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Labour Analgesia

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159 papers 100 to 500 followers A collection from an obstetric anesthesiologist with an interest in patient centred analgesia and new modalities
By Ron George Anesthesiologist with special interests in Obstetrics, Pain, and Global Health
https://www.readbyqxmd.com/read/27885658/early-skin-to-skin-contact-for-mothers-and-their-healthy-newborn-infants
#1
REVIEW
Elizabeth R Moore, Nils Bergman, Gene C Anderson, Nancy Medley
BACKGROUND: Mother-infant separation post birth is common. In standard hospital care, newborn infants are held wrapped or dressed in their mother's arms, placed in open cribs or under radiant warmers. Skin-to-skin contact (SSC) begins ideally at birth and should last continually until the end of the first breastfeeding. SSC involves placing the dried, naked baby prone on the mother's bare chest, often covered with a warm blanket. According to mammalian neuroscience, the intimate contact inherent in this place (habitat) evokes neuro-behaviors ensuring fulfillment of basic biological needs...
November 25, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27870739/performance-of-the-angle-labor-pain-questionnaire-during-initiation-of-epidural-analgesia-in-early-active-labor
#2
Pamela J Angle, Christine Kurtz Landy, Jasmine Djordjevic, Jon Barrett, Alanna Kibbe, Saiena Sriparamananthan, Yuna Lee, Lydia Hamata, Pearl Zaki, Alex Kiss
BACKGROUND: The Angle Labor Pain Questionnaire (A-LPQ) is a new, 22-item multidimensional psychometric questionnaire that measures the 5 most important dimensions of women's childbirth pain experiences using 5 subscales: The Enormity of the Pain, Fear/Anxiety, Uterine Contraction Pain, Birthing Pain, and Back Pain/Long Haul. Previous work showed that the A-LPQ has overall good psychometric properties and performance during early active labor in women without pain relief. The current study assessed the tool's sensitivity to change during initiation of labor epidural analgesia with the standardized response mean (SRM, primary outcome)...
December 2016: Anesthesia and Analgesia
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
#3
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
#4
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/27862689/applying-lean-six-sigma-methodology-to-reduce-cesarean-section-rate
#5
Ze-Ying Chai, Hua-Min Hu, Xiu-Ling Ren, Bao-Jin Zeng, Ling-Zhi Zheng, Feng Qi
OBJECTIVES: This study aims to reduce cesarean section rate and increase rate of vaginal delivery. METHODS: By using Lean Six Sigma (LSS) methodology, the cesarean section rate was investigated and analyzed through a 5-phase roadmap consisting of Define, Measure, Analyze, Improve, and Control. The principal causes of cesarean section were identified, improvement measures were implemented, and the rate of cesarean section before and after intervention was compared...
November 14, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27821151/-i-ve-changed-my-mind-mindfulness-based-childbirth-and-parenting-mbcp-for-pregnant-women-with-a-high-level-of-fear-of-childbirth-and-their-partners-study-protocol-of-the-quasi-experimental-controlled-trial
#6
Irena K Veringa, Esther I de Bruin, Nancy Bardacke, Larissa G Duncan, Francisca J A van Steensel, Carmen D Dirksen, Susan M Bögels
BACKGROUND: Approximately 25 % of pregnant women suffer from a high level of Fear of Childbirth (FoC), as assessed by the Wijma Delivery Expectancy Questionnaire (W-DEQ-A, score ≥66). FoC negatively affects pregnant women's mental health and adaptation to the perinatal period. Mindfulness-Based Childbirth and Parenting (MBCP) seems to be potentially effective in decreasing pregnancy-related anxiety and stress. We propose a theoretical model of Avoidance and Participation in Pregnancy, Birth and the Postpartum Period in order to explore FoC and to evaluate the underlying mechanisms of change of MBCP...
November 7, 2016: BMC Psychiatry
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
#7
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/27685468/the-angle-labor-pain-questionnaire-reliability-validity-sensitivity-to-change-and-responsiveness-during-early-active-labor-without-pain-relief
#8
Pamela Angle, Christine Kurtz Landy, Jasmine Djordjevic, Jon Barrett, Alanna Kibbe, Saiena Sriparamananthan, Yuna Lee, Lydia Hamata, Alex Kiss
OBJECTIVES: The Angle Labor Pain Questionnaire (A-LPQ) is a new, condition-specific, multidimensional psychometric instrument which measures the most important dimensions of women's childbirth pain experiences using 5 subscales: The Enormity of the Pain, Fear/Anxiety, Uterine Contraction Pain, Birthing Pain and Back Pain/Long Haul. This study assessed the A-LPQ's test-retest reliability during early active labor without pain relief. METHODS: Two versions of the A-LPQ were randomly administered during 2 test sessions separated by a 20 minute window...
