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Anesthesia and analgesia for labor and delivery

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https://www.readbyqxmd.com/read/28012862/impact-of-obesity-on-post-dural-puncture-headache
#1
J Song, T Zhang, A Choy, A Penaco, V Joseph
INTRODUCTION: Previous studies have suggested an inverse relationship between obesity and development of dural puncture headache following spinal anesthesia. However, few have investigated the relationship between obesity and headaches after accidental dural puncture with an epidural needle. This study explored whether obesity has any association with headaches following an accidental dural puncture. METHODS: Records of patients who received epidural analgesia for labor and vaginal delivery between January 2011 and June 2015 were reviewed...
October 29, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28002168/nitrous-oxide-during-labor-maternal-satisfaction-does-not-depend-exclusively-on-analgesic-effectiveness
#2
Michael G Richardson, Brandon M Lopez, Curtis L Baysinger, Matthew S Shotwell, David H Chestnut
BACKGROUND: Evidence on the analgesic effectiveness of nitrous oxide for labor pain is limited. Even fewer studies have looked at patient satisfaction. Although nitrous oxide appears less effective than neuraxial analgesia, it is unclear whether labor analgesic effectiveness is the most important factor in patient satisfaction. We sought to compare the relationship between analgesic effectiveness and patient satisfaction with analgesia in women who delivered vaginally using nitrous oxide, neuraxial analgesia (epidural or combined spinal-epidural [CSE]), or both (neuraxial after a trial of nitrous oxide)...
December 19, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27984250/a-randomized-controlled-trial-of-music-use-during-epidural-catheter-placement-on-laboring-parturient-anxiety-pain-and-satisfaction
#3
Dan M Drzymalski, Lawrence C Tsen, Arvind Palanisamy, Jie Zhou, Chuan-Chin Huang, Bhavani S Kodali
BACKGROUND: Although music is frequently used to promote a relaxing environment during labor and delivery, the effect of its use during the placement of neuraxial techniques is unknown. Our study sought to determine the effects of music use on laboring parturients during epidural catheter placement, with the hypothesis that music use would result in lower anxiety, lower pain, and greater patient satisfaction. METHODS: We conducted a prospective, randomized, controlled trial of laboring parturients undergoing epidural catheter placement with or without music...
December 14, 2016: Anesthesia and Analgesia
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
#4
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/27741203/maternal-and-neonatal-outcomes-with-early-compared-with-delayed-pushing-among-nulliparous-women
#5
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/27681521/efficacy-and-effects-of-parenteral-pethidine-or-meptazinol-and-regional-analgesia-for-pain-relief-during-delivery-a-comparative-observational-study
#6
J Singer, A Jank, S Amara, P D H Stepan, U Kaisers, C Hoehne
Background: Peripartum anesthesia may consist of parenteral opioids and/or regional analgesia. There is only limited data in the literature comparing both methods in daily obstetric practice. This observational study investigated the opioids pethidine and meptazinol as well as regional analgesics with regard to their administration, efficacy, side effects and subjective maternal satisfaction with therapy. The rates of secondary regional analgesia administration after administration of the respective opioid served as a means of evaluating treatment...
September 2016: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/27619509/remifentanil-for-labor-analgesia-a-comprehensive-review
#7
Yayoi Ohashi, Leyla Baghirzada, Hiroyuki Sumikura, Mrinalini Balki
Japan has seen significant developments in obstetric anesthesia in recent years, including the establishment of the Japanese Society of Obstetric Anesthesia and Perinatology. However, labor pain, which is one of the most important issues in obstetric practice, is still not treated aggressively. The rate of epidural administration for labor analgesia is very low in Japan as compared to other developed countries. Remifentanil has been used for labor analgesia, as part of general anesthesia for cesarean delivery, as well as for various fetal procedures around the world...
September 12, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27580408/cerebrospinal-fluid-cutaneous-fistula-after-continuous-spinal-catheter-in-an-obstetric-patient
#8
Mark J Lenart, Jeffrey M Carness
A 23-year-old woman at 41 weeks and 6 days estimated gestational age underwent continuous spinal analgesia for labor after a recognized, unintended dural puncture. Excellent analgesia was maintained throughout labor and vaginal delivery, the intrathecal catheter was left in situ for 24 hours postpartum, and the catheter was subsequently removed without apparent complication. On physical examination during her anesthesia postoperative visit, clear fluid was noted to be slowly draining from the catheter insertion site...
