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https://www.readbyqxmd.com/read/29147776/-pain-therapy-in-obstetrics
#1
J Wallenborn, I Kühnert, D O Chebac, P Kranke
Labor pains can be stronger than pain caused by fractures and as a result of fear and stress can even have a negative effect on the course of parturition. A proportion of 75% of all women in labor use one or more supportive forms of analgesia to relieve labor pains. The procedures used range from supportive non-pharmacological measures, single intramuscular or intravenous analgesics and a prolonged inhalative analgesia up to highly efficient neuraxial blocks. Non-pharmacological interventions are considered to be generally safe but poorly effective...
November 17, 2017: Der Schmerz
https://www.readbyqxmd.com/read/29135475/using-activity-trackers-to-quantify-postpartum-ambulation-a-prospective-observational-study-of-ambulation-after-regional-anesthesia-and-analgesia-interventions
#2
Julia Ma, Rachel Martin, Bokman Chan, Michael Gofeld, Michael P Geary, John G Laffey, Faraj W Abdallah
BACKGROUND: Early postoperative ambulation is associated with enhanced functional recovery, particularly in the postpartum population, but ambulation questionnaires are limited by recall bias. This observational study aims to objectively quantify ambulation after neuraxial anesthesia and analgesia for cesarean delivery and vaginal delivery, respectively, by using activity tracker technology. The hypothesis was that vaginal delivery is associated with greater ambulation during the first 24 h postdelivery, compared to cesarean delivery...
November 14, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29112650/maternal-pulse-pressure-and-the-risk-of-postepidural-complications-a-randomized-controlled-trial
#3
Justin R Lappen, Stephen A Myers, Norman Bolen, Brian M Mercer, Edward K S Chien
OBJECTIVE: To test the hypothesis that increasing the intravenous fluid bolus volume at the time of epidural placement in women with narrow pulse pressure would reduce postepidural fetal heart rate (FHR) abnormalities, hypotension, and resuscitative obstetric interventions. METHODS: We performed a single-center randomized controlled trial. Eligible participants were normotensive with a nonanomalous singleton gestation at or after 35 weeks and with a narrow pulse pressure (less than 45 mm Hg) on admission...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29107311/the-use-of-remifentanil-as-the-primary-agent-for-analgesia-in-parturients
#4
REVIEW
Bryan Anderson
Pain control in parturients can be particularly challenging for the hospital staff. To achieve optimal outcomes in anesthesia patients, it is important to consider multiple options for pain control, especially when traditional options pose a problem or are not options. In particular, there are parturient clients for whom the use of neuraxial anesthesia (epidural and spinal blockade) is not an option. One option that warrants consideration for patient centered anesthesia practice is the use of remifentanil.
December 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29105108/obesity-and-complications-from-neuraxial-analgesia-we-need-to-know-more
#5
EDITORIAL
Leonie Callaway, Victoria Eley
No abstract text is available yet for this article.
November 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/29099429/the-society-for-obstetric-anesthesia-and-perinatology-consensus-statement-on-the-anesthetic-management-of-pregnant-and-postpartum-women-receiving-thromboprophylaxis-or-higher-dose-anticoagulants
#6
Lisa Leffert, Alexander Butwick, Brendan Carvalho, Katherine Arendt, Shannon M Bates, Alex Friedman, Terese Horlocker, Timothy Houle, Ruth Landau, Heloise Dubois, Roshan Fernando, Tim Houle, Sandra Kopp, Douglas Montgomery, Joseph Pellegrini, Richard Smiley, Paloma Toledo
Venous thromboembolism is recognized as a leading cause of maternal death in the United States. Thromboprophylaxis has been highlighted as a key preventive measure to reduce venous thromboembolism-related maternal deaths. However, the expanded use of thromboprophylaxis in obstetrics will have a major impact on the use and timing of neuraxial analgesia and anesthesia for women undergoing vaginal or cesarean delivery and other obstetric surgeries. Experts from the Society of Obstetric Anesthesia and Perinatology, the American Society of Regional Anesthesia, and hematology have collaborated to develop this comprehensive, pregnancy-specific consensus statement on neuraxial procedures in obstetric patients receiving thromboprophylaxis or higher dose anticoagulants...
November 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29073508/lower-limbs-venous-compression-reduces-the-incidence-of-maternal-hypotension-following-epidural-analgesia-during-term-labor
#7
Violaine Peyronnet, Arnaud Roses, Aude Girault, Marie Pierre Bonnet, Francois Goffinet, Vassilis Tsatsaris, Edouard Lecarpentier
OBJECTIVE(S): Every year in France, 10% to 20% of the 600 000 women given epidural analgesia during labor experience hypotension, which in 15% of cases is associated with fetal heart rate abnormalities. The efficiency of lower limbs venous compression in preventing the occurrence of maternal hypotension after neuraxial anesthesia has already been demonstrated, but only in the context of scheduled cesarean section. We assessed the preventive effect of medical lower limbs venous compression on the incidence of maternal hypotension after epidural analgesia during spontaneous term labor...