September 28, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27628861/the-psychoprophylactic-method-of-painless-childbirth-in-socialist-czechoslovakia-from-state-propaganda-to-activism-of-enthusiasts
#9
Ema Hrešanová
This paper explores the history of the 'psychoprophylactic method of painless childbirth' in socialist Czechoslovakia, in particular, in the Czech and Moravian regions of the country, showing that it substantially differs from the course that the method took in other countries. This non-pharmacological method of pain relief originated in the USSR and became well known as the Lamaze method in western English-speaking countries. Use of the method in Czechoslovakia, however, followed a very different path from both the West, where its use was refined mainly outside the biomedical frame, and the USSR, where it ceased to be pursued as a scientific method in the 1950s after Stalin's death...
October 2016: Medical History
https://www.readbyqxmd.com/read/27378709/a-retrospective-review-of-an-epidural-blood-patch-database-the-incidence-of-epidural-blood-patch-associated-with-obstetric-neuraxial-anesthetic-techniques-and-the-effect-of-blood-volume-on-efficacy
#10
J L Booth, P H Pan, J A Thomas, L C Harris, R D'Angelo
BACKGROUND: The optimal volume of blood required to treat post-dural puncture headache remains in question. In our institution a target volume of 30mL is used for an epidural blood patch unless the patient experiences pain during injection. METHODS: The institutional database was retrospectively reviewed for epidural blood patch and delivery statistics over a 15-year period to determine if the volume of blood administered during the procedure directly correlated with the number of epidural blood patches administered...
June 3, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27574464/managing-anesthesia-for-cesarean-section-in-obese-patients-current-perspectives
#11
REVIEW
Agnes M Lamon, Ashraf S Habib
Obesity is a worldwide epidemic. It is associated with increased comorbidities and increased maternal, fetal, and neonatal complications. The risk of cesarean delivery is also increased in obese parturients. Anesthetic management of the obese parturient is challenging and requires adequate planning. Therefore, those patients should be referred to antenatal anesthetic consultation. Anesthesia-related complications and maternal mortality are increased in this patient population. The risk of difficult intubation is increased in obese patients...
2016: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/24257387/a-retrospective-assessment-of-the-incidence-of-respiratory-depression-after-neuraxial-morphine-administration-for-postcesarean-delivery-analgesia
#12
Theresa R Crowgey, Jennifer E Dominguez, Cathleen Peterson-Layne, Terrence K Allen, Holly A Muir, Ashraf S Habib
Respiratory depression can occur after neuraxial morphine administration. In the obstetric population, there are little data on respiratory depression after neuraxial morphine administration in women undergoing cesarean delivery. In this single-center, retrospective study in 5036 obstetric patients (mean body mass index = 34 kg/m) who underwent cesarean delivery and received neuraxial morphine, we did not identify any instances of respiratory depression requiring naloxone administration or rapid response team involvement...
December 2013: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/24149580/a-randomized-controlled-trial-of-the-efficacy-and-respiratory-effects-of-patient-controlled-intravenous-remifentanil-analgesia-and-patient-controlled-epidural-analgesia-in-laboring-women
#13
RANDOMIZED CONTROLLED TRIAL
Daniel Stocki, Idit Matot, Sharon Einav, Smadar Eventov-Friedman, Yehuda Ginosar, Carolyn F Weiniger
BACKGROUND: Safe and effective alternatives are required in labor when epidural analgesia is not appropriate. We hypothesized that patient-controlled IV remifentanil labor analgesia would not be inferior to patient-controlled epidural labor analgesia. METHODS: This randomized nonblinded controlled noninferiority study in healthy women with a singleton fetus and vertex presentation was performed at 1 site. Women were randomized to receive patient-controlled IV analgesia titrated from 20 mcg up to a maximum bolus dose of 60 mcg with a lockout interval of 1 to 2 minutes, or patient-controlled epidural analgesia 0...
