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Anesthesia and analgesia for labor and delivery

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https://www.readbyqxmd.com/read/29773486/labor-analgesia-in-czech-republic-and-slovakia-a-2015-national-survey
#1
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
#2
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/29628829/using-dexamethasone-as-an-adjuvant-to-levobupivacaine-in-epidural-anesthesia-to-change-the-pain-intensity-and-duration-in-painless-labor
#3
Hassan Mohamed Ali, Amr Wahdan
Background and Objective: This is a randomized controlled trial aiming at comparing the effectiveness of levobupivacaine alone versus a levobupivacaine with dexamethasone in the epidural injection for painless labor. Patients and Methods: This is a comparative randomized controlled double-blinded clinical trial with 49 patients were included in this study, all of them were primigravidas and were during vaginal delivery with a cervical dilatation ≥4 cm. Patients were included randomly in one of two groups either Group C (26 cases) with epidural levobupivacaine 0...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29527296/management-of-eight-labor-and-delivery-patients-dependent-on-buprenorphine-subutex%C3%A2-a-retrospective-chart-review
#4
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
https://www.readbyqxmd.com/read/29319586/the-role-of-the-anesthesiologist-in-preventing-severe-maternal-morbidity-and-mortality
#5
Emily McQuaid, Lisa R Leffert, Brian T Bateman
Anesthesiologists are responsible for the safe and effective provision of analgesia for labor and anesthesia for cesarean delivery and other obstetric procedures. In addition, obstetric anesthesiologists often have a unique role as the intensivists of the obstetric suite. The anesthesiologist is frequently the clinician with the greatest experience in the acute bedside management of a hemodynamically unstable patient and expertise in life-saving interventions. This review will discuss (1) risks associated with neuraxial and general anesthesia for labor and delivery, and (2) clinical scenarios in which the obstetric anesthesiologist is commonly called upon to function as a "peridelivery intensivist...
January 9, 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29141373/-a-concentration-response-observation-of-hydromorphone-combined-with-ropivacaine-in-labor-analgesia
#6
Y Y Lu, H Huang, W L Mao, R H Liu, M J Hu, L X Shao, M P Hu, J Li
Objective: To investigate the median effective dose (ED(50)) of hydromorphone and the appropriate concentration of ropivacaine combined with hydromorphone in epidural labor analgesia. Methods: One hundred and forty nulliparous women undergoing labor selected for delivery with epidural analgesia were enrolled in our hospital from January to June 2016. The first of top 50 women received 0.12% ropivacaine plus 20 μg/ml hydromorphone complex solution, then sequential women were used the modified sequential method to determine the ED(50) and ED(95) of hydromorphone...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29033728/anesthesia-in-pregnancy-with-heart-disease
#7
REVIEW
Ankur Luthra, Ritika Bajaj, Anudeep Jafra, Kiran Jangra, V K Arya
Management of pregnant women with heart disease remains challenging due to the advancement of innovations in cardiac surgery and correction of complex cardiac anomalies, and more recently, with the successful performance of heart transplants, cardiac diseases are not only likely to coexist with pregnancy, but will also increase in frequency over the years to come. In developing countries with a higher prevalence of rheumatic fever, cardiac disease may complicate as many as 5.9% of pregnancies with a high incidence of maternal death...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28861414/continuous-spinal-anesthesia-for-obstetric-anesthesia-and-analgesia
#8
REVIEW
Ivan Veličković, Borislava Pujic, Charles W Baysinger, Curtis L Baysinger
The widespread use of continuous spinal anesthesia (CSA) in obstetrics has been slow because of the high risk for post-dural puncture headache (PDPH) associated with epidural needles and catheters. New advances in equipment and technique have not significantly overcome this disadvantage. However, CSA offers an alternative to epidural anesthesia in morbidly obese women, women with severe cardiac disease, and patients with prior spinal surgery. It should be strongly considered in parturients who receive an accidental dural puncture with a large bore needle, on the basis of recent work suggesting significant reduction in PDPH when intrathecal catheters are used...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28781763/modern-neuraxial-anesthesia-for-labor-and-delivery
#9
REVIEW
Marie-Louise Meng, Richard Smiley
The availability of safe, effective analgesia during labor has become an expectation for women in most of the developed world over the past two or three decades. More than 60% of women in the United States now receive some kind of neuraxial procedure during labor. This article is a brief review of the advantages and techniques of neuraxial labor analgesia along with the recent advances and controversies in the field of labor analgesia. For the most part, we have aimed the discussion at the non-anesthesiologist to give other practitioners a sense of the state of the art and science of labor analgesia in the second decade of the 21st century...
