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https://www.readbyqxmd.com/read/28535940/-postpartum-hemorrhage-and-pregnancy-induced-hypertension-during-emergency-lower-segment-cesarean-section-dexmedetomidine-to-our-rescue
#1
Uma Hariharan
Dexmedetomidine is a highly selective α-2 agonist which has recently revolutionized our anesthesia and intensive care practice. An obstetric patient presented for emergency cesarean delivery under general anesthesia, with pre-eclampsia and postpartum hemorrhage. In carefully selected cases with refractory hypertension and postpartum hemorrhage, dexmedetomidine can be used for improving overall patient outcome. It was beneficial in controlling both the blood pressure and uterine bleeding during cesarean section in our patient...
May 20, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28535554/anesthetic-considerations-and-perioperative-management-of-spinal-cord-stimulators-literature-review-and-initial-recommendations
#2
Michael E Harned, Brandon Gish, Allison Zuelzer, Jay S Grider
BACKGROUND: Patients with implanted spinal cord stimulators (SCS) present to the anesthesia care team for management at many different points along the care continuum. Currently, the literature is sparse on the perioperative management. What is available is confusing; monopolar electrocautery is contraindicated but often used, full body magnetic resonance imaging (MRI) is safe with particular systems but with other manufactures only head and specific extremities exams are safe. Moreover, there are anesthetizing locations outside of the operating room where implanted SCS can interact with surrounding medical equipment and pose significant risk to patient and device...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28525510/zika-virus-obstetric-and-pediatric-anesthesia-considerations
#3
Jacqueline L Tutiven, Benjamin T Pruden, James S Banks, Mario Stevenson, David J Birnbach
As of November 2016, the Florida Department of Health (FDH) and the Centers for Disease Control and Prevention have confirmed more than 4000 travel-related Zika virus (ZIKV) infections in the United States with >700 of those in Florida. There have been 139 cases of locally acquired infection, all occurring in Miami, Florida. Within the US territories (eg, Puerto Rico, US Virgin Islands), >30,000 cases of ZIKV infection have been reported. The projected number of individuals at risk for ZIKV infection in the Caribbean and Latin America approximates 5 million...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28499552/puerperal-ventral-epidural-hematoma-after-epidural-labor-analgesia
#4
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/28499551/lessons-learned-from-a-single-institution-s-retrospective-analysis-of-emergent-cesarean-delivery-following-external-cephalic-version-with-and-without-neuraxial-anesthesia
#5
A Ainsworth, H P Sviggum, M C Tolcher, A L Weaver, M A Holman, K W Arendt
OBJECTIVES: To evaluate the risk of emergent cesarean delivery with the use of neuraxial anesthesia for external cephalic version in a single practice. BACKGROUND: Randomized trials have shown increased external cephalic version success when neuraxial anesthesia is used, without additional risk. We hypothesized that in our actual clinical practice, outside the confines of randomized trials, neuraxial anesthesia could be associated with an increased risk of emergent cesarean delivery...
April 2, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28491126/developing-obstetric-medicine-training-in-latin-america
#6
José Rojas-Suarez, Niza Suarez, Oier Ateka-Barrutia
Maternal mortality is an important indicator of health in populations around the world. The distribution of maternal mortality ratio globally shows that middle- and low-income countries have ∼99% of the mortality burden. Most countries of Latin America are considered to be middle- or low-income countries, as well as areas of major inequities among the different social classes. Medical problems in pregnancy remain an important cause of morbidity and mortality in this region. Previous data indicate the need for a call to action for adequate diagnosis and care of medical diseases in obstetric care...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28477261/barriers-to-collaborative-anesthetic-care-between-anesthesiologists-and-nurses-on-the-labour-and-delivery-unit-a-study-using-a-modified-delphi-technique
#7
Lillia Y Fung, Kristi Downey, Nancy Watts, Jose C A Carvalho
INTRODUCTION: The practice of obstetrical anesthesia relies on collaborative effort between anesthesiologists and nurses, but teamwork remains a challenge. We sought to identify a consensus on the perceived barriers to collaborative care between anesthesiologists and perinatal nurses in a Canadian tertiary labour and delivery (L&D) unit. METHODS: A cross-sectional consensus-building study was conducted using a modified Delphi technique. We aimed to reach consensus on the barriers to collaborative care as well as to identify the reasons behind the issues and possible interventions...
