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https://www.readbyqxmd.com/read/29887886/anesthesiologists-preferences-regarding-visitor-presence-during-placement-of-neuraxial-labor-analgesia
#1
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/29847969/postdural-puncture-headache-and-epidural-blood-patch-in-a-large-obstetric-anaesthesia-population
#2
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/29794308/reducing-risk-of-spinal-haematoma-from-spinal-and-epidural-pain-procedures
#3
Harald Breivik, Hilde Norum, Christian Fenger-Eriksen, Seppo Alahuhta, Gísli Vigfússon, Owain Thomas, Michael Lagerkranser
BACKGROUND AND AIMS: Central neuraxial blocks (CNB: epidural, spinal and their combinations) and other spinal pain procedures can cause serious harm to the spinal cord in patients on antihaemostatic drugs or who have other risk-factors for bleeding in the spinal canal. The purpose of this narrative review is to provide a practise advisory on how to reduce risk of spinal cord injury from spinal haematoma (SH) during CNBs and other spinal pain procedures. Scandinavian guidelines from 2010 are part of the background for this practise advisory...
April 25, 2018: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29790194/the-impact-of-epidural-analgesia-on-the-duration-of-the-second-stage-of-labor
#4
Anat Shmueli, Lina Salman, Sharon Orbach-Zinger, Amir Aviram, Liran Hiersch, Rony Chen, Rinat Gabbay-Benziv
BACKGROUND: We aimed to describe the length of second stage of labor in a contemporary cohort. We calculated the 5th, 50th, and 95th percentiles for second-stage length stratified by parity and epidural analgesia use and evaluated the effect of labor induction and oxytocin augmentation in our cohort. METHODS: We did a retrospective analysis of all live, singleton, term vaginal deliveries in one tertiary hospital. Multivariate linear regression was used to evaluate second-stage duration confounders...
May 22, 2018: Birth
https://www.readbyqxmd.com/read/29773486/labor-analgesia-in-czech-republic-and-slovakia-a-2015-national-survey
#5
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)...
April 7, 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
#6
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
https://www.readbyqxmd.com/read/29743028/investigating-determinants-for-patient-satisfaction-in-women-receiving-epidural-analgesia-for-labour-pain-a-retrospective-cohort-study
#7
Daryl Jian An Tan, Rehena Sultana, Nian Lin Reena Han, Alex Tiong Heng Sia, Ban Leong Sng
BACKGROUND: Epidural analgesia is a popular choice for labour pain relief. Patient satisfaction is an important patient-centric outcome because it can significantly influence both mother and child. However, there is limited evidence in the correlations between clinical determinants and patient satisfaction. We aim to investigate clinical covariates that are associated with low patient satisfaction in parturients receiving labour neuraxial analgesia. METHODS: After institutional ethics approval was obtained, we conducted a retrospective cohort study using electronic and corresponding hardcopy records from 10,170 parturients receiving neuraxial analgesia between the periods of January 2012 to December 2013 in KK Women's and Children's Hospital in Singapore...
May 9, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29724183/the-effect-of-epidural-education-on-primigravid-women-s-decision-to-request-epidural-analgesia-a-cross-sectional-study
#8
Maha Heshaam Alakeely, Arwa Khalaf Almutari, Ghadah Abdulrhman Alhekail, Zainah Ahmad Abuoliat, Alaa Althubaiti, Laila Abdul-Rahman AboItai, Hanan Al-Kadri
BACKGROUND: Epidural analgesia represents one of the most effective pharmacological ways to relieve labour pain. Women's awareness regarding the use of epidurals is increasing. As the decision to use epidural analgesia during labour is affected by many social, personal and medical factors, this study aimed to explore the factors contributing to a pregnant women's decision to use epidurals and to understand the benefit of implementing a health education program regarding epidural analgesia...
May 3, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29693946/a-case-of-sudden-shock-during-caesarean-section-in-whi-ch-amniotic-fluid-embolism-is-suspected
#9
Hiroo Shimono, Satoko Haraguchi, Yuko Minoda, Mari Beppu, Naomi Shinmura, Yuki Suzuki, Mikiko Higashi, Yuichi Kanmura
We report a case of sudden shock during caesarean section under combined spinal epidural anesthesia. The patient was a 29-year-old woman. During the operation vital signs had been almost stable until a female-baby was born. But after the delivery of the placenta, the patient developed an episode of coughing and dyspnea followed by unconsciousness and bradycardia. She was given adrenaline and intubated, appearing ventricular fibrillation on a EKG. Cardiopulmonary resuscitation was immediately started and sinus rhythm returned...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29687477/obstetric-interventions-trends-and-drivers-of-change-a-20-year-population-based-study-from-iceland
#10
Emma M Swift, Gunnar Tomasson, Helga Gottfreðsdóttir, Kristjana Einarsdóttir, Helga Zoega
BACKGROUND: Population data on obstetric interventions is often limited to cesarean delivery. We aimed to provide a more comprehensive overview of trends in use of several common obstetric interventions over the past 2 decades. METHODS: The study was based on nationwide data from the Icelandic Medical Birth Register. Incidence of labor induction, epidural analgesia, cesarean, and instrumental delivery was calculated for all births in 1995-2014. Change over time was expressed as relative risk (RR), using Poisson regression with 95% confidence intervals (CI) adjusted for several maternal and pregnancy-related characteristics...
