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Analgesia labor

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https://www.readbyqxmd.com/read/27871590/does-nitrous-oxide-labor-analgesia-influence-the-pattern-of-neuraxial-analgesia-usage-an-impact-study-at-an-academic-medical-center
#1
Lesley E Bobb, Michaela K Farber, Catherine McGovern, William Camann
STUDY OBJECTIVE: To compare the rate of epidural use before and after the implementation of nitrous oxide (N2O). DESIGN: Data were obtained from a nursing database of N2O usage and our obstetric anesthesia database. We compared 8 months before and 8 months after the introduction of N2O. It was available 24 h/d, 7 d/wk, consistent with neuraxial analgesia availability. Epidural utilization before and after introduction of N2O was compared using χ(2) analysis. SETTING: Labor and delivery floor...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870739/performance-of-the-angle-labor-pain-questionnaire-during-initiation-of-epidural-analgesia-in-early-active-labor
#2
Pamela J Angle, Christine Kurtz Landy, Jasmine Djordjevic, Jon Barrett, Alanna Kibbe, Saiena Sriparamananthan, Yuna Lee, Lydia Hamata, Pearl Zaki, Alex Kiss
BACKGROUND: The Angle Labor Pain Questionnaire (A-LPQ) is a new, 22-item multidimensional psychometric questionnaire that measures the 5 most important dimensions of women's childbirth pain experiences using 5 subscales: The Enormity of the Pain, Fear/Anxiety, Uterine Contraction Pain, Birthing Pain, and Back Pain/Long Haul. Previous work showed that the A-LPQ has overall good psychometric properties and performance during early active labor in women without pain relief. The current study assessed the tool's sensitivity to change during initiation of labor epidural analgesia with the standardized response mean (SRM, primary outcome)...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27870644/analysis-of-physiological-respiratory-variable-alarm-alerts-among-laboring-women-receiving-remifentanil
#3
Carolyn F Weiniger, Brendan Carvalho, Daniel Stocki, Sharon Einav
BACKGROUND: Remifentanil may be used by laboring women for analgesia, despite controversy because of potential apneas. We evaluated candidate variables as early warning alerts for apnea, based on prevalence, positive predictive rate, sensitivity for apnea event detection, and early warning alert time intervals (lead time) for apnea. METHODS: We performed a secondary analysis of respiratory physiological data that had been collected during a prospective IRB-approved study of laboring women receiving IV patient-controlled boluses of remifentanil 20 to 60 μg every 1 to 2 minutes...
November 18, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27861178/use-of-prothrombin-complex-concentrate-for-warfarin-reversal-before-the-performance-of-an-epidural-blood-patch-in-a-patient-with-cortical-vein-thrombosis-and-subdural-hematoma
#4
Kallol Chaudhuri, Cooper W Phillips, Swapna Chaudhuri, John Wasnick
Compared to conventional therapy, several studies with prothrombin complex concentrate (PCC) have recently demonstrated its superior efficacy in rapidly replacing vitamin K-dependent factors for patients with life-threatening hemorrhage. We present a novel use of PCC in a patient with intracranial hypotension, who had received warfarin for treatment of cortical vein thrombosis. However, after anticoagulation, she proceeded to develop bilateral subdural hematomas with descent of cerebellar tonsils. Given the possibility of an occult dural puncture during labor analgesia, an epidural blood patch was performed after administration of PCC and normalization of coagulation parameters, with prompt improvement of the patient's headache...
November 17, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27859542/midwives-management-during-the-second-stage-of-labor-in-relation-to-second-degree-tears-an-experimental-study
#5
Malin Edqvist, Ingegerd Hildingsson, Margareta Mollberg, Ingela Lundgren, Helena Lindgren
INTRODUCTION: Most women who give birth for the first time experience some form of perineal trauma. Second-degree tears contribute to long-term consequences for women and are a risk factor for occult anal sphincter injuries. The objective of this study was to evaluate a multifaceted midwifery intervention designed to reduce second-degree tears among primiparous women. METHODS: An experimental cohort study where a multifaceted intervention consisting of 1) spontaneous pushing, 2) all birth positions with flexibility in the sacro-iliac joints, and 3) a two-step head-to-body delivery was compared with standard care...