May 5, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28461175/in-office-hysteroscopic-extraction-of-intrauterine-devices-in-pregnant-patients-who-underwent-prior-ultrasound-guided-extraction-failure
#8
Shlomo B Cohen, Jerome Bouaziz, Alexandra Bar On, Eyal Schiff, Motti Goldenberg, Roy Maschiach
STUDY OBJECTIVE: To determine an effective method of intrauterine device (IUD) retrieval from pregnant women who had previous unsuccessful ultrasound-guided IUD extraction failure. DESIGN: Retrospective cohort study (Canadian task force classification II-1) SETTING: Gynecology department of an outpatient clinic. PATIENTS: Pregnant patients in their first trimester with IUD in situ who underwent prior unsuccessful ultrasound-guided IUD extraction...
April 28, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28452901/effect-of-pain-and-analgesia-on-compensatory-reserve
#9
Carmen Hinojosa-Laborde, Jessie Renee D Fernandez, Gary W Muniz, Corinne D Nawn, Rebecca K Burns, Thuan H Le, Kathy B Porter, John T Hardy, Victor A Convertino
BACKGROUND: The measurement of the body's capacity to compensate for reduced blood volume can be assessed with a Compensatory Reserve Measurement (CRM). The CRM, which is calculated from changes in features of the arterial waveform, represents the integration of compensatory mechanisms during states of low tissue perfusion and oxygenation such as hemorrhage. This study was designed to test the hypothesis that pain which activates compensatory mechanisms and analgesia that result in reduced blood pressure are associated with lower compensatory reserve...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28451033/-epidural-analgesia-in-20-parturients-at-the-sylvanus-olympio-university-hospital-center-in-lom%C3%A3-togo
#10
Pilakimwé Egbohou, Tabana Mouzou, Hamza Doles Sama, Pikabalo Tchétike, Sarakawabalo Assénouwé, Gnimdou Akala-Yoba, Kadjika Tomta
We conducted a prospective and descriptive study on epidural analgesia (EA) at the Sylvanus Olympio University Hospital Center in Lomé from February to June 2014. After taking consent from pregnant women selected by simple random sampling and in the absence of contraindication for anesthesia (pre-anesthetic assessment performed in their 8th month of pregnancy), women were enrolled. Out of 29 selected women, 20 (69%) underwent EA. The average age was 30.6 ± 6.6 years: primiparas 35%, multiparas 50%, Obese women (BMI> 30)25%...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28446852/clinical-performance-of-emergency-surgical-officers-in-southern-ethiopia
#11
Abera A Gobeze, Zelalem Kebede, Yifru Berhan, Biku Ghosh
BACKGROUND: Serious shortage of gynecologists and surgeons for several decades leading to a three-year masters level training was initiated in 2009. However, systematic analysis was not done to assess the graduates' performance. The purpose of this study was to assess improvement in access to emergency surgical and obstetrical care services. METHODS: Both quantitative and qualitative methods were employed to assess the competence of emergency surgical officers (ESOs) in their decision making and surgical skills in eight hospitals between 2012 and 2014...
September 2016: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28445174/obstetric-anesthesia-for-a-pregnant-woman-with-brainstem-cavernous-malformations-a-case-report
#12
Misuzu Hayashi, Manabu Kakinohana
There are no well-defined guidelines for obstetric and anesthetic management of pregnant patients with cerebral cavernous malformations (CMs). We need to pay careful attention to the attendant risks of both general and neuraxial anesthesia in this population. Here, we describe the anesthetic management of a pregnant woman with brainstem CMs who underwent cesarean delivery. We selected a general anesthetic technique because of concerns of undesirable effects of neuraxial anesthesia in the presence of cerebral CMs...
