
Garg Kamakshi, Grewal Anju, Singh Tania, Gupta Priyanka, Bansal Kamya, Pruthi Gegal, Chuttani Priyanka
Introduction: Varying levels of knowledge and attitudes among parturients and physicians toward epidural analgesia result in its low utilization. We aimed to assess the knowledge, attitude, and practice of parturients, obstetricians, and anesthesiologists regarding epidural labor analgesia. Methodology: We surveyed obstetricians, anesthesiologists, and parturients availing care and later delivered at our hospital from July 1, 2017, to December 31, 2017. Knowledge, attitude, and practice regarding epidural analgesia were collected using a semi-structured predesigned questionnaire...
April 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29943508/effects-of-adrenaline-on-maternal-and-fetal-fentanyl-absorption-in-epidural-analgesia-a-randomized-trial
#8
F Haidl, L A Rosseland, O Spigset, V Dahl
BACKGROUND: The combination of low-dose local anesthesia and lipophilic opioids such as fentanyl is established as a standard solution for labor epidural analgesia. Fentanyl increases efficacy, but may have negative effects on the neonate in terms of reduced neonatal neurologic and adaptive capacity scores and breast feeding. We hypothesized that addition of adrenaline 2 μg/mL to a solution of bupivacaine 1 mg/mL and fentanyl 2 μg/mL would reduce the systemic uptake of fentanyl, resulting in reduced serum fentanyl in the fetus at birth...
June 25, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29939847/maternal-body-mass-index-and-use-of-labor-neuraxial-analgesia-a-population-based-retrospective-cohort-study
#9
Alexander J Butwick, Cynthia A Wong, Nan Guo
BACKGROUND: Neuraxial labor analgesia may benefit obese women by optimizing cardiorespiratory function and mitigating complications related to emergency general anesthesia. We hypothesized that obese women have a higher rate of neuraxial analgesia compared with nonobese parturients. METHODS: Using U.S. natality data, our cohort comprised 17,220,680 deliveries, which accounts for 61.5% of 28 million births in the United States between 2009 and 2015. We examined the relationships between body mass index class and neuraxial labor analgesia, adjusting for sociodemographic, antenatal, pregnancy, and peripartum factors...
June 25, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29923127/pregnancy-associated-myocardial-infarction
#10
REVIEW
Michael C Honigberg, Nandita S Scott
PURPOSE OF REVIEW: To educate clinicians about the epidemiology, etiologies, diagnosis, and management of pregnancy-associated myocardial infarction (PAMI). RECENT FINDINGS: The risk of myocardial infarction is increased more than threefold around the time of pregnancy. In the recent series, PAMI is most commonly caused by spontaneous coronary artery dissection, followed by atherosclerosis. Percutaneous coronary intervention or coronary artery bypass grafting may be required, but conservative management with medical therapy is generally advised when possible, particularly in cases of coronary dissection...
June 19, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29914232/current-practice-in-obstetric-anesthesia-and-analgesia-in-public-hospitals-of-greece-a-2016-national-survey
#11
Chryssoula Staikou, Alexandros Μakris, Kassiani Theodoraki, Athanasia Τsaroucha, Amalia Douma, Eleni Μoka, Eleni Αrnaoutoglou, Tilemahos Paraskevopoulos, Ioanna Siafaka, Efi Stavropoulou, Eriphili Αrgyra
Aims: The aim of this nationwide descriptive survey was to assess the use of regional anesthesia in obstetrics in Greek public hospitals. Methods: The survey was conducted between March and August, 2016. A structured questionnaire was sent to 50 Anesthesia Departments in Greek Public Hospitals with obstetric units. Results: The response rate was 94%. Data corresponded to 9475 cesarean and 8155 vaginal deliveries. Regional anesthesia was used in 69...
June 19, 2018: Balkan Medical Journal
https://www.readbyqxmd.com/read/29900579/women-s-experiences-with-water-birth-a-matched-groups-prospective-study
#12
Anthony Lathrop, Carrie F Bonsack, David M Haas
BACKGROUND: Water birth has become an increasingly popular childbirth option, but has also come under scrutiny because of its possible risks and benefits. The primary objective of this study was to explore potential benefits of water birth by comparing the experiences of women who gave birth in water versus conventionally. We also compared maternal and newborn outcomes. METHODS: We performed a prospective study of 66 women who had water births and 132 who had conventional births...
June 13, 2018: Birth
https://www.readbyqxmd.com/read/29900352/lebanese-women-s-awareness-and-attitude-toward-epidural-anesthesia-during-labor
#13
M Fawaz, S Malas
Women׳s choice to use epidural anesthesia (EA) for relief of labor pain varies from one culture to another. A descriptive cross-sectional design was used to gather data from a sample of 200 women in childbearing age. Data was gathered from general population in Lebanon. Demographic data, knowledge and attitudes questionnaires towards EA were used to gather data for this study. The data in this article provides demographic data about Lebanese women and their awareness and attitudes towards epidural anesthesia...
August 2018: Data in Brief
https://www.readbyqxmd.com/read/29887886/anesthesiologists-preferences-regarding-visitor-presence-during-placement-of-neuraxial-labor-analgesia
#14
Sangeeta Kumaraswami, Suryanarayana Pothula, Mario Anthony Inchiosa, Keshar Paul Kubal, Micah Alexander Burns
Introduction: Neuraxial labor analgesia has become an integral part of modern obstetric anesthetic practice. Presence of a familiar person during its placement may be beneficial to the patient. A survey was sent to anesthesiologists practicing obstetric anesthesia in the USA to determine their views. Methods: The survey queried the following: existence of a written policy; would they allow a visitor; visitor's view, sitting or standing; reasons to allow or not allow a visitor; and influence by other staff on the decision...
