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Analgesia labor

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https://www.readbyqxmd.com/read/28333819/practice-bulletin-no-177-obstetric-analgesia-and-anesthesia
#1
(no author information available yet)
Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333811/practice-bulletin-no-177-summary-obstetric-analgesia-and-anesthesia
#2
(no author information available yet)
Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28328535/the-assessment-of-labor-a-brief-history
#3
Wayne R Cohen, Emanuel A Friedman
In the 1930s, investigators in the US, Germany and Switzerland made the first attempts to quantify the course of labor in a clinically meaningful way. They emphasized the rupture of membranes as a pivotal event governing labor progress. Attention was also placed on the total number of contractions as a guide to normality. Beginning in the 1950s, Friedman determined that changes in cervical dilatation and fetal station over time were the most useful parameters for the assessment of labor progress. He showed all normal labors had similar patterns of dilatation and descent, differing only in the durations and slopes of their component parts...
March 22, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28321899/labor-induction-and-cesarean-delivery-a-prospective-cohort-study-of-first-births-in-pennsylvania-usa
#4
Kristen H Kjerulff, Laura B Attanasio, Joyce K Edmonds, Katy B Kozhimannil, John T Repke
BACKGROUND: Mode of delivery at first childbirth largely determines mode of delivery at subsequent births, so it is particularly important to understand risk factors for cesarean delivery at first childbirth. In this study, we investigated risk factors for cesarean delivery among nulliparous women, with focus on the association between labor induction and cesarean delivery. METHODS: A prospective cohort study of 2851 nulliparous women with singleton pregnancies who attempted vaginal delivery at hospitals in Pennsylvania, 2009-2011, was conducted...
March 21, 2017: Birth
https://www.readbyqxmd.com/read/28319538/remifentanil-patient-controlled-intravenous-analgesia-for-labor-pain-relief-is-it-really-an-option-to-consider
#5
M Van de Velde
No abstract text is available yet for this article.
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28316849/spontaneous-pneumomediastinum-in-labor
#6
Mohamed Adnane Berdai, Said Benlamkadem, Smael Labib, Mustapha Harandou
Spontaneous pneumomediastinum and subcutaneous emphysema also known as Hamman's syndrome is a very rare complication of labor that is often related to the valsalva maneuver during the labor. In most case, Hamman's syndrome is a self-limiting condition, rarely complicated unless there are underlying respiratory diseases. Chest X-ray can be a useful early diagnostic technique in severe clinical presentation. We report an uneventful pregnancy in a primigravid parturient, which was complicated in the late second stage of labor by the development of subcutaneous emphysema, pneumomediastinum, and mild pneumothorax...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28306579/continuous-epidural-analgesia-using-an-ester-linked-local-anesthetic-agent-2-chloroprocaine-during-labor-a-case-report
#7
Simon C Lee, Vanessa Moll
We report the use of the ester-linked local anesthetic, 2-chloroprocaine, for continuous epidural analgesia in a patient in labor with a history of allergic reaction to amide local anesthetics. The patient gave a reliable history of pruritus, hives, erythema, and swelling on her lower extremity after having received a preservative-free amide local anesthetic. This allergy had been confirmed by a dermatologist by her reports. The patient requested an epidural for labor analgesia that was placed successfully...
