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Labour epidural anesthesia

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https://www.readbyqxmd.com/read/27668095/epidural-analgesia-with-ropivacaine-during-labour-in-a-patient-with-a-scn5a-gene-mutation
#1
A L M J van der Knijff-van Dortmont, M Dirckx, J J Duvekot, J W Roos-Hesselink, A Gonzalez Candel, C D van der Marel, G P Scoones, V F R Adriaens, I J J Dons-Sinke
SCN5A gene mutations can lead to ion channel defects which can cause cardiac conduction disturbances. In the presence of specific ECG characteristics, this mutation is called Brugada syndrome. Many drugs are associated with adverse events, making anesthesia in patients with SCN5A gene mutations or Brugada syndrome challenging. In this case report, we describe a pregnant patient with this mutation who received epidural analgesia using low dose ropivacaine and sufentanil during labour.
2016: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/27422266/evaluation-of-failed-and-high-blocks-associated-with-spinal-anesthesia-for-cesarean-delivery-following-inadequate-labour-epidural-a-retrospective-cohort-study
#2
Lisa M Einhorn, Ashraf S Habib
PURPOSE: The purpose of this retrospective cohort study was to investigate factors associated with failed and high spinal blocks in patients who received spinal anesthesia for Cesarean delivery following a labour epidural that was inadequate for surgical anesthesia. METHODS: We searched our perioperative database for women with a labour epidural who received spinal or combined spinal-epidural anesthesia for Cesarean delivery due to the inadequacy of the existing epidural...
October 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26634280/interscapular-pain-associated-with-neuraxial-labour-analgesia-a-case-series
#3
Thomas T Klumpner, Paloma Toledo, Cynthia A Wong, Jason R Farrer
PURPOSE: Some labouring women with neuraxial labour analgesia experience severe upper back pain, typically between the scapulae. This pain may complicate management of neuraxial analgesia/anesthesia, and it may also have important implications for the mode of delivery. This case series describes the clinical course and management of three patients who developed interscapular pain associated with neuraxial labour analgesia. PRINCIPAL FINDINGS: Neuraxial labour analgesia was initiated in all patients with a combined spinal-epidural technique and maintained via patient-controlled epidural analgesia...
April 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26370260/anesthetic-management-of-a-parturient-with-hypermobility-phenotype-but-possible-vascular-genotype-ehlers-danlos-syndrome
#4
Kelly Fedoruk, Karen Chong, Mathew Sermer, Jose C A Carvalho
PURPOSE: We describe a case of a term parturient previously clinically diagnosed with hypermobility type Ehlers-Danlos syndrome (EDS) but later diagnosed with a genotype that may be associated with vascular type EDS. CLINICAL FEATURES: This 26-yr-old primigravida had been clinically diagnosed with hypermobility type EDS prior to her pregnancy. Nevertheless, subsequent genetic testing during pregnancy revealed a heterozygous variant of unknown significance in the COL3A1 gene causative for vascular type EDS...
December 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/25860126/carbetocin-at-cesarean-delivery-for-labour-arrest-a-sequential-allocation-trial-to-determine-the-effective-dose
#5
RANDOMIZED CONTROLLED TRIAL
Nhathien Nguyen-Lu, Jose Carlos Almeida Carvalho, Dan Farine, Gareth Seaward, Xiang Y Ye, Mrinalini Balki
PURPOSE: The aim of this study was to estimate the effective dose 90% (ED90) of carbetocin to provide adequate uterine tone at Cesarean delivery (CD) for labour arrest. METHODS: We conducted a double-blind dose-finding study of carbetocin using a biased-coin up-and-down design in women undergoing CD for labour arrest under epidural anesthesia. Forty healthy term pregnant women who had received at least three hours of oxytocin infusion during labour were recruited for the study...
August 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/25532087/continuous-versus-patient-controlled-epidural-analgesia-for-labour-analgesia-and-their-effects-on-maternal-motor-function-and-ambulation
#6
RANDOMIZED CONTROLLED TRIAL
Margarita Lovach-Chepujnoska, Jordan Nojkov, Slagjana Joshevska-Jovanovska, Robert Domazetov
BACKGROUND AND OBJECTIVES: The advantages of patient-controlled epidural analgesia (PCEA) for delivery compared with continuous epidural analgesia (CEA) have been a point of interest in research obstetric anaesthesia for more than two decades. The aim of this single blind randomized controlled study was to evaluate the incidence of motor block and ability to perform partial knee flexion in women who received CEA or PCEA. METHOD: Fifty-one healthy nulliparous women were included in this study...
2014: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/25501494/low-dose-intrathecal-local-anesthetic-does-not-increase-the-threshold-current-for-the-epidural-stimulation-test-a-prospective-observational-trial-of-neuraxial-analgesia-in-labouring-women
#7
Jose C A Carvalho, Rakhi Khemka, Julian Loke, Ban C H Tsui
PURPOSE: The purpose of this study was to investigate the ability of the electrical epidural stimulation test (EST) to determine the position of the epidural catheter during combined spinal-epidural (CSE) anesthesia for labour analgesia. METHODS: This was a prospective observational trial of attempted EST during neuraxial analgesia in labouring women. Ten women received a double-segment CSE technique and one woman underwent continuous spinal analgesia following inadvertent dural puncture and deliberate placement of the catheter tip in the intrathecal space...