2018: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/29862280/the-efficacy-of-programmed-intermittent-epidural-bolus-for-postoperative-analgesia-after-open-gynecological-surgery-a-randomized-double-blinded-study
#15
Shiho Satomi, Nami Kakuta, Chiaki Murakami, Yoko Sakai, Katsuya Tanaka, Yasuo M Tsutsumi
Background: It is well known that the programmed intermittent epidural bolus (PIEB) technique effectively provides epidural anesthesia in labor. This randomized double-blind trial compared the postoperative analgesic efficacy of PIEB with that of continuous epidural infusion (CEI) in patients undergoing gynecological surgery under combined general-epidural anesthesia. Methods: Patients undergoing open gynecological surgery under combined general-epidural anesthesia were randomized at a 1 : 1 ratio to receive PIEB or CEI...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29850316/management-of-a-pregnancy-with-a-solid-pseudopapillary-neoplasm-of-the-pancreas
#16
Atakan Tanacan, Gokcen Orgul, Ahmet Bülent Dogrul, Fatih Aktoz, Osman Abbasoglu, M Sinan Beksac
A 26-year-old primigravid patient, at 35 weeks and 2 days of gestation, was referred to Hacettepe University Hospital for pancreatic mass, giant cervical myoma, maternal systemic lupus erythematosus, thrombocytopenia, and onset of preterm labor. At 36 weeks and 1 day of gestation (6 days after admission to the hospital), regular uterine contractions started and cervical dilatation with effacement was observed. Because of breech presentation and giant cervical myoma, a cesarean section was performed on the primigravid patient under general anesthesia...
2018: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29847969/postdural-puncture-headache-and-epidural-blood-patch-in-a-large-obstetric-anaesthesia-population
#17
Blanca Martínez, Enrique Canser, Alberto Alonso, Eduardo Alonso, Elena Gredilla, Jesús Díez, Fernando Gilsanz
OBJECTIVE: Postdural puncture headache (PDPH) is the most common serious complication in obstetric anesthesia. We show the incidence of accidental dural puncture (ADP), PDPH, epidural blood patch (EBP) and associated morbidity following a protocol established in an obstetric anesthesia department. METHODS: An observational, prospective, analytical study performed in 66,540 epidural labor analgesia procedures. The objective is to describe the incidence of ADP, PDPH and EBP in a large obstetric anesthesia population, as well as morbidity associated with ADP and EBP...
March 2018: Asian journal of anesthesiology
https://www.readbyqxmd.com/read/29782398/benefit-and-harm-of-adding-epinephrine-to-a-local-anesthetic-for-neuraxial-and-locoregional-anesthesia-a-meta-analysis-of-randomized-controlled-trials-with-trial-sequential-analyses
#18
Clément Tschopp, Martin R Tramèr, Alexis Schneider, Maroun Zaarour, Nadia Elia
BACKGROUND: This systematic review examines the benefit and harm of adding epinephrine to local anesthetics for epidural, intrathecal, or locoregional anesthesia. METHODS: We searched electronic databases to October 2017 for randomized trials comparing any local anesthetic regimen combined with epinephrine, with the same local anesthetic regimen without epinephrine, reporting on duration of analgesia, time to 2 segments regression, or any adverse effects. Trial quality was assessed using the Cochrane risk of bias tool and a random-effects model was used...
July 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29773486/labor-analgesia-in-czech-republic-and-slovakia-a-2015-national-survey
#19
J Bláha, P Štourač, M Grochová, R Klozová, S Richterová, P Nosková, D Seidlová, V Zenkner, A Novotný, D Schwarz, J Ščamburová, M Kosinová, Ch Kufa, M Kirchnerová, J Macková, L Várošová, R Toboláková, J Cepák, J Firment
BACKGROUND: The purpose of this international survey was to describe the current practices and techniques of labor analgesia in the Czech Republic (CZE) and Slovakia (SVK). METHODS: All Czech and Slovak departments that provide obstetric anesthesia were invited to participate in a one-month (November 2015) prospective study that monitored in detail all peripartum anesthetic procedures delivered by anesthesiologists. Participating centers recorded all data on-line in the CLADE-IS database (Masaryk University, CZE)...
August 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29768964/effects-of-combined-spinal-epidural-analgesia-on-first-stage-of-labor-a-cohort-study
#20
Silvia Poma, Luigia Scudeller, Chiara Verga, Giorgio Mirabile, Barbara Gardella, Federica Broglia, Maria Ciceri, Marinella Fuardo, Simona Pellicori, Maddalena Gerletti, Silvia Zizzi, Elena Masserini, Maria Paola Delmonte, Giorgio Antonio Iotti
BACKGROUND: Neuraxial anesthesia is considered as the gold standard in the control labor of pain. Its variants are epidural analgesia and combined spinal-epidural analgesia. Few studies, as yet, have investigated the duration of labor as a primary outcome. Some authors have suggested that combined spinal-epidural analgesia may reduce labor duration but at the moment the benefit of shortening labor is uncertain. The main aim of this study was to compare combined spinal-epidural with epidural analgesia in terms of their effect on duration of stage I labor, maternal, and neonatal outcomes...
May 17, 2018: Journal of Maternal-fetal & Neonatal Medicine
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