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obstetric analgesia

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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
#1
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/27855515/influence-of-obstetrical-events-on-satisfaction-and-anxiety-during-childbirth-a-prospective-longitudinal-study
#2
Lucia Floris, Olivier Irion, Delphine Courvoisier
The aim of this study was to investigate the feelings of anxiety and satisfaction among 79 primiparas who had uncomplicated pregnancies, at the time of hospital admission and after birth, considering the mode of delivery, analgesia, and pain levels. Questionnaires were completed at admission to the hospital and two months after delivery, using the State-Trait Anxiety Inventory (STAI) state scale and the Labour Agentry Scale. The mean (SD) STAI state score was higher at admission (36.7 (10.7)) than 4 months after childbirth (32...
November 17, 2016: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/27831958/anesthetic-and-obstetrical-factors-associated-with-the-effectiveness-of-epidural-analgesia-for-labor-pain-relief-an-observational-population-based-study
#3
Marie-Pierre Bonnet, Caroline Prunet, Christophe Baillard, Laure Kpéa, Béatrice Blondel, Camille Le Ray
BACKGROUND AND OBJECTIVES: The effectiveness of labor epidural analgesia is difficult to explore, as it includes the maternal satisfaction with analgesia as well as the overall childbirth experience. In this population-based study, we sought to identify factors associated with the effectiveness of epidural analgesia for labor pain relief. METHODS: We performed a secondary analysis of the 2010 French National Perinatal Survey, a cross-sectional study of a representative sample of births in France...
November 9, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27828798/effects-of-epidural-labor-analgesia-with-low-concentrations-of-local-anesthetics-on-obstetric-outcomes-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#4
Ting-Ting Wang, Shen Sun, Shao-Qiang Huang
BACKGROUND: Low concentrations of local anesthetics (LCLAs) are increasingly popular for epidural labor analgesia. The effects of epidural analgesia with low concentrations of anesthetics on the duration of the second stage of labor and the instrumental birth rate, however, remain controversial. A systematic review was conducted to compare the effects of epidural analgesia with LCLAs with those of nonepidural analgesia on obstetric outcomes. METHODS: The databases of PubMed, Embase, and the Cochrane controlled trials register were independently searched by 2 researchers, and randomized controlled trials that compared epidural labor analgesia utilizing LCLAs with nonepidural analgesia were retrieved...
November 8, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27827521/ultrasonography-for-neuraxial-blocks-a-review-of-the-evidence
#5
Maria F Elgueta, Silvia Duong, Roderick J Finlayson, De Qh Tran
INTRODUCTION: This narrative review summarizes the evidence derived from randomized controlled trials (RCTs) pertaining to the use of adjunctive ultrasonography (US) for neuraxial blocks. EVIDENCE ACQUISITION: The literature search was conducted using the MEDLINE, EMBASE and PUBMED databases. For the MEDLINE and EMBASE searches, the MESH terms "ultrasonography" and key word "ultrasound" were queried; using the operator "and", they were combined with the MESH terms "neuraxial block", "epidural anesthesia", "epidural analgesia", "spinal anesthesia", "spinal analgesia", "intrathecal anesthesia", "intrathecal analgesia", "caudal anesthesia", and "caudal analgesia"...
November 9, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27821464/safety-of-labour-and-delivery-following-closures-of-obstetric-services-in-small-community-hospitals
#6
Jennifer A Hutcheon, Corinne A Riddell, Erin C Strumpf, Lily Lee, Sam Harper
BACKGROUND: In recent decades, many smaller hospitals in British Columbia, Canada, have stopped providing planned obstetric services. We examined the effect of these service closures on the labour and delivery outcomes of pregnant women living in affected communities. METHODS: We used maternal postal codes to identify delivery records (1998-2014) of women residing in a community affected by service closure. The records were obtained from the British Columbia Perinatal Data Registry...