October 16, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29063607/spinal-or-general-anaesthesia-for-lower-limb-amputation-in-peripheral-artery-disease-a-retrospective-cohort-study
#8
M Niskakangas, S Dahlbacka, J Liisanantti, M Vakkala, T Kaakinen
BACKGROUND: The present study aimed to determine which method of anaesthesia (spinal anaesthesia or general anaesthesia) is better in reducing post-operative analgesic requirements in patients undergoing major limb amputation for lower-limb ischaemia. Another aim was to find out if anaesthesiologists use neuraxial anaesthesia in high-risk patients despite abnormal coagulation profile or use of anticoagulation. METHODS: The study was a retrospective cohort study...
October 24, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28991063/dose-response-curves-for-intrathecal-bupivacaine-levobupivacaine-and-ropivacaine-given-for-labor-analgesia-in-nulliparous-women
#9
Warwick D Ngan Kee, Floria F Ng, Kim S Khaw, Shannon P Y Tang, Alison G P Koo
BACKGROUND AND OBJECTIVES: Bupivacaine, levobupivacaine, and ropivacaine are often given intrathecally for labor analgesia, but limited data are available for their dose-response properties in this context. The objective of this study was to describe the dose-response curves of these local anesthetics when given intrathecally for labor analgesia, to determine values for D50 (dose producing a 50% response) and to compare the calculated values of D50 for levobupivacaine and ropivacaine with those for bupivacaine...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28940900/successful-control-of-pain-from-malignant-psoas-syndrome-by-spinal-opioid-with-local-anesthetic-agents
#10
Takashi Yamaguchi, Katsuyuki Katayama, Mina Matsumoto, Yoshifumi Sato, Noriko Nakayama, Ko Hisahara
BACKGROUNDS: Malignant psoas syndrome (MPS) is a rare but distressing pain syndrome observed in advanced cancer patients. Pain due to MPS is often refractory to multi-modal analgesic treatment, including opioid analgesics. As only one case demonstrating the efficacy of neuraxial analgesia in managing pain due to MPS has been reported, its role in MPS remains uncertain. CASES: We present three cases demonstrating the successful management of pain due to MPS using spinal opioids with local anesthetic agents...
September 23, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28936908/central-neuraxial-analgesia-for-labor-an-update-of-the-literature
#11
Serena Sodha, Alexandra Reeve, Roshan Fernando
Numerous techniques are in use to provide analgesia for labor, of which central neuraxial block is widely considered superior to non-neuraxial options. Central neuraxial techniques have evolved over many years to provide greater efficacy, safety and maternal satisfaction. This narrative review focuses on the literature relating to central neuraxial labor analgesia from the past 5 years, from November 2010 to October 2015. We discuss the evidence related to the various central neuraxial techniques used, the increasingly widespread use of ultrasound guidance and the evidence surrounding other novel methods of central neuraxial block insertion...
September 2017: Pain Management
https://www.readbyqxmd.com/read/28926440/epidural-labor-analgesia-fentanyl-dose-and-breastfeeding-success-a-randomized-clinical-trial
#12
RANDOMIZED CONTROLLED TRIAL
Amy I Lee, Robert J McCarthy, Paloma Toledo, Mary Jane Jones, Nancy White, Cynthia A Wong
BACKGROUND: Breastfeeding is an important public health concern. High cumulative doses of epidural fentanyl administered for labor analgesia have been reported to be associated with early termination of breastfeeding. We tested the hypothesis that breastfeeding success is adversely influenced by the cumulative epidural fentanyl dose administered for labor analgesia. METHODS: The study was a randomized, double-blind, controlled trial of parous women at greater than 38 weeks gestation who planned to breastfeed, had successfully breastfed a prior infant, and who received neuraxial labor analgesia...
October 2017: Anesthesiology
https://www.readbyqxmd.com/read/28922227/incidence-and-risk-factors-of-coagulation-profile-derangement-after-liver-surgery-implications-for-the-use-of-epidural-analgesia-a-retrospective-cohort-study
#13
Pierre Jacquenod, Grégoire Wallon, Mathieu Gazon, Benjamin Darnis, Pierre Pradat, Victor Virlogeux, Olivier Farges, Frédéric Aubrun
BACKGROUND: Hepatic surgery is a major abdominal surgery. Epidural analgesia may decrease the incidence of postoperative morbidities. Hemostatic disorders frequently occur after hepatic resection. Insertion or withdrawal (whether accidental or not) of an epidural catheter during coagulopathic state may cause an epidural hematoma. The aim of the study is to determine the incidence of coagulopathy after hepatectomy, interfering with epidural catheter removal, and to identify the risk factors related to coagulopathy...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28919152/erector-spinae-plane-esp-block-in-the-management-of-post-thoracotomy-pain-syndrome-a-case-series
#14
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
BACKGROUND AND AIMS: Post thoracotomy pain syndrome (PTPS) remains a common complication of thoracic surgery with significant impact on patients' quality of life. Management usually involves a multidisciplinary approach that includes oral and topical analgesics, performing appropriate interventional techniques, and coordinating additional care such as physiotherapy, psychotherapy and rehabilitation. A variety of interventional procedures have been described to treat PTPS that is inadequately managed with systemic or topical analgesics...
