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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
#1
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/28040125/preoperative-measurement-of-maternal-abdominal-circumference-relates-the-initial-sensory-block-level-of-spinal-anesthesia-for-cesarean-section-an-observational-study
#2
Chi-Hang Kuok, Chung-Hsin Huang, Pei-Shan Tsai, Yuan-Pi Ko, Wei-Shih Lee, Yung-Wei Hsu, Fang-Yu Hung
OBJECTIVE: Lumbosacral cerebrospinal fluid volume is decreased as the enlarging uterus compresses the inferior vena cava during pregnancy. A subsequent greater cephalad spread of sensory blockade is observed. Gravid uterus plays a crucial role in affecting the spinal anesthesia level. We hypothesized that maternal abdominal circumference can reflect compressive effect of the uterus and investigated the relationship between abdominal circumference and the level of sensory blockade, and incidence of hypotension following spinal anesthesia with hyperbaric bupivacaine in term parturients...
December 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28033693/comparison-of-morphine-suppository-and-diclofenac-suppository-for-pain-management-after-elective-caesarean-section
#3
RANDOMIZED CONTROLLED TRIAL
Atossa Mahdavi, Zeinab Telkabadi, Ashraf Aleyasin, Marzieh Agha Hosseini, Leili Safdarian, Ali Momenzadeh
This study investigated efficacy and side effects of Morphine suppository for pain management after the first elective caesarean delivery in comparison to Diclofenac suppository. One hundred women aged 18-40 with term pregnancies undergoing elective caesarean section for the first time participated in this prospective project. Exclusion criteria included drug sensitivity, fetal malformations or defects, and complications during the cesarean operation. After same spinal anesthesia and same surgical techniques and in the recovery room patients consecutively received 100 mg diclofenac suppository or 10 mg morphine suppository...
November 2016: Acta Medica Iranica
https://www.readbyqxmd.com/read/28017175/anesthesia-for-cesarean-section-in-a-patient-with-isolated-unilateral-absence-of-a-pulmonary-artery
#4
Tomonori Furuya, Ryoji Iida, Jyumpei Konishi, Jitsu Kato, Takahiro Suzuki
BACKGROUND AND OBJECTIVES: Congenital unilateral absence of a pulmonary artery (UAPA) is a rare anomaly. Although there are several reports regarding pregnancy in patients with unilateral absence of a pulmonary artery, there are no case reports describing anesthesia for Cesarean section in a patient with unilateral absence of a pulmonary artery. CASE REPORT: We present a patient with unilateral absence of a pulmonary artery who underwent Cesarean sections twice at the ages of 24 and 26 years under spinal anesthesia for surgery and epidural analgesia for postoperative pain relief...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28013485/influence-of-saline-based-hydroxyethyl-starch-on-umbilical-cord-blood-electrolytes
#5
Tomoaki Yatabe, Atsushi Nishigaki, Takahiko Tamura, Masataka Yokoyama
Hydroxyethyl starch (HES) is widely used to prevent and treat spinal anesthesia-induced hypotension during cesarean section. However, the use of saline-based HES may lead to hyperchloremia. This study aimed to clarify the effects of saline-based HES on umbilical cord chloride level at delivery. We retrospectively analyzed 93 consecutive single-pregnancy patients who underwent cesarean section with combined spinal-epidural anesthesia. The patients were divided into two groups, depending on the use of 6% HES 130/0...
December 24, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27984230/transversus-abdominis-plane-block-versus-wound-infiltration-for-analgesia-after-cesarean-delivery-a-randomized-controlled-trial
#6
Mohamed Mohamed Tawfik, Yaser Mohamed Mohamed, Rania Elmohamadi Elbadrawi, Mostafa Abdelkhalek, Maiseloon Mostafa Mogahed, Hanaa Mohamed Ezz
BACKGROUND: Transversus abdominis plane (TAP) block and local anesthetic wound infiltration provide analgesia after cesarean delivery. Studies comparing the 2 techniques are scarce, with conflicting results. This double-blind, randomized controlled trial aimed to compare bilateral ultrasound-guided TAP block with single-shot local anesthetic wound infiltration for analgesia after cesarean delivery performed under spinal anesthesia. We hypothesized that the TAP block would decrease postoperative cumulative fentanyl consumption at 24 hours...
December 15, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27973611/publication-trends-in-acupuncture-research-a-20-year-bibliometric-analysis-based-on-pubmed
#7
Yan Ma, Ming Dong, Kehua Zhou, Carol Mita, Jianping Liu, Peter M Wayne
OBJECTIVE: Acupuncture has become popular and widely practiced in many countries around the world. Despite the large amount of acupuncture-related literature that has been published, broader trends in the prevalence and scope of acupuncture research remain underexplored. The current study quantitatively analyzes trends in acupuncture research publications in the past 20 years. METHODS: A bibliometric approach was used to search PubMed for all acupuncture-related research articles including clinical and animal studies...