November 14, 2016: Birth
https://www.readbyqxmd.com/read/27831958/anesthetic-and-obstetrical-factors-associated-with-the-effectiveness-of-epidural-analgesia-for-labor-pain-relief-an-observational-population-based-study
#6
Marie-Pierre Bonnet, Caroline Prunet, Christophe Baillard, Laure Kpéa, Béatrice Blondel, Camille Le Ray
BACKGROUND AND OBJECTIVES: The effectiveness of labor epidural analgesia is difficult to explore, as it includes the maternal satisfaction with analgesia as well as the overall childbirth experience. In this population-based study, we sought to identify factors associated with the effectiveness of epidural analgesia for labor pain relief. METHODS: We performed a secondary analysis of the 2010 French National Perinatal Survey, a cross-sectional study of a representative sample of births in France...
November 9, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27828798/effects-of-epidural-labor-analgesia-with-low-concentrations-of-local-anesthetics-on-obstetric-outcomes-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#7
Ting-Ting Wang, Shen Sun, Shao-Qiang Huang
BACKGROUND: Low concentrations of local anesthetics (LCLAs) are increasingly popular for epidural labor analgesia. The effects of epidural analgesia with low concentrations of anesthetics on the duration of the second stage of labor and the instrumental birth rate, however, remain controversial. A systematic review was conducted to compare the effects of epidural analgesia with LCLAs with those of nonepidural analgesia on obstetric outcomes. METHODS: The databases of PubMed, Embase, and the Cochrane controlled trials register were independently searched by 2 researchers, and randomized controlled trials that compared epidural labor analgesia utilizing LCLAs with nonepidural analgesia were retrieved...
November 8, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27794565/comparison-between-three-methods-of-fetal-weight-estimation-during-the-active-stage-of-labor-performed-by-residents-a-prospective-cohort-study
#8
Eran Weiner, Yossi Mizrachi, Nataly Fainstein, Osnat Elyashiv, Noa Mevorach-Zussman, Jacob Bar, Michal Kovo
OBJECTIVE: To compare the accuracy of ultrasonographic, calculated, and clinical methods for the estimation of fetal weight (EFW) performed during active labor by residents. METHODS: Parturients in active labor underwent prospectively EFW by 3 methods: ultrasonographic, clinical, and calculated (extrapolating EFW from a previous scan). Three different blinded residents evaluated each woman. Background variables were examined for their effect on the accuracy of each method...
October 29, 2016: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/27776074/committee-opinion-no-679-immersion-in-water-during-labor-and-delivery
#9
(no author information available yet)
Immersion in water during labor or delivery has been popularized over the past several decades. The prevalence of this practice in the United States is uncertain because it has not been studied in births outside of the home and birth centers, and the data are not recorded on birth certificates. Among randomized controlled trials included in a 2009 Cochrane systematic review that addressed immersion in the first stage of labor, results were inconsistent with regard to maternal benefits. Neither the Cochrane systematic review nor any individual trials included in that review reported any benefit to the newborn from maternal immersion during labor or delivery...
November 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27776069/committee-opinion-no-679-summary-immersion-in-water-during-labor-and-delivery
#10
(no author information available yet)
Immersion in water during labor or delivery has been popularized over the past several decades. The prevalence of this practice in the United States is uncertain because it has not been studied in births outside of the home and birth centers, and the data are not recorded on birth certificates. Among randomized controlled trials included in a 2009 Cochrane systematic review that addressed immersion in the first stage of labor, results were inconsistent with regard to maternal benefits. Neither the Cochrane systematic review nor any individual trials included in that review reported any benefit to the newborn from maternal immersion during labor or delivery...