September 11, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28915426/intravenous-dexamethasone-as-an-adjunct-to-improve-labor-analgesia-a-randomized-double-blinded-placebo-controlled-clinical-trial
#15
Pratibha Dube, Sukanya Mitra, Jasveer Singh, Richa Saroa, Reeti Mehra
OBJECTIVE: To study the role of intravenous (i.v.) dexamethasone as an analgesic adjunct in labor analgesia. DESIGN: Double-blinded randomized controlled trial. SETTING: Labor analgesia in a tertiary-care teaching hospital. PATIENTS: Eighty consenting ASA I-II parturients, age>18year, nulliparous, single gestation, cephalic presentation at ≥36 wk. of gestation, in early spontaneous labor (cervical dilatation≤5cm) requesting epidural analgesia...
September 12, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28894976/implicating-anaesthesia-and-the-perioperative-period-in-cancer-recurrence-and-metastasis
#16
Julia A Dubowitz, Erica K Sloan, Bernhard J Riedel
Cancer, currently the leading cause of death in the population aged less than 85 years, poses a significant global disease burden and is anticipated to continue to increase in incidence in both developed and developing nations. A substantial proportion of cancers are amenable to surgery, with more than 60% of patients undergoing tumour resection. Up to 80% of patients will receive anaesthesia for diagnostic, therapeutic or palliative intervention. Alarmingly, retrospective studies have implicated surgical stress in disease progression that is predominantly characterised by metastatic disease-the primary cause of cancer-associated mortality...
September 11, 2017: Clinical & Experimental Metastasis
https://www.readbyqxmd.com/read/28863031/association-between-intrapartum-magnesium-administration-and-the-incidence-of-maternal-fever-a-retrospective-cross-sectional-study
#17
Elizabeth M S Lange, Scott Segal, Carlo Pancaro, Cynthia A Wong, William A Grobman, Gregory B Russell, Paloma Toledo
BACKGROUND: Intrapartum maternal fever is associated with several adverse neonatal outcomes. Intrapartum fever can be infectious or inflammatory in etiology. Increases in interleukin 6 and other inflammatory markers are associated with maternal fever. Magnesium has been shown to attenuate interleukin 6-mediated fever in animal models. We hypothesized that parturients exposed to intrapartum magnesium would have a lower incidence of fever than nonexposed parturients. METHODS: In this study, electronic medical record data from all deliveries at Northwestern Memorial Hospital (Chicago, Illinois) between 2007 and 2014 were evaluated...
December 2017: Anesthesiology
https://www.readbyqxmd.com/read/28858898/the-accuracy-of-a-handheld-ultrasound-device-for-neuraxial-depth-and-landmark-assessment-a-prospective-cohort-trial
#18
Katherine M Seligman, Carolyn F Weiniger, Brendan Carvalho
This study investigated the accuracy of a wireless handheld ultrasound with pattern recognition software that recognizes lumbar spine bony landmarks and measures depth to epidural space (Accuro, Rivanna Medical, Charlottesville, VA) (AU). AU measurements to epidural space were compared to Tuohy needle depth to epidural space (depth to loss of resistance at epidural placement). Data from 47 women requesting labor epidural analgesia were analyzed. The mean difference between depth to epidural space measured by AU versus needle depth was -0...
August 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28797894/neuraxial-magnesium-sulfate-improves-postoperative-analgesia-in-cesarean-section-delivery-women-a-meta-analysis-of-randomized-controlled-trials
#19
Shih-Ching Wang, Po-Ting Pan, Hsiao-Yean Chiu, Chun-Jen Huang
BACKGROUND: We conducted this meta-analysis to elucidate whether additional neuraxial magnesium sulfate (MgSO4) can improve postoperative analgesia in women undergoing Cesarean section (CS) delivery. METHOD: We searched Pubmed, Embase and ClinicalTrial.gov. We included only randomized controlled trials that have compared the quality of postoperative analgesia with and without additional neuraxial MgSO4 in women undergoing CS delivery with neuraxial anesthesia regimens...
July 29, 2017: Asian J Anesthesiol
https://www.readbyqxmd.com/read/28781763/modern-neuraxial-anesthesia-for-labor-and-delivery
#20
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
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