2016: PloS One
https://www.readbyqxmd.com/read/27914146/pregnancy-and-delivery-in-a-generalized-dystonia-patient-treated-with-internal-globus-pallidal-deep-brain-stimulation-a-case-report
#8
Hye Ran Park, Jae Meen Lee, Hyeyoung Park, Chae Won Shin, Han Joon Kim, Hee Pyoung Park, Dong Gyu Kim, Beom Seok Jeon, Sun Ha Paek
Internal globus pallidus (GPi) deep brain stimulation (DBS) has been widely accepted as an effective treatment modality of medically refractory dystonia. However, there have been few studies regarding the safety issue of pregnancy and childbirth related with DBS. This report describes a female patient who was pregnant and delivered a baby after GPi DBS surgery. A 33-year-old female patient with acquired generalized dystonia underwent bilateral GPi DBS implantation. She obtained considerable improvement in both movement and disability after DBS implantation...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27829881/moyamoya-disease-in-pregnancy-and-delivery-planning-a-case-series-and-literature-review
#9
Erica Weston, Niharika Mehta
Moyamoya disease is a rare condition characterized by stenosis or occlusion of the intracranial internal carotid arteries leading to the development of fragile collateral vessels. Disruption of these vessels can lead to both ischemic and hemorrhagic strokes. As such, these patients are sensitive to changes in intracranial pressure and pose a challenge in pregnancy and delivery planning. Two cases of a parturients with moyamoya disease are presented, and the literature regarding safe method of delivery in similar patients is reviewed...
December 2016: Obstetric Medicine
https://www.readbyqxmd.com/read/27824749/treatment-decisions-at-the-time-of-miscarriage-diagnosis
#10
Courtney A Schreiber, Veronica Chavez, Paul G Whittaker, Sarah J Ratcliffe, Ebony Easley, Frances K Barg
OBJECTIVE: To describe the factors patients and physicians prioritize during first-trimester miscarriage management and assess what drives satisfaction with care. METHODS: We conducted a mixed-methods study of clinically stable women seeking surgical, medical, or expectant miscarriage treatment. Women with first-trimester fetal demise or anembryonic gestation (N=55) completed demographic and psychosocial surveys. Using purposive sampling, 45 (82%) completed in-depth interviews...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27816157/evaluation-and-management-of-maternal-cardiac-arrhythmias
#11
REVIEW
Torri D Metz, Amber Khanna
Pregnant women often complain of palpitations. The differential diagnosis for new-onset palpitations in pregnancy ranges from benign conditions to life-threatening arrhythmias. Maternal arrhythmias can occur in isolation or in the setting of underlying structural heart disease. Optimal management of maternal cardiac arrhythmias includes identification of the specific arrhythmia, diagnosis of comorbid conditions, and appropriate intervention. In general, management of maternal cardiac arrhythmias is similar to that of the general population...
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27810130/-surgical-methods-of-abortion
#12
T Linet
OBJECTIVE: A state of the art of surgical method of abortion focusing on safety and practical aspects. MATERIAL AND METHODS: A systematic review of French-speaking or English-speaking evidence-based literature about surgical methods of abortion was performed using Pubmed, Cochrane and international recommendations. RESULTS: Surgical abortion is efficient and safe regardless of gestational age, even before 7 weeks gestation (EL2). A systematic prophylactic antibiotics should be preferred to a targeted antibiotic prophylaxis (grade A)...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27804180/non-invasive-high-intensity-focused-ultrasound-treatment-of-the-placental-unit-preliminary-in-vivo-study-using-a-monkey-model-of-pregnancy
#13
J Caloone, C Huissoud, A Kocot, J Vincenot, C Dehay, P Giroud, P Misery, F Allias, R C Rudigoz, D Melodelima
OBJECTIVE: To demonstrate the feasibility and efficacy of high-intensity focused ultrasound (HIFU) to non-invasively treat placental tissues in a monkey model of pregnancy. MATERIALS AND METHODS: A toroidal HIFU transducer working at 2.5 MHz with an integrated ultrasound-imaging probe was used. Eight pregnant monkeys were exposed to HIFU treatment after anesthesia. Lesions on placental tissues were performed non-invasively by placing the HIFU probe on the skin. Fetal and maternal parameters, such as maternal heart rate, fetal heart rate, and subcutaneous and intra-amniotic fluid temperature, were recorded during HIFU exposure...