April 24, 2018: Birth
https://www.readbyqxmd.com/read/29664053/labor-onset-oxytocin-use-and-epidural-anesthesia-for-vaginal-birth-after-cesarean-section-and-associated-effects-on-maternal-and-neonatal-outcomes-in-a-tertiary-hospital-in-china-a-retrospective-study
#11
Shao-Wen Wu, He Dian, Wei-Yuan Zhang
Background: In the mainland of China, the trial of labor after cesarean section is still a relatively new technique. In this study, we aimed to investigate the effects of labor onset, oxytocin use, and epidural anesthesia on maternal and neonatal outcomes for vaginal birth after cesarean section (VBAC) in a tertiary hospital in China. Methods: This was a retrospective study carried out on 212 VBAC cases between January 2015 and June 2017 in Beijing Obstetrics and Gynecology Hospital, Capital Medical University...
April 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29662280/effects-of-epidural-labour-analgesia-in-mother-and-foetus
#12
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/29657082/horner-s-syndrome-following-obstetric-neuraxial-blockade-a-systematic-review-of-the-literature
#13
D J Chambers, K Bhatia
Horner's syndrome is a rarely reported complication of neuraxial blockade. In obstetric practice, the neurological signs of Horner's syndrome may cause anxiety amongst patients and healthcare staff, but more importantly may herald the onset of maternal hypotension. Medline, CINAHL, and EMBASE databases were searched to identify cases of Horner's syndrome following obstetric neuraxial blockade. Anaesthetic technique, clinical features, anaesthetic management of the Horner's syndrome and time to resolution were assessed...
March 17, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29656689/risk-factors-for-postpartum-urinary-retention-after-vaginal-delivery-at-term-without-epidural-anesthesia
#14
Shunji Suzuki, Erina Kakizaki, Risa Kobayashi, Satomi Teshima
OBJECTIVE: We performed a retrospective case-control study of vaginal delivery at term without epidural anesthesia to identify clinical predictions of postpartum urinary retention (PUR). METHODS: We reviewed the obstetric records of all singleton vaginal deliveries at Japanese Red Cross, Katsushika Maternity Hospital form January 2016 through December 2017. RESULTS: There were 58 women (2.4%) complicated by PUR and 2391 women without PUR. A multivariate analysis revealed nulliparity, instrumental delivery, and episiotomy as independent risk factors for PUR (nulliparity: adjusted OR 2...
May 2, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29628594/an-unusual-case-of-a-parturient-with-uncorrected-pentalogy-of-fallot-presenting-for-elective-cesarean-section-delivery-of-twins
#15
Ying Ci Ho, Sek Koon Boey, Abey Matthew Varughese Mathews, Hooi Geok See, Nian Chih Hwang
We present a 31-year-old primigravida with uncorrected pentalogy of Fallot, pregnant with monochorionic-diamniotic twins, undergoing elective lower segment cesarean section at 36 weeks gestation. Preoperative workup included a transthoracic echocardiogram which revealed a large ventricular septal defect of 1.8 cm with bidirectional shunting, a moderate size atrial septal defect of 1.8 cm with predominant left-to-right shunting, an overriding aorta, moderate right ventricular hypertrophy, and severe pulmonary valve stenosis...
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
#16
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
https://www.readbyqxmd.com/read/29587655/impedance-cardiography-as-tool-for-continuous-hemodynamic-monitoring-during-cesarean-section-randomized-prospective-double-blind-study
#17
Alessandro D'Ambrosio, Antonella Cotoia, Renata Beck, Potito Salatto, Lada Zibar, Gilda Cinnella
BACKGROUND: Impedance Cardiography (ICG) is a non-invasive tool for continuous hemodynamic monitoring. Aims of our study were to assess the utility of ICG to evaluate the hemodynamic impact of 6 mg (GL6) vs 8 mg (GL8) levobupivacaine combined with fentanyl in healthy patients undergoing elective cesarean section; secondary, to compare the duration and quality of analgesia and anesthesia. METHODS: Sixty-two women receiving combined spinal-epidural (CSE) for elective cesarean delivery were randomly allocated to GL6 or GL8 groups...
March 27, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29553965/efficacy-of-an-ergonomic-ankle-support-aid-for-squatting-position-in-improving-pushing-skills-and-birth-outcomes-during-the-second-stage-of-labor-a-randomized-controlled-trial
#18
Yu-Ching Lin, Meei-Ling Gau, Ghi-Hwei Kao, Hung-Chang Lee
BACKGROUND: The physical positions that are adopted by women during childbirth significantly impact their childbirth outcomes and experiences. Literature studies have associated using a squatting position with reduced childbirth pain and increased comfort and pushing efficiency. However, the major disadvantage of the squatting position is that women may lack the muscular fitness and stamina necessary to sustain this position for a long period. PURPOSE: The aim of this study was to compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor...
March 16, 2018: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29543614/neuraxial-labor-analgesia-a-focused-narrative-review-of-the-2017-literature
#19
Mitko Kocarev, Fouzia Khalid, Fatima Khatoon, Roshan Fernando
PURPOSE OF REVIEW: Neuraxial labor analgesia remains the most effective and one of the most commonly utilized methods for pain relief during labor. This narrative review article is a summary of the literature published in 2017 on neuraxial analgesia for labor. RECENT FINDINGS: From a total of 41 identified articles, 13 were included in the review. The topics have been structured into three categories: initiation of neuraxial analgesia, maintenance of neuraxial analgesia, and neuraxial analgesia and obstetric outcomes...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29527296/management-of-eight-labor-and-delivery-patients-dependent-on-buprenorphine-subutex%C3%A2-a-retrospective-chart-review
#20
Solina Tith, Garinder Bining, Laurent Bollag
Background : Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by "The American College of Obstetrics and Gynecology" as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists' unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia...
2018: F1000Research
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