November 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27770212/erratum-to-remifentanil-for-labor-analgesia-a-comprehensive-review
#11
Yayoi Ohashi, Leyla Baghirzada, Hiroyuki Sumikura, Mrinalini Balki
No abstract text is available yet for this article.
October 21, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27766983/factors-associated-with-cesarean-delivery-during-labor-in-primiparous-women-assisted-in-the-brazilian-public-health-system-data-from-a-national-survey
#12
Marcos Augusto Bastos Dias, Rosa Maria Soares Madeira Domingues, Arthur Orlando Corrêa Schilithz, Marcos Nakamura-Pereira, Maria do Carmo Leal
BACKGROUND: The rate of cesarean delivery (CD) in Brazil has increased over the past 40 years. The CD rate in public services is three times above the World Health Organization recommended values. Among strategies to reduce CD, the most important is reduction of primary cesarean. This study aimed to describe factors associated with CD during labor in primiparous women with a single cephalic pregnancy assisted in the Brazilian Public Health System (SUS). METHODS: This study is part of the Birth in Brazil survey, a national hospital-based study of 23,894 postpartum women and their newborns...
October 17, 2016: Reproductive Health
https://www.readbyqxmd.com/read/27766979/good-practices-according-to-who-s-recommendation-for-normal-labor-and-birth-and-women-s-assessment-of-the-care-received-the-birth-in-brazil-national-research-study-2011-2012
#13
Marcia Leonardi Baldisserotto, Mariza Miranda Theme Filha, Silvana Granado Nogueira da Gama
BACKGROUND: The World Health Organization recommends good practices for the conduct of uncomplicated labor and birth, with the aim of improving the quality of and assessment by women of childbirth care. The aim of this study was to evaluate the association between adoption of good practices according to WHO's recommendation for normal labor and birth and assessment by women of the care received. METHODS: Birth in Brazil is a national hospital-based study with countrywide representation consisting of 23,894 mothers and their newborns, conducted between February 2011 and October 2012...
October 17, 2016: Reproductive Health
https://www.readbyqxmd.com/read/27755057/programmed-intermittent-epidural-bolus-for-labor-analgesia-during-first-stage-of-labor-a-biased-coin-up-and-down-sequential-allocation-trial-to-determine-the-optimum-interval-time-between-boluses-of-a-fixed-volume-of-10-ml-of-bupivacaine-0-0625-with-fentanyl
#14
Marcelo Epsztein Kanczuk, Nicholas Martin Barrett, Cristian Arzola, Kristi Downey, Xiang Y Ye, Jose C A Carvalho
BACKGROUND: Most studies that have compared programmed intermittent epidural bolus (PIEB) with continuous epidural infusion regimens have included patient-controlled epidural analgesia and/or manual bolus as rescue analgesia for breakthrough pain. Consequently, the optimal time interval between PIEB is yet to be determined. We designed a study to establish the optimal time interval between PIEB of 10 mL of bupivacaine 0.0625% with fentanyl 2 μg/mL to produce effective analgesia in 90% of women during first stage of labor without breakthrough pain...
October 11, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27746539/levobupivacaine-for-labor-analgesia
#15
Joginder Pal Attri, Reena Makhni, Savinder Sethi
BACKGROUND: Combined spinal-epidural analgesia has become the preferred technique for labor analgesia as it combines the benefits of both spinal analgesia and flexibility of epidural catheter. Study was carried out with the primary aim to compare levobupivacaine and ropivacaine with fentanyl in terms of onset and duration of sensory block and to know maternal and fetal outcome. MATERIALS AND METHODS: In a prospective randomized double-blind study, 60 primipara of the American Society of Anesthesiologists health status Class I and II with singleton pregnancy in active stage of labor were randomly allocated into two groups of 30 each...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27741203/maternal-and-neonatal-outcomes-with-early-compared-with-delayed-pushing-among-nulliparous-women
#16
Lynn M Yee, Grecio Sandoval, Jennifer Bailit, Uma M Reddy, Ronald J Wapner, Michael W Varner, Steve N Caritis, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Dwight J Rouse, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To describe factors associated with delayed pushing and evaluate the relationship between delayed pushing and perinatal outcomes in nulliparous women with singleton term gestations. METHODS: This was a secondary analysis of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Assessment of Perinatal Excellence cohort of 115,502 women and their neonates born in 25 U.S. hospitals from 2008 to 2011. Nulliparous women with singleton, cephalic, nonanomalous term births who achieved 10-cm cervical dilation were included...