November 2, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27793852/acute-exposure-to-progesterone-attenuates-cardiac-contraction-by-modifying-myofilament-calcium-sensitivity-in-the-female-mouse-heart
#14
Hirad A Feridooni, Jennifer K MacDonald, Anjali Ghimire, W Glen Pyle, Susan E Howlett
: Acute application of progesterone attenuates cardiac contraction, although the underlying mechanisms are unclear. We investigated whether progesterone modified contraction in isolated ventricular myocytes and identified the Ca(2+) handling mechanisms involved in female C57BL/6 mice (6-9 mo; sodium pentobarbital anesthesia). Cells were field-stimulated (4 Hz; 37°C) and exposed to progesterone (0.001-10.0 μM) or vehicle (35 min). Ca(2+) transients (fura-2) and cell shortening were recorded simultaneously...
January 1, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27793386/imelda-transvaginal-approach-to-ectopic-pregnancy-diagnosis-by-transvaginal-hydrolaparoscopy-and-treatment-by-transvaginal-natural-orifice-transluminal-endoscopic-surgery
#15
Jan Baekelandt, Jona Vercammen
OBJECTIVE: To demonstrate a new minimally invasive approach for the diagnosis and treatment of ectopic pregnancy. DESIGN: Stepwise explanation of the technique using original video footage. SETTING: Hospital. PATIENT(S): Since 2014, 15 patients were treated transvaginally for ectopic pregnancy and pregnancy of unknown location (PUL). INTERVENTION(S): In case of a diagnosis of ectopic pregnancy on ultrasound, a 2...
January 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/27749354/continuous-peripheral-nerve-blocks-an-update-of-the-published-evidence-and-comparison-with-novel-alternative-analgesic-modalities
#16
Brian M Ilfeld
A continuous peripheral nerve block (CPNB) consists of a percutaneously inserted catheter with its tip adjacent to a target nerve/plexus through which local anesthetic may be administered, providing a prolonged block that may be titrated to the desired effect. In the decades after its first report in 1946, a plethora of data relating to CPNB was published, much of which was examined in a 2011 Anesthesia & Analgesia article. The current update is an evidence-based review of the CPNB literature published in the interim...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27738550/propofol-related-infusion-syndrome-in-the-peripartum-period
#17
Akwugo A Eziefule, Solafa Elshatanoufy, Mili Thakur, Frederico G Rocha
Background Propofol is a widely known, commonly used drug. Complications can occur with the use of this drug, including propofol-related infusion syndrome (PRIS). PRIS, in the obstetric population, has not been documented; however, we report a case of a patient who developed PRIS after an emergent cesarean delivery of a preterm infant. Case Study A 35-year-old multigravida woman presented complaining of leakage of fluid and decreased fetal movement. Her pregnancy was complicated by methadone maintenance therapy due to a history of opioid abuse...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27726424/ultrasound-guided-percutaneous-catheter-drainage-of-large-breast-abscesses-in-lactating-women-how-to-preserve-breastfeeding-safely
#18
Giuseppe Falco, Monica Foroni, Fabio Castagnetti, Luigi Marano, Daniele Bordoni, Nicola Rocco, Vanessa Marchesi, Valentina Iotti, Rita Vacondio, Guglielmo Ferrari
INTRODUCTION: Management of breast abscess in lactating women remains controversial. During pregnancy, women may develop different kinds of benign breast lesions that could require a surgical incision performed under general anesthesia with consequent breastfeeding interruption. The purpose of this study was to prospectively evaluate the management of large breast abscesses with ultrasound-assisted drainage aiming at breastfeeding preservation. MATERIALS AND METHODS: 34 lactating women with a diagnosis of unilateral breast abscess have been treated with an ultrasound (US)-assisted drainage of the abscess...
December 2016: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/27699729/the-management-of-factor-xi-deficiency-in-pregnancy
#19
Joanna Davies, Rezan Kadir
Management of factor XI (FXI) deficiency in pregnancy is complicated by lack of correlation between FXI level and bleeding risk. Clinicians should be vigilant about the potential for prolonged or excessive bleeding following miscarriage or termination of pregnancy, or postpartum hemorrhage (PPH). A multidisciplinary approach along with an individual care plan is recommended to prevent bleeding complications. Assessment of bleeding history, FXI level, and global tests of hemostasis can aid management decisions regarding hemostatic prophylaxis...
October 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27662063/delayed-neuraxial-hematoma-in-parturient-with-fontan-circulation-following-neuraxial-anesthesia-for-cesarean-section
#20
Chukwudi O Chiaghana, Justin M Bremer, Joshua W Sappenfield, Adam L Wendling
OBJECTIVE: Neuraxial hematoma is a rare complication of spinal or epidural anesthesia. However, variable coagulation factor defects are relatively common in patients with Fontan circulation, and may predispose such patients to either increased risk of thrombosis or coagulopathy. These defects may indirectly increase their risk of neuraxial hematoma. CASE REPORT: We report a case of delayed neuraxial hematoma after the start of full-dose anticoagulation for pulmonary embolus on a postpartum patient with Fontan physiology who had continuous spinal anesthesia for cesarean delivery 4 days earlier...
September 22, 2016: Regional Anesthesia and Pain Medicine
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