November 7, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/27766983/factors-associated-with-cesarean-delivery-during-labor-in-primiparous-women-assisted-in-the-brazilian-public-health-system-data-from-a-national-survey
#7
Marcos Augusto Bastos Dias, Rosa Maria Soares Madeira Domingues, Arthur Orlando Corrêa Schilithz, Marcos Nakamura-Pereira, Maria do Carmo Leal
BACKGROUND: The rate of cesarean delivery (CD) in Brazil has increased over the past 40 years. The CD rate in public services is three times above the World Health Organization recommended values. Among strategies to reduce CD, the most important is reduction of primary cesarean. This study aimed to describe factors associated with CD during labor in primiparous women with a single cephalic pregnancy assisted in the Brazilian Public Health System (SUS). METHODS: This study is part of the Birth in Brazil survey, a national hospital-based study of 23,894 postpartum women and their newborns...
October 17, 2016: Reproductive Health
https://www.readbyqxmd.com/read/27759743/perioperative-and-periprocedural-airway-management-and-respiratory-safety-for-the-obese-patient-2016-siaarti-consensus
#8
Flavia Petrini, Ida Di Giacinto, Rita Cataldo, Clelia Esposito, Vittorio Pavoni, Paolo Donato, Antonella Trolio, Guido Merli, Massimiliano Sorbello, Paolo Pelosi
Proper management of obese patients requires a team vision and appropriate behaviors by all health care providers in hospital. Specialist competencies are fundamental, as are specific clinical pathways and good clinical practices designed to deal with patients whose body mass index is ≥30 kg/m2. Standards of care for bariatric and non-bariatric surgery and for the critical care management of this population exist but are not well defined nor clearly followed in every hospital. Thus every anesthesiologist is likely to deal with this challenging population...
October 19, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27741203/maternal-and-neonatal-outcomes-with-early-compared-with-delayed-pushing-among-nulliparous-women
#9
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/27726918/anaesthetic-management-of-parturients-with-univentricular-congenital-heart-disease-and-the-fontan-operation
#10
R S Monteiro, D P Dob, M R Cauldwell, M A Gatzoulis
Women with a single ventricle circulation palliated with the Fontan operation require specialist multidisciplinary management. We report 14 such cases with successful pregnancies and detail the pathophysiology encountered. A combined obstetric and cardiac service between Chelsea and Westminster Hospital and Royal Brompton Hospital provides care for women with heart disease, and maintains a prospective database of referred women. We searched this database for women with a known Fontan circulation and reviewed the case notes and electronic patient records between January 1994 and December 2015...
December 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27692473/effect-of-combined-spinal-epidural-analgesia-in-labor-on-frequency-of-emergency-cesarean-delivery-among-nulliparous-chinese-women
#11
Fen Wang, Yun-Xia Cao, Shan-Gao Ke, Tao-Hua Zhu, Miao Zhang
OBJECTIVE: To determine whether combined spinal-epidural analgesia (CSEA) during labor increases the frequency of emergency cesarean delivery among Chinese nulliparous women. METHODS: In a retrospective study, the medical records of nulliparous women with a singleton fetus in cephalic presentation who delivered at term at Tongling Maternity Hospital, China, between January 2012 and December 2014 were reviewed. Information about CSEA, mode of delivery, labor duration, oxytocin augmentation, and neonatal outcome was obtained...
December 2016: International Journal of Gynaecology and Obstetrics
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
#12
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/27663486/the-use-of-pain-relief-during-labor-among-migrant-obstetric-populations
#13
Viera Husarova, Laura Macdarby, Patrick Dicker, Fergal D Malone, Conan L McCaul
OBJECTIVE: To identify patterns in intrapartum analgesia use in the migrant obstetric population. METHODS: A retrospective analysis included all deliveries with neonates above 500g in weight at a university hospital in Dublin, Ireland between 2009 and 2013. Analgesia was classified as neuraxial or non-neuraxial. Parturients were excluded owing to missing data, elective cesarean deliveries, and the use of analgesia during treatment for obstetric complications. RESULTS: There were 36 689 deliveries included in the present study...