April 25, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28437304/nitrous-oxide-utility-in-labor-and-birth-a-multipurpose-modality
#13
Michelle Collins
The use of nitrous oxide (N2O) for labor and birth has very recently emerged as a viable modality in the United States, despite a long history of use in Canada and Europe. Usually associated with dental procedures, there are significant differences between dental and parturition utility, efficacy, and staff exposure. In addition to using it for pain relief and anxiolysis, those centers utilizing it have noted it to be multipurpose and useful for such situations as: external cephalic version, manual removal of placenta, intravenous starts, during placement of urinary catheters and intracervical Foley bulbs...
April 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28430683/core-topics-in-obstetric-anesthesia
#14
Sharon Orbach-Zinger
No abstract text is available yet for this article.
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28426504/contributors-advances-in-obstetric-anesthesia
#15
(no author information available yet)
No abstract text is available yet for this article.
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28413284/combined-mitral-and-aortic-stenosis-in-parturient-anesthesia-management-for-labor-and-delivery
#16
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/28398928/anesthetic-management-of-mitochondrial-encephalopathy-with-lactic-acidosis-and-stroke-like-episodes-melas-syndrome-in-a-high-risk-pregnancy-a-case-report
#17
Josh D Bell, Kushlin Higgie, Mital Joshi, Joshua Rucker, Sahar Farzi, Naveed Siddiqui
MELAS syndrome (mitochondrial encephalopathy, lactic acidosis, and stroke-like symptoms) is a rare and complex mitochondrial disorder. We present the in-hospital course of a 36-year-old gravida 2, para 0 with MELAS syndrome and severe preeclampsia, complicated by hyponatremia, hyperkalemia, and diabetes. A retained placenta with postpartum hemorrhage required urgent instrumental delivery under spinal anesthesia, transfusion, and intensive care unit admission for pulmonary edema, effusions, and atelectasis. Postpartum endometritis and sepsis also were encountered...
April 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28367293/thoracic-interfascial-nerve-block-for-breast-surgery-in-a-pregnant-woman-a-case-report
#18
Boohwi Hong, Seok-Hwa Yoon, Ann Misun Youn, Bum June Kim, Seunghyun Song, Yeomyung Yoon
Regional anesthesia for non-obstetric surgery in parturients is a method to decrease patient and fetal risk during general anesthesia. Thoracic interfascial nerve block can be used as an analgesic technique for surgical procedures of the thorax. The Pecs II block is an interfascial block that targets not only the medial and lateral pectoral nerves, but also the lateral cutaneous branch of the intercostal nerve. Pecto-intercostal fascial block (PIFB) targets the anterior cutaneous branch of the intercostal nerve...
April 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28337935/a-novel-approach-in-the-treatment-of-neonatal-gastroschisis-a-review-of-the-literature-and-a-single-center-experience
#19
Vito Briganti, Daniela Luvero, Caterina Gulia, Roberto Piergentili, Simona Zaami, Elsa Laura Buffone, Cristina Vallone, Roberto Angioli, Claudio Giorlandino, Fabrizio Signore
Gastroschisis is a congenital abdominal wall defect and its management remains an issue. We performed a review of the literature to summarize its evaluation, management and outcome and we describe a new type of surgical reduction performed in our center without anesthesia (GA), immediately after birth, in the delivery room. Between January 2002 and March 2013, we enrolled all live born infants with gastroschisis referred to the third level Division of Obstetrics and Gynecology "San Camillo" of Rome.Two groups of infants were identified: group 1 in which gastroschis reduction was performed by the traditional technique and group 2 in which reduction was immediately performed after birth in the delivery room without GA...
March 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28335653/anesthesia-management-of-complete-versus-incomplete-placenta-previa-a-retrospective-cohort-study
#20
Sharon Orbach-Zinger, Carolyn F Weiniger, Amir Aviram, Alexander Balla, Shai Fein, Leonid A Eidelman, Alexander Ioscovich
PURPOSE: Placenta previa (PP) is a major cause of obstetric hemorrhage. Clinical diagnosis of complete versus incomplete PP has a significant impact on the peripartum outcome. Our study objective is to examine whether distinction between PP classifications effect anesthetic management. METHODS AND MATERIALS: This multi-center, retrospective, cohort study was performed in two tertiary university-affiliated medical centers between the years 2005 and 2013. Electronic delivery databases were reviewed for demographic, anesthetic, obstetric hemorrhage, and postoperative outcomes for all cases...
April 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
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