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28298774/a-survey-on-awareness-about-the-role-of-anesthesia-and-anesthesiologists-among-the-patients-undergoing-surgeries-in-a-tertiary-care-teaching-women-and-children-hospital
#8
Vinay Marulasiddappa, H N Nethra
BACKGROUND: Although anesthesiology has grown tremendously and although anesthesiologists play a crucial role in the perioperative management of patients and also outside operating theater (OT) such as critical care, pain clinic, and labor analgesia, they do not get due recognition. We conducted a study to assess the awareness about the role of anesthesia and anesthesiologists among patients scheduled to undergo surgery in a Government Tertiary Care Teaching Women and Children Hospital...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298752/quality-of-labor-epidural-analgesia-and-maternal-outcome-with-levobupivacaine-and-ropivacaine-a-double-blinded-randomized-trial
#9
T Senthil Kumar, P Rani, V R Hemanth Kumar, Sunita Samal, S Parthasarathy, M Ravishankar
BACKGROUND: Quality of labor analgesia plays a vital role in the maternal outcome. Very few literature are available analyzing the quality of epidural labor analgesia. AIM: The aim of this study was to compare the effectiveness of 0.1% levobupivacaine and 0.1% ropivacaine with fentanyl as an adjuvant for epidural labor analgesia in terms of onset, duration, quality of analgesia, and degree of motor blockade. METHODOLOGY: Sixty nulliparous parturients, with singleton uncomplicated pregnancy, were recruited by continuous sampling...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28284462/an-observational-study-of-agreement-between-percentage-pain-reduction-calculated-from-visual-analog-or-numerical-rating-scales-versus-that-reported-by-parturients-during-labor-epidural-analgesia
#10
E Pratici, S Nebout, N Merbai, J Filippova, D Hajage, H Keita
BACKGROUND: This study aimed to determine the level of agreement between calculated percentage pain reduction, derived from visual analog or numerical rating scales, and patient-reported percentage pain reduction in patients having labor epidural analgesia. METHODS: In a prospective observational study, parturients were asked to rate their pain intensity on a visual analog scale and numerical rating scale, before and 30min after initiation of epidural analgesia...
February 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28283828/risk-factors-and-peripartum-outcomes-of-failed-epidural-a-prospective-cohort-study
#11
Carmen Bucstain, Gali Garmi, Noah Zafran, Sivan Zuarez-Easton, Julia Carmeli, Raed Salim
PURPOSE: Awareness to rate, risk factors, and the associated peripartum outcomes of failed epidural analgesia (FEA) may improve expectations and labor management. We aimed to identify risk factors for FEA and to examine peripartum outcomes associated with failure. METHODS: A prospective cohort study conducted between March 2015 and August 2015, at a single university medical center. Laboring women at ≥34 weeks, receiving epidural analgesia, were eligible. Pain was evaluated using a 0-10 cm visual analogue scale (VAS)...
March 10, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28279445/a-comprehensive-analysis-of-continuous-epidural-analgesia-s-effect-on-labor-and-neonates-in-maternal-hypertensive-disorder-patients
#12
Bin Han, Mingjun Xu
BACKGROUND: Maternal hypertensive disorder is one of the most common and severe medical complications during pregnancy. Epidural analgesia administration is widely used during labor process. AIM: To evaluate the potential advantage or disadvantage of continuous epidural analgesia's on labor and neonates for maternal hypertensive disorder patients comprehensively. METHODS: We have retrospectively analyzed 232 patients who diagnosed as maternal hypertensive disorder in our hospital since 2015...
January 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/28260290/-the-influence-of-the-intrapartum-inventions-on-the-maternal-and-neonatal-outcomes-of-vaginal-birth-after-cesarean
#13
S W Wu, D He, W Y Zhang
Objective: To investigate the maternal and neonatal outcomes after different intrapartum interventions for vaginal birth after cesarean (Vaginal Birth After Cesarean-section, VBAC). Methods: One hundred and forty three cases in Beijing Obstetrics & Gynecology Hospital, Capital Medical University from January 2015 to November 2016 were selected retrospectively.The relationship between the intrapartum inventions such as induction style, oxytocin usage and spinal analgesia and the maternal and neonatal outcomes such as delivery way, labor time, postpartum hemorrhage and fetal distress were analyzed in pregnant women underwent VBAC...
February 21, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28247084/anatomy-of-the-sacral-hiatus-and-its-clinical-relevance-in-caudal-epidural-block
#14
Hassan Bagheri, Figen Govsa
PURPOSE: Caudal epidural anesthesia (CEB) is widely used for the prevention of chronic lower back pain, the control of intraoperative analgesia such as genitourinary surgery and labor pain cases in sacral epidural space approach for the implementation of analgesia. CEB is an anesthetic solution used into the sacral canal via sacral hiatus (SH). For optimal access into the sacral epidural space, detailed anatomical landmarks of SH are required. This study aims at exploring the anatomical structures and differences of the SH by using the sacral bone as a guide point to failure criteria for reviewing the caudal epidural anesthesia and improving the criteria for success in practice...