September 1, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27574464/managing-anesthesia-for-cesarean-section-in-obese-patients-current-perspectives
#9
REVIEW
Agnes M Lamon, Ashraf S Habib
Obesity is a worldwide epidemic. It is associated with increased comorbidities and increased maternal, fetal, and neonatal complications. The risk of cesarean delivery is also increased in obese parturients. Anesthetic management of the obese parturient is challenging and requires adequate planning. Therefore, those patients should be referred to antenatal anesthetic consultation. Anesthesia-related complications and maternal mortality are increased in this patient population. The risk of difficult intubation is increased in obese patients...
2016: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/27529316/failure-to-extend-epidural-labor-analgesia-for-cesarean-delivery-anesthesia-a-focused-review
#10
Suzanne K W Mankowitz, Antonio Gonzalez Fiol, Richard Smiley
Extension of epidural labor analgesia for cesarean delivery anesthesia may fail. There are a number of factors associated with labor epidural catheter failure. This focused review discusses these associations and anesthetic options when faced with inadequate surgical epidural anesthesia for cesarean delivery.
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27195636/no-pain-labor-delivery-a-global-health-initiative-s-impact-on-clinical-outcomes-in-china
#11
Ling-Qun Hu, Pamela Flood, Yunping Li, Weike Tao, Peishan Zhao, Yun Xia, May C Pian-Smith, Francis S Stellaccio, Jean-Pierre P Ouanes, Fengling Hu, Cynthia A Wong
The availability of labor analgesia is highly variable in the People's Republic of China. There are widespread misconceptions, by both parturients and health care providers, that labor epidural analgesia is harmful to mother and baby. Meanwhile, China has one of the highest cesarean delivery rates in the world, exceeding 50%. The goal of the nongovernmental No Pain Labor & Delivery (NPLD) is to facilitate sustainable increases in vaginal delivery rates by increasing access to safe neuraxial labor analgesia, thereby decreasing the cesarean delivery rate...
June 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27121239/labor-epidural-analgesia-and-breastfeeding-a-systematic-review
#12
REVIEW
Cynthia A French, Xiaomei Cong, Keun Sam Chung
Despite widespread use of epidural analgesia during labor, no consensus has been reached among obstetric and anesthesia providers regarding its effects on breastfeeding. The purpose of this review was to examine the relationship between labor epidural analgesia and breastfeeding in the immediate postpartum period. PubMed, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature were searched for articles published in 1990 or thereafter, using the search term breastfeeding combined with epidural, labor epidural analgesia, labor analgesia, or epidural analgesia Of 117 articles, 23 described empirical studies specific to labor epidural analgesia and measured a breastfeeding outcome...
August 2016: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
https://www.readbyqxmd.com/read/27101497/the-2015-gerard-w-ostheimer-lecture-what-s-new-in-labor-analgesia-and-cesarean-delivery
#13
REVIEW
Katherine W Arendt
Every year the Board of Directors of the Society for Obstetric Anesthesia and Perinatology selects an individual to review the literature pertinent to obstetric anesthesiology published the previous calendar year. This individual selects the most notable contributions, creates a syllabus of the articles, and then presents his/her overview in an annual lecture named in honor of the late Gerard W. Ostheimer, a pioneering obstetric anesthesiologist from the Brigham and Women's Hospital. This article reviews the literature published in 2014 focusing on the themes of labor analgesia and cesarean delivery...
May 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27100449/risk-of-chronic-low-back-pain-among-parturients-who-undergo-cesarean-delivery-with-neuraxial-anesthesia-a-nationwide-population-based-retrospective-cohort-study
#14
MULTICENTER STUDY
Yuan-Yi Chia, Yuan Lo, Yan-Bo Chen, Chun-Peng Liu, Wei-Chun Huang, Chun-Hsien Wen
To investigate the risk of chronic low back pain (LBP) in parturients undergoing cesarean delivery (CD) with neuraxial anesthesia (NA). LBP is common during pregnancy and also after delivery, but its etiology is poorly understood. Previous studies that investigated the correlation between epidural labor analgesia and chronic low back pain were inconclusive. These studies lacked objective diagnostic criteria for LBP and did not exclude possible confounders. We performed this nationwide population-based retrospective cohort study to explore the relationship between CD with NA and subsequent LBP...