November 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27737447/optimal-perioperative-care-in-major-head-and-neck-cancer-surgery-with-free-flap-reconstruction-a-consensus-review-and-recommendations-from-the-enhanced-recovery-after-surgery-society
#17
Joseph C Dort, D Gregory Farwell, Merran Findlay, Gerhard F Huber, Paul Kerr, Melissa A Shea-Budgell, Christian Simon, Jeffrey Uppington, David Zygun, Olle Ljungqvist, Jeffrey Harris
Importance: Head and neck cancers often require complex, labor-intensive surgeries, especially when free flap reconstruction is required. Enhanced recovery is important in this patient population but evidence-based protocols on perioperative care for this population are lacking. Objective: To provide a consensus-based protocol for optimal perioperative care of patients undergoing head and neck cancer surgery with free flap reconstruction. Evidence Review: Following endorsement by the Enhanced Recovery After Surgery (ERAS) Society to develop this protocol, a systematic review was conducted for each topic...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27701372/may-pre-procedure-neuroaxial-ultrasound-improve-the-identification-of-potential-epidural-space-when-compared-with-anatomical-landmarks-a-prospective-randomized-study
#18
Paolo Perna, Antonio Gioia, Riccardo Ragazzi, Carlo A Volta, Massimo Innamorato
BACKGROUND: Regional epidural analgesia is considered the gold standard for pain treatment in labour but the epidural catheter placement may be a difficult procedure because of the difficulty in anatomical landmarks palpation. These difficulties increase in pregnant women. Pre-procedure neuroaxial ultrasound may facilitate the procedure. METHODS: Prospectic randomized controlled study conducted in the Labour Ward. We randomized two groups of women undergoing epidural analgesia: Group A (28 patients), with loss of resistance technique and Group B (30 patients) with US assisted procedure...
October 4, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27695168/epidural-analgesia-complicated-by-dural-ectasia-in-the-marfan-syndrome
#19
Benjamin B Vacula, Chelsea Gray, Michael P Hofkamp, Patrick T Noonan, Russell K McAllister, Kimberly A Pilkinton, Zhiying Diao
Patients with the Marfan syndrome are considered to be high risk during pregnancy and warrant a complete multidisciplinary evaluation. One goal is to minimize hemodynamic fluctuations during labor since hypertensive episodes may result in aortic dissection or rupture. Although they may prevent these complications, neuraxial techniques may be complicated by dural ectasia. The case of a parturient with the Marfan syndrome and mild dural ectasia is presented. During attempted labor epidural placement, unintentional dural puncture occurred...
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27692473/effect-of-combined-spinal-epidural-analgesia-in-labor-on-frequency-of-emergency-cesarean-delivery-among-nulliparous-chinese-women
#20
Fen Wang, Yun-Xia Cao, Shan-Gao Ke, Tao-Hua Zhu, Miao Zhang
OBJECTIVE: To determine whether combined spinal-epidural analgesia (CSEA) during labor increases the frequency of emergency cesarean delivery among Chinese nulliparous women. METHODS: In a retrospective study, the medical records of nulliparous women with a singleton fetus in cephalic presentation who delivered at term at Tongling Maternity Hospital, China, between January 2012 and December 2014 were reviewed. Information about CSEA, mode of delivery, labor duration, oxytocin augmentation, and neonatal outcome was obtained...
December 2016: International Journal of Gynaecology and Obstetrics
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