March 2014: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/11035349/the-effect-of-a-rapid-change-in-availability-of-epidural-analgesia-on-the-cesarean-delivery-rate-a-meta-analysis
#14
S Segal, M Su, P Gilbert
OBJECTIVE: This study was undertaken to quantitatively estimate the effect of a rapid introduction or withdrawal of on-demand epidural analgesia on the cesarean delivery rate. STUDY DESIGN: MEDLINE and meeting abstracts were searched for studies reporting the cesarean delivery rate immediately before and after a rapid change in the availability of epidural analgesia. Nine studies reporting data on 37,753 patients were selected. Meta-analysis was performed to estimate the means and 95% confidence intervals for the changes in rates of total cesarean deliveries, cesarean deliveries among nulliparous women, cesarean deliveries for dystocia, and operative vaginal deliveries...
October 2000: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27551736/active-management-of-labor-epidural-analgesia-is-the-key-to-successful-conversion-of-epidural-analgesia-to-cesarean-delivery-anesthesia
#15
Melissa E Bauer, Jill M Mhyre
No abstract text is available yet for this article.
August 22, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27537928/risk-factors-for-unintended-dural-puncture-in-obstetric-patients-a-retrospective-cohort-study
#16
Sharon Orbach-Zinger, Eran Ashwal, Lilach Hazan, Danielle Bracco, Alex Ioscovich, Liran Hiersch, Andrey Khinchuck, Amir Aviram, Leonid A Eidelman
BACKGROUND: Unintended dural puncture (UDP) is one of the main risks of epidural analgesia, with a reported incidence of approximately 1.5% among the obstetric population. UDP is associated with maternal adverse outcomes, with the most frequent adverse outcome being postdural puncture headache (PDPH). Our retrospective cohort study objective was to identify demographic and obstetric risk factors that increase the risk of unintentional dural puncture as well as describing the obstetric outcome once a dural puncture has occurred...
October 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27529316/failure-to-extend-epidural-labor-analgesia-for-cesarean-delivery-anesthesia-a-focused-review
#17
Suzanne K W Mankowitz, Antonio Gonzalez Fiol, Richard Smiley
Extension of epidural labor analgesia for cesarean delivery anesthesia may fail. There are a number of factors associated with labor epidural catheter failure. This focused review discusses these associations and anesthetic options when faced with inadequate surgical epidural anesthesia for cesarean delivery.
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27443376/hypertensive-disorders-of-pregnancy
#18
Ana Sjaus, Dolores M McKeen, Ronald B George
PURPOSE: In this continuing professional development module, we review recent Society of Obstetricians and Gynaecologists of Canada (SOGC) guidelines for the classification and diagnosis of hypertensive disorders of pregnancy (HDP) as well as review the clinical features, laboratory investigations, and outcomes of HDP. We explore the evidence for anesthetic management and prevention of end-organ damage in women with HDP and describe the role and contribution of anesthesiologists as part of a multidisciplinary care team...
September 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27500349/risk-factors-for-dyspareunia-after-first-childbirth
#19
Natasha R Alligood-Percoco, Kristen H Kjerulff, John T Repke
OBJECTIVE: To investigate risk factors for dyspareunia among primiparous women. METHODS: This was a planned secondary analysis using data from the 1- and 6-month postpartum interviews of a prospective study of women who delivered their first neonate in Pennsylvania, 2009-2011. Participants who had resumed sexual intercourse by the 6-month interview (N=2,748) constituted the analytic sample. Women reporting a big or medium problem with painful intercourse at 6 months were categorized as having dyspareunia...
September 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27464978/implementation-of-programmed-intermittent-epidural-bolus-for-the-maintenance-of-labor-analgesia
#20
Brendan Carvalho, Ronald B George, Benjamin Cobb, Christine McKenzie, Edward T Riley
Programmed intermittent epidural bolus (PIEB) is an exciting new technology that has the potential to improve the maintenance of epidural labor analgesia. PIEB compared with a continuous epidural infusion (CEI) has the potential advantage of greater spread within the epidural space and therefore better sensory blockade. Studies have demonstrated a local anesthetic-sparing effect, fewer instrumental vaginal deliveries, less motor blockade, and improvements in maternal satisfaction with PIEB compared with CEI...
October 2016: Anesthesia and Analgesia
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