March 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/25501493/anesthetic-management-and-outcomes-of-parturients-with-dilated-cardiomyopathy-in-an-academic-centre
#8
Unyime S Ituk, Ashraf S Habib, Carrie M Polin, Terrence K Allen
PURPOSE: This study examines the peripartum anesthetic management and outcomes of women with dilated cardiomyopathy in a large university medical centre over a seven-year period. PRINCIPAL FINDINGS: Twenty-five women were included in this series, 18 with a new diagnosis of cardiomyopathy and seven with a history of cardiomyopathy. Sixteen patients (64%) identified themselves as African American, seven (28%) were Caucasian, and two patients (8%) were Hispanic. The median (range) gestational age at the time of a new diagnosis of cardiomyopathy was 29 (7-38) weeks...
March 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/25470853/evolving-pattern-of-spinal-anaesthesia-in-stable-eclamptic-patients-undergoing-caesarean-section-at-university-of-benin-teaching-hospital-benin-nigeria
#9
J M Afolayan, C E Nwachukwu, E S Esangbedo, P O Omu, F E Amadasun, J O Fadare
BACKGROUND: Eclampsia is still associated with high maternal and perinatal and perinatal morbidity and mortality, especially in resource poor countries with limited access to perinatal and critical care facilities. The ideal method of anaesthesia for caesarean section in eclamptics is not generally agreed upon. METHODS: Review of the patients' case notes as well as records of the institution's Labour Ward Theatre, Intensive Care Unit and Postnatal Ward was carried out between January 2011 and December 2012...
October 2014: Nigerian Journal of Medicine: Journal of the National Association of Resident Doctors of Nigeria
https://www.readbyqxmd.com/read/25327872/sequential-use-of-double-balloon-catheter-and-oral-misoprostol-versus-oral-misoprostol-alone-for-induction-of-labour-at-term-crbplus-trial-a-multicentre-open-label-randomised-controlled-trial
#10
RANDOMIZED CONTROLLED TRIAL
S Kehl, J Ziegler, E Schleussner, B Tuschy, S Berlit, J Kirscht, F Hägele, C Weiss, J Siemer, M Sütterlin
OBJECTIVE: To evaluate the efficacy of inducing labour using a double-balloon catheter and oral misoprostol sequentially, in comparison with oral misoprostol alone. DESIGN: A multicentre randomised controlled trial. SETTING: Five hospitals in Germany. POPULATION: A total of 326 pregnant women with an unfavourable cervix undergoing labour induction at term. METHODS: Women were randomly assigned according to a computer-generated allocation sequence to sequential use of double-balloon catheter and oral misoprostol (study group) or oral misoprostol alone (control group)...
January 2015: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/25190961/importance-of-transesophageal-echocardiography-in-peripartum-cardiomyopathy-undergoing-lower-section-cesarean-section-under-regional-anesthesia
#11
Poonam Malhotra Kapoor, Sameer Goyal, Kalpana Irpachi, Barya Smita
Peripartum cardiomyopathy is a relatively rare but life threatening disease. The etiology and pathogenesis of peripartum cardiomyopathy is generally centered upon viral and autoimmune mechanism. This case report describes the anesthetic management of a patient with term pregnancy suffering from dilated peripartum cardiomyopathy planned for cesarean section, successfully managed with epidural anesthesia after precipitate labour.
July 2014: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/25125249/reversal-of-high-spinal-anesthesia-with-cerebrospinal-lavage-after-inadvertent-intrathecal-injection-of-local-anesthetic-in-an-obstetric-patient
#12
Heather Y Z Ting, Ban C H Tsui
PURPOSE: High or total spinal anesthesia commonly results from accidental placement of an epidural catheter in the intrathecal space with subsequent injection of excessive volumes of local anesthetic. Cerebrospinal lavage has been shown to be effective at reversing the effects of high/total spinal anesthesia but is rarely considered in obstetric cases. Here, we describe the use of cerebrospinal lavage to prevent potential complications from high/total spinal anesthesia after unintentional placement of an intrathecal catheter in a labouring obstetric patient...
November 2014: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/24824157/a-randomised-controlled-trial-of-outpatient-compared-with-inpatient-cervical-ripening-with-prostaglandin-e%C3%A2-opra-study
#13
RANDOMIZED CONTROLLED TRIAL
C Wilkinson, R Bryce, P Adelson, D Turnbull
OBJECTIVE: To compare clinical outcomes from outpatient with inpatient cervical prostaglandin E2 ripening for low risk labour induction. DESIGN: Randomised controlled trial. SETTING: Two tertiary hospitals in Adelaide, Australia. POPULATION: Women with uncomplicated term pregnancies, scheduled for induction of labour for reasons of post-dates or for social reasons. METHODS: Eight hundred and twenty-seven women were randomised at induction decision to an outpatient or inpatient group...