2017: F1000Research
https://www.readbyqxmd.com/read/28763356/randomized-controlled-trial-of-the-clinical-efficacy-of-multiport-versus-uniport-wire-reinforced-flexible-catheters-for-labor-epidural-analgesia
#10
John Philip, Shiv K Sharma, Timothy J Sparks, Joan S Reisch
BACKGROUND: The purpose of this prospective, randomized, controlled trial was to determine whether multiple ports improve the analgesic efficacy of wire-reinforced flexible catheters used for labor epidural analgesia (LEA). METHODS: Six hundred fifty laboring patients were randomized to receive epidural analgesia using either a multiport or uniport wire-reinforced flexible catheter. The primary outcome was analgesic success, defined as the incidence of adequate analgesia following the initial bolus given to initiate LEA...
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28719524/establishing-obstetric-anesthesiology-practice-guidelines-in-the-republic-of-armenia-a-global-health-collaboration
#11
Gordon Yuill, Ashot Amroyan, Simon Millar, Emil Vardapetyan, Ashraf S Habib, Medge D Owen
BACKGROUND: Disparity exists in anesthesia practices between high- and low-to-middle income countries, and awareness has been raised within the global health community to improve the standards of anesthesia care and patient safety. The establishment of international collaborations and appropriate practice guidelines may help address clinical care deficiencies. This report's aim was to assess the impact of a multiyear collaboration on obstetric anesthesia practices in the Republic of Armenia...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28708666/socioeconomic-deprivation-and-utilization-of-anesthetic-care-during-pregnancy-and-delivery-a-secondary-analysis-of-a-french-prospective-multicenter-cohort-study
#12
MULTICENTER STUDY
Elie Kantor, Jean Guglielminotti, Elie Azria, Dominique Luton, Mandelbrot Laurent, Jean-François Oury, Dominique Mahieu-Caputo, Philippe Ravaud, Candice Estellat
BACKGROUND: Socioeconomic deprivation is associated with reduced use of antenatal resources and poor maternal outcomes with pregnancy. Research examining the association between socioeconomic deprivation and use of obstetric anesthesia care in a country providing universal health coverage is scarce. We hypothesized that in a country providing universal health coverage, France, socioeconomic deprivation is not associated with reduced use of anesthetic care during pregnancy and delivery...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28653359/ultrasound-assessment-of-gastric-content-in-the-immediate-postpartum-period-a-prospective-observational-descriptive-study
#13
F Vial, N Hime, J Feugeas, N Thilly, P Guerci, H Bouaziz
INTRODUCTION: Pulmonary aspiration of gastric contents in pregnant women undergoing general anesthesia or sedation/analgesia in the peripartum period is a feared complication in obstetric anesthesia. We assessed the changes in antral cross-sectional area (CSA) with ultrasonography in laboring women and in the immediate postpartum period. PATIENTS AND METHODS: In an observational study in a university-affiliated maternity, gastric ultrasonography examinations were performed in non-consecutive laboring women, after epidural analgesia insertion and after childbirth...
August 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28649565/increasing-regional-anesthesia-use-in-a-serbian-teaching-hospital-through-an-international-collaboration
#14
REVIEW
Curtis L Baysinger, Borislava Pujic, Ivan Velickovic, Medge D Owen, Joanna Serafin, Matthew S Shotwell, Ferne Braveman
Many low- and middle-income countries (LMICs) report low rates of regional anesthesia (RA) use for cesarean delivery (CD), despite its association with lower maternal major morbidity and mortality. Also, the prevalence of neuraxial analgesia for labor (NAL) is often low in LMICs. We report on the results of a collaboration in clinical education over a multi-year period between Kybele Inc., an international non-profit organization, and Klinicki Centar Vojvodine (CCV), a teaching hospital in Novi Sad, Serbia, to increase RA use for CD and NAL at CCV...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28600029/racial-and-ethnic-disparities-in-obstetric-anesthesia
#15
Elizabeth M S Lange, Suman Rao, Paloma Toledo
Racial and ethnic disparities are prevalent within healthcare and have persisted despite advances in medicine and public health. Disparities have been described in the use of neuraxial labor analgesia, with minority women being less likely to use neuraxial labor analgesia than non-minority white women. Minority women are also more likely to have a general anesthetic for cesarean delivery than non-minority women. The origins of these disparities are likely multi-factorial, with patient-, provider-, and systems-level contributors...