February 28, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28238320/-oxytocin-administration-during-spontaneous-labour-guidelines-for-clinical-practice-guidelines-short-text
#15
C Dupont, M Carayol, C Le Ray, C Barasinski, R Beranger, A Burguet, A Chantry, C Chiesa, B Coulm, A Evrard, C Fischer, L Gaucher, C Guillou, F Leroy, E Phan, A Rousseau, V Tessier, F Vendittelli, C Deneux-Tharaux, D Riethmuller
OBJECTIVES: To define the different stages of spontaneous labour. To determine the indications, modalities of use and the effects of administering synthetic oxytocin. And to describe undesirable maternal and perinatal outcomes associated with the use of synthetic oxytocin. METHOD: A systematic review was carried out by searching Medline database and websites of obstetrics learned societies until March 2016. RESULTS: The 1st stage of labor is divided in a latence phase and an active phase, which switch at 5cm of cervical dilatation...
January 2017: Gynecol Obstet Fertil Senol
https://www.readbyqxmd.com/read/28235511/increasing-body-mass-index-predicts-increasing-difficulty-failure-rate-and-time-to-discovery-of-failure-of-epidural-anesthesia-in-laboring-patients
#16
Ayse O Kula, Matthias L Riess, Elizabeth H Ellinas
STUDY OBJECTIVE: Obese parturients both greatly benefit from neuraxial techniques, and may represent a technical challenge to obstetric anesthesiologists. Several studies address the topic of obesity and neuraxial analgesia in general, but few offer well described definitions or rates of "difficulty" and "failure" of labor epidural analgesia. Providing those definitions, we hypothesized that increasing body mass index (BMI) is associated with negative outcomes in both categories and increased time needed for epidural placement...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28221178/non-neuraxial-labor-analgesia-options
#17
John C Markley, Mark D Rollins
Although it is the most effective method to treat labor pain, neuraxial analgesia may be undesired, contraindicated, unsuccessful, or unavailable. Providing safe choices for labor pain relief is a central goal of health care providers alike. Consequently, knowledge of the efficacy, clinical implementation, and side effects of various non-neuraxial strategies is needed to provide appropriate options for laboring patients. In addition to nonpharmacologic alternatives, inhaled nitrous oxide and systemic opioids represent two broad classes of non-neuraxial pharmacologic labor analgesia most commonly available...
February 17, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28217389/management-of-parturients-in-active-labor-with-arnold-chiari-malformation-tonsillar-herniation-and-syringomyelia
#18
Ramsis F Ghaly, Tatiana Tverdohleb, Kenneth D Candido, Nebojsa Nick Knezevic
BACKGROUND: Arnold-Chiari malformation Type 1 (ACM-1) in parturients is a topic of ongoing discussion between obstetricians and anesthesiologists. The primary unanswered question remains; How should the anesthesia provider proceed with labor analgesia and anesthesia for cesarean section when confronted with an advanced, asymptomatic, or minimally symptomatic case of ACM-1 during labor? CASE DESCRIPTION: A 24-year-old, ASA II, G1P0 full-term parturient presented to Labor and Delivery for vaginal delivery...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28217071/difficulty-in-the-removal-of-epidural-catheter-for-labor-analgesia
#19
Mohamed S Hajnour, Rashid Saeed Khokhar, Abdul Aziz Ahmed Ejaz, Tariq Al Zahrani, Naveed Uddin Kanchi
For labor pain management epidural analgesia is a popular and an effective method. Difficult removal of epidural catheters occasionally occurs, and several maneuvers have been recommended. The purpose of this article is to raise awareness of the problem of retained epidural catheter fragments and identify the potential impact of complications.
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28210635/combined-spinal-epidural-for-vaginal-delivery-in-a-parturient-with-takayasu-s-arteritis
#20
Sean Patrick Clifford, Paul Brian Mick, Brian Matthew Derhake
Takayasu's arteritis is a rare, progressive panendarteritis involving all layers of the arterial wall. This disease includes variable involvement of the aorta and its major branches. The most common complication with this condition is severe, uncontrolled hypertension, often leading to end organ dysfunction. We describe the management of a 27-year-old woman diagnosed with Takayasu's arteritis that presented in labor with intense pain and underwent a combined spinal-epidural for anesthetic management. Per literature review, a combined spinal-epidural technique for planned vaginal delivery has not been described for a laboring Takayasu patient...
October 2016: Journal of Investigative Medicine High Impact Case Reports
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