January 2015: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/24641638/prophylactic-vs-therapeutic-blood-patch-for-obstetric-patients-with-accidental-dural-puncture-a-randomised-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
M H Stein, S Cohen, M A Mohiuddin, V Dombrovskiy, I Lowenwirt
Epidural blood patch is a standard treatment for obstetric patients experiencing a severe post-dural puncture headache. Patients who sustained an accidental dural puncture during establishment of epidural analgesia during labour or at caesarean delivery were randomly assigned to receive a prophylactic epidural blood patch or conservative treatment with a therapeutic epidural blood patch if required. Eleven of 60 (18.3%) patients in the prophylactic epidural blood patch group developed a post-dural puncture headache compared with 39 of 49 (79...
April 2014: Anaesthesia
https://www.readbyqxmd.com/read/24507621/birth-control-to-what-extent-do-women-report-being-informed-and-involved-in-decisions-about-pregnancy-and-birth-procedures
#15
Rachel Thompson, Yvette D Miller
BACKGROUND: Health policy, guidelines, and standards advocate giving patients comprehensive information and facilitating their involvement in health-related decision-making. Routine assessment of patient reports of these processes is needed. Our objective was to examine decision-making processes, specifically information provision and consumer involvement in decision-making, for nine pregnancy, labour, and birth procedures, as reported by maternity care consumers in Queensland, Australia...
2014: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/24361190/anaesthesia-for-parturients-with-severe-cystic-fibrosis-a-case-series
#16
M Deighan, S Ash, R McMorrow
Cystic fibrosis affects 1 in 1600-2500 live births and is inherited in an autosomal recessive manner. It primarily involves the respiratory, gastrointestinal and reproductive tracts, with impaired clearance of, and obstruction by, increasingly viscous secretions. Severe respiratory disease, diabetes and gastro-oesophageal reflux may result. Improvements in medical management and survival of cystic fibrosis patients means more are committing to pregnancies. Although guidance for anaesthesia in this patient group is available, management and outcome data associated with more severe cases are sparse...
February 2014: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/24360330/management-of-labour-and-delivery-in-a-woman-with-refractory-supraventricular-tachycardia
#17
A T Dennis, M D Gerstman
Supraventricular tachycardia is uncommon in pregnancy. It is defined as intermittent pathological and usually narrow complex tachycardia >120 beats/min which originates above the ventricle, excluding atrial fibrillation, flutter and multifocal atrial tachycardia. It is usually self-limiting or relatively easily treated with most cases responding to physical or pharmacological therapies. We describe a case of a woman in the third trimester of pregnancy who developed treatment-resistant supraventricular tachycardia and required induction of labour and delivery to stop the arrhythmia...
February 2014: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/24170528/epidural-analgesia-in-labour-and-neonatal-respiratory-distress-a-case-control-study
#18
MULTICENTER STUDY
Manoj Kumar, Sue Chandra, Zainab Ijaz, Ambikaipakan Senthilselvan
BACKGROUND: Epidural analgesia is the commonest mode for providing pain relief in labour, with a combination of bupivacaine and fentanyl most often used in practice. OBJECTIVE: To test whether late-preterm and term neonates exposed to opioids in epidural analgesia in labour are more likely to develop respiratory distress in the immediate neonatal period. METHODS: A case-control study was conducted of singleton infants born during January 2006 to December 2010...
March 2014: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/24165060/successful-pregnancy-epidural-anaesthesia-labour-and-delivery-in-a-woman-with-sturge-weber-syndrome-and-previous-hemispherectomy
#19
Aly Shah Aziz, Dini Hui, Vinod Chinnappa, Richard I Aviv, Richard H Swartz
BACKGROUND: The outcomes of pregnancy and subsequent delivery of healthy neonates in women who have undergone previous near total hemispherectomy for Sturge-Weber syndrome (SWS) have rarely been reported. CASE: A woman with SWS had two successful and uncomplicated pregnancies and deliveries under epidural anaesthesia after undergoing a near total hemispherectomy with subsequent unilateral cerebral palsy. Non-contrast MRI of the brain revealed post hemispherectomy changes with no residual meningeal angiomatosis...
October 2013: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/24164577/meta-analysis-of-the-success-of-block-following-combined-spinal-epidural-vs-epidural-analgesia-during-labour
#20
M Heesen, M Van de Velde, S Klöhr, J Lehberger, R Rossaint, S Straube
Observational studies suggest that combined spinal-epidural analgesia (CSE) is associated with more reliable positioning, lower epidural catheter replacement rates, and a lower incidence of unilateral block compared with epidural analgesia. However, evidence from high-quality trials still needs to be assessed systematically. We performed a systematic review that included 10 randomised controlled trials comparing CSE and epidural analgesia in 1722 labouring women in labour. The relative risk of unilateral block was significantly reduced after CSE vs epidural analgesia (0...
January 2014: Anaesthesia
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