August 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28599396/five-years-experience-in-an-anesthesiology-antenatal-clinic-for-high-risk-patients
#16
Daniel Shatalin, Yaacov Gozal, Sorina Grisaru-Granovsky, Alexander Ioscovich
INTRODUCTION: The aim, of this study is to describe our approach and outcomes in an outpatient anesthesia/analgesia antepartum clinic among ambulatory high-risk obstetric patients. METHODS: This was a retrospective evaluation of the activity of the anesthesiology antenatal clinic from its inception in 2010 until 2016 (a 5-year period). The clinic works in collaboration with the Department of Obstetrics and Gynecology. The catchment area of the study University Affiliated Hospital attends a multiethnic population characterized by high parity...
May 24, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28598915/anesthetic-and-obstetric-management-of-syringomyelia-during-labor-and-delivery-a-case-series-and-systematic-review
#17
REVIEW
Gráinne Patricia Garvey, Vibhangini S Wasade, Kellie E Murphy, Mrinalini Balki
BACKGROUND: Syringomyelia is a rare, slowly progressive neurological condition characterized by the presence of a syrinx within the spinal cord. Consensus regarding the safest mode of delivery and anesthetic management in patients with syringomyelia remains controversial and presents management dilemmas. This study reviews the cases of syringomyelia at our institution and provides a systematic review of the literature to guide decisions regarding labor and delivery management. METHODS: A retrospective review of cases at our hospital from 2002 to 2014 and a systematic review of the literature from 1946 to 2014 were undertaken...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28506404/-dural-sinus-thrombosis-following-epidural-analgesia-for-delivery-a-clinical-case
#18
Marco Aurelio Dornelles, Luis M Pereira
BACKGROUND AND OBJECTIVES: Neurological complications of spinal anesthesia are rare conditions. Headache caused by low pressure of the cerebrospinal fluid is one of the most frequent, which occurs after post-dural puncture. A comprehensive history and physical exam must be carried out before making the diagnosis of Post-Dural Puncture Headache (PDPH) and additional tests are necessary to exclude the possibility of developing serious neurological complications such as Dural Sinus Thrombosis (DST)...
May 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28499552/puerperal-ventral-epidural-hematoma-after-epidural-labor-analgesia
#19
I Gruzman, I Shelef, A Y Weintraub, A Zlotnik, O Erez
Serious complications in obstetric anesthesia are a rare occurrence. High neuraxial block, respiratory arrest in labor and delivery, and an unrecognized spinal catheter are among the most frequently reported serious complications. A serious complication occurs in approximately 1:3000 obstetric patients. Neuraxial hematoma after obstetric epidural analgesia or anesthesia is extremely rare. We present a case of a puerperal spinal epidural hematoma following epidural labor analgesia. The patient presented with foot drop, which resolved after conservative treatment...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28413284/combined-mitral-and-aortic-stenosis-in-parturient-anesthesia-management-for-labor-and-delivery
#20
Manish Kela, Madhvi Buddhi
Maternal heart disease complicates 0.2-3% of pregnancies. The optimal management of the pregnant patient with cardiac disease depends on the co-operative efforts of the obstetrician, the cardiologist and the anesthesiologist involved in peripartum care. A comprehensive understanding of physiology of pregnancy and pathophysiology of underlying cardiac disease is of primary importance in provision of obstetric analgesia or anesthesia for these high-risk groups of patients. We report a successful and uncomplicated use of epidural anesthesia for labor and delivery in patient with combined aortic and mitral stenosis...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
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