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Anesthesia and analgesia for labor and delivery

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https://www.readbyqxmd.com/read/28719524/establishing-obstetric-anesthesiology-practice-guidelines-in-the-republic-of-armenia-a-global-health-collaboration
#1
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-french-retrospective-multicenter-cohort-study
#2
Elie Kantor, Jean Guglielminotti, Elie Azria, Dominique Luton, Mandelbrot Laurent, Oury Jean-François, 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...
July 13, 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
#3
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...
June 26, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28649565/increasing-regional-anesthesia-use-in-a-serbian-teaching-hospital-through-an-international-collaboration
#4
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
#5
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...
June 6, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28599396/five-years-experience-in-an-anesthesiology-antenatal-clinic-for-high-risk-patients
#6
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
#7
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...
June 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28506404/-dural-sinus-thrombosis-following-epidural-analgesia-for-delivery-a-clinical-case
#8
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
#9
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...
March 31, 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
#10
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
https://www.readbyqxmd.com/read/28333819/practice-bulletin-no-177-obstetric-analgesia-and-anesthesia
#11
(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
#12
(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/28235511/increasing-body-mass-index-predicts-increasing-difficulty-failure-rate-and-time-to-discovery-of-failure-of-epidural-anesthesia-in-laboring-patients
#13
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/28217389/management-of-parturients-in-active-labor-with-arnold-chiari-malformation-tonsillar-herniation-and-syringomyelia
#14
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/28202311/anesthetic-considerations-for-labor-and-delivery-in-women-with-cerebrospinal-fluid-shunts
#15
S Rajagopalan, S Gopinath, V T Trinh, S Chandrasekhar
BACKGROUND: The anesthetic management of labor and delivery in pregnant women with cerebrospinal fluid shunts can be challenging. We conducted a literature review to understand the anesthetic implications in pregnant women with cerebrospinal fluid shunts. METHODS: We searched PubMed, EMBASE, and Medline databases to identify reports of pregnant women with cerebrospinal fluid shunts during the 30-year period from 1985 to 2015. Twenty-four studies reporting anesthetic techniques for labor and delivery were included in the analyses...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28183557/parturient-recall-of-neuraxial-analgesia-risks-impact-of-labor-pain-vs-no-labor-pain
#16
Christopher M Burkle, David A Olsen, Hans P Sviggum, Adam K Jacob
STUDY OBJECTIVE: Information exchange between anesthesia providers and parturients about neuraxial analgesia risks often occurs in the presence of labor pain. This study examined whether the presence of pain impacted the level of recall of information provided to parturients regarding risks of neuraxial techniques. DESIGN: Single-center, nonrandomized study. SETTING: Labor and delivery suite and postpartum patient rooms in a large academic medical center...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28121757/the-perinatal-birth-environment-communication-strategies-and-processes-for-adherence-to-a-standardized-guideline-in-women-undergoing-second-stage-labor-with-epidural-anesthesia
#17
Samantha A Sommerness, Rebecca Gams, Phillip N Rauk, Ananta Bangdiwala, Daniel V Landers, Melissa D Avery, Charles Hirt, Kristi Miller, Amy Millar, Suzin Cho, Andrea Shields
Key to any perinatal safety initiative is buy-in and strong leadership from obstetric and pediatric providers, advanced practice nurses, and labor and delivery nurses in collaboration with ancillary staff. In the fall of 2007, executives of a large Midwestern hospital system created the Zero Birth Injury Initiative. This multidisciplinary group sought to eliminate birth injury using the Institute of Healthcare Improvement Perinatal Bundles. Concurrently, the team implemented a standardized second-stage labor guideline for women who choose epidural analgesia for pain management to continue the work of eliminating birth injuries in second-stage labor...
January 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28121644/peripartum-management-of-obstructive-sleep-apnea
#18
Jessica M Booth, Ashley M Tonidandel
The prevalence of obstructive sleep apnea is unknown during pregnancy, but the syndrome is likely underdiagnosed and rising in frequency along with the obesity epidemic. Obstructive sleep apnea is associated with adverse outcomes, including hypertensive disorders of pregnancy, gestational diabetes, preterm, and cesarean delivery. Obese pregnant women should be screened and referred to a sleep medicine specialist for evaluation. Continuous positive airway pressure is the treatment of choice with demonstrated safety and compliance in pregnancy...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28099175/two-for-one-a-case-report-of-intravenous-lipid-emulsion-to-treat-local-anesthetic-systemic-toxicity-in-term-pregnancy
#19
Jonathan Dun-Chi Lin, Eellan Sivanesan, Terese T Horlocker, Andres Missair
Combined spinal-epidural (CSE) analgesia is a frequently used method of labor analgesia. Although it is considered safe and effective, CSE can be complicated by local anesthetic systemic toxicity (LAST), a potentially life-threatening condition. We present a case of LAST that developed in a primigravida 50 minutes after uneventful placement of a CSE. Her symptoms resolved within 10 minutes of administering intralipid emulsion. She subsequently underwent cesarean delivery under spinal anesthesia for failure to progress without sequelae in the mother or infant...
January 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28012862/impact-of-obesity-on-post-dural-puncture-headache
#20
J Song, T Zhang, A Choy, A Penaco, V Joseph
INTRODUCTION: Previous studies have suggested an inverse relationship between obesity and development of post-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...
May 2017: International Journal of Obstetric Anesthesia
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