April 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27088993/obstetric-anesthesia-workforce-survey-a-30-year-update
#15
Andrea J Traynor, Meredith Aragon, Debashis Ghosh, Ray S Choi, Colleen Dingmann, Zung Vu Tran, Brenda A Bucklin
BACKGROUND: Obstetric Anesthesia Workforce Surveys were conducted in 1981, 1992, and 2001, and the 10-year update was conducted in 2012. Anesthesia providers from US hospitals were surveyed to identify the methods used to provide obstetric anesthesia. Our primary hypothesis was that the provision of obstetric anesthesia services has changed in the past 10 years. METHODS: A sample of hospitals was generated based on the number of births per year and US census region...
June 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26879874/new-pain-management-options-for-the-surgical-patient-on-methadone-and-buprenorphine
#16
REVIEW
Sudipta Sen, Sailesh Arulkumar, Elyse M Cornett, Julie A Gayle, Ronda R Flower, Charles J Fox, Alan D Kaye
Perioperative management of patients receiving opioid addiction therapy presents a unique challenge for the anesthesiologist. The goal of pain management in this patient population is to effectively manage postoperative pain, to improve patient satisfaction and outcomes, and to reduce the cost of health care. Multimodal analgesics, including nonsteroid anti-inflammatory drugs, intravenous acetaminophen, gabapentanoid agents, and low-dose ketamine infusions, have been used to improve postoperative pain and to reduce postoperative opioid use...
March 2016: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/26812080/restriction-of-oral-intake-during-labor-whither-are-we-bound
#17
Jeffrey D Sperling, Joshua D Dahlke, Baha M Sibai
In 1946, Dr Curtis Mendelson suggested that aspiration during general anesthesia for delivery was avoidable by restricting oral intake during labor. This suggestion proved influential, and restriction of oral intake in labor became the norm. These limitations may contribute to fear and feelings of intimidation among parturients. Modern obstetrics, especially in the setting of advances in obstetric anesthesia, does not mirror the clinical landscape of Mendelson; hence, one is left to question if his findings remain relevant or if they should inform current recommendations...
May 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26797554/racial-and-ethnic-disparities-in-mode-of-anesthesia-for-cesarean-delivery
#18
Alexander J Butwick, Yair J Blumenfeld, Kathleen F Brookfield, Lorene M Nelson, Carolyn F Weiniger
BACKGROUND: Racial and ethnic disparities have been identified in the provision of neuraxial labor analgesia. These disparities may exist in other key aspects of obstetric anesthesia care. We sought to determine whether racial/ethnic disparities exist in mode of anesthesia for cesarean delivery (CD). METHODS: Women who underwent CD between 1999 and 2002 at 19 different obstetric centers in the United States were identified from the Maternal-Fetal Medicine Units Network Cesarean Registry...
February 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26646349/primary-spoken-language-and-neuraxial-labor-analgesia-use-among-hispanic-medicaid-recipients
#19
Paloma Toledo, Stanley T Eosakul, William A Grobman, Joe Feinglass, Romana Hasnain-Wynia
BACKGROUND: Hispanic women are less likely than non-Hispanic Caucasian women to use neuraxial labor analgesia. It is unknown whether there is a disparity in anticipated or actual use of neuraxial labor analgesia among Hispanic women based on primary language (English versus Spanish). METHODS: In this 3-year retrospective, single-institution, cross-sectional study, we extracted electronic medical record data on Hispanic nulliparous with vaginal deliveries who were insured by Medicaid...
January 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26600441/anesthetic-complications-in-pregnancy
#20
REVIEW
Amie Hoefnagel, Albert Yu, Anna Kaminski
Anesthesia complications in the parturient can be divided into 2 categories: those related to airway manipulation and those related to neuraxial anesthesia. Physiologic changes of pregnancy can lead to challenging intubating conditions in a patient at risk of aspiration. Neuraxial techniques are used to provide analgesia for labor and anesthesia for surgical delivery. Therefore, complications associated with neuraxial techniques are often seen in this population. In the event of maternal cardiac arrest, modification to advanced cardiac life support algorithms must be made to accommodate the gravid uterus and to deliver the fetus if return of maternal circulation is not prompt...
January 2016: Critical Care Clinics
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