November 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/27648611/von-willebrand-disease-and-pregnancy-a-review-of-evidence-and-expert-opinion
#14
Emily Reynen, Paula James
von Willebrand disease (VWD) is a common, inherited bleeding disorder. There are three main types of VWD, which result in a quantitative or qualitative deficiency in von Willebrand factor (VWF) and in severe cases, also Factor VIII (FVIII). The severity of bleeding depends on the underlying pathophysiology. Type 1 VWD is usually mild, while types 2 or 3 VWD can be associated with moderate or significant bleeding. Managing pregnant women with VWD requires a multidisciplinary approach. Such patients are at increased risk of postpartum hemorrhage...
September 20, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27641087/nine-year-audit-of-post-dural-puncture-headache-in-a-tertiary-obstetric-hospital-in-singapore
#15
J C Tien, M J Lim, W L Leong, E Lew
BACKGROUND: The KK Women's and Children's Hospital is a tertiary obstetric unit with approximately 11000 deliveries per year. Epidural analgesia is used in about 40% of laboring women. We reviewed the incidence and management of post-dural puncture headache over a nine-year period. METHODS: A retrospective audit of labor epidural analgesia database records from 1 June 2005 to 31 May 2014 was conducted, identifying an "event" as an accidental dural puncture, an inadvertent intrathecal catheter insertion and/or development of a post-dural puncture headache...
December 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27619509/remifentanil-for-labor-analgesia-a-comprehensive-review
#16
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/27608347/anaesthetists-experiences-with-the-early-labour-epidural-recommendation-for-obese-parturients-a-qualitative-study
#17
V A Eley, L K Callaway, A A J van Zundert, J Lipman, C Gallois
Caring for obese pregnant women presents challenges for all medical professionals. Despite a lack of supporting evidence, expert opinion and international guidelines suggest early labour epidural insertion for obese women. Anecdotally this is not supported by all anaesthetists. This qualitative study explored the experiences of anaesthetists regarding early epidural analgesia in obese parturients, to answer the research question: Are anaesthetists consistent in how they apply early epidural analgesia in obese parturients? Personal in-depth interviews with 42 specialist anaesthetists working in south-east Queensland, Australia, were completed between February and April, 2015...
September 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27608337/anaesthetic-management-of-obese-parturients-what-is-the-evidence-supporting-practice-guidelines
#18
V A Eley, A A J van Zundert, J Lipman, L K Callaway
Increasing rates of obesity in western populations present management difficulties for clinicians caring for obese pregnant women. Various governing bodies have published clinical guidelines for the care of obese parturients. These guidelines refer to two components of anaesthetic care: anaesthetic consultation in the antenatal period for women with a body mass index (BMI) ≥ 40 kg/m(2) and the provision of early epidural analgesia in labour. These recommendations are based on the increased incidence of obstetric complications and the predicted risks and difficulties in providing anaesthetic care...
September 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27592614/the-reseau-mater-an-efficient-infection-control-for-endometritis-but-not-for-urinary-tract-infection-after-vaginal-delivery
#19
Louis Ayzac, Emmanuelle Caillat-Vallet, Raphaële Girard, Michel Berland
"RESEAU MATER" is useful to monitor nosocomial infections in maternity and contributes to the decreasing trend of it, since its implementation. Specifically, this network demonstrates its efficiency in the control of endometritis following vaginal deliveries, but not in the control of urinary tract infections. The aim of this study is to determine whether the difference between the control of endometritis and of urinary tract infection could be explained by an unsuitable regression model or by an unsuitable care policy concerning urinary cares...
September 1, 2016: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/27580408/cerebrospinal-fluid-cutaneous-fistula-after-continuous-spinal-catheter-in-an-obstetric-patient
#20
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
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