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Postcesarean analgesia

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16 papers 0 to 25 followers
Sarah Armstrong, Roshan Fernando
Neuraxial opioids are an integral part of obstetric anaesthesia and have contributed to greatly improved analgesia for labour and caesarean delivery, both intraoperatively and postoperatively. Despite these advantages, neuraxial opioids may be associated with a number of side effects, some of which (such as respiratory depression), although rare, may be associated with significant morbidity and mortality. The risk of respiratory depression appears to be increased with less lipophilic opioids such as morphine but can be reduced with careful patient selection and monitoring...
May 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Rose G Jannuzzi
OBJECTIVES: Opioid-induced pruritus is a common side effect of opioid treatment in patients with acute pain associated with surgery or childbirth. There are several options available to treat opioid-induced pruritus, including nalbuphine. However, it is not known whether nalbuphine offers greater efficacy in treating pruritus without attenuation of analgesia and an increase in the incidence of adverse outcomes. METHODS: A systematic search of studies assessing treatment efficacy of nalbuphine was conducted through Medline, PubMed, Cochrane Library, CINAHL, and ProQuest databases...
January 2016: Clinical Journal of Pain
Ylva Vladic Stjernholm, Annie Nyberg, Monica Cardell, Charlotte Höybye
INTRODUCTION: Maternal S-cortisol levels increase throughout pregnancy and peak in the third trimester. Even higher levels are seen during the physical stress of delivery. Since analgesia for women in labor has improved, it is possible that maternal stress during labor is reduced. The aim of this study was to compare maternal S-cortisol during vaginal delivery and elective cesarean section. MATERIALS AND METHODS: Twenty healthy women with spontaneous vaginal delivery and healthy women (n = 20) undergoing elective cesarean section were included in the study...
August 2016: Archives of Gynecology and Obstetrics
Rafael Blanco, Tarek Ansari, Emad Girgis
BACKGROUND: Effective postoperative analgesia after caesarean section is important because it enables early ambulation and facilitates breast-feeding. Several case reports have shown that local anaesthetic injection around the quadratus lumborum muscle is effective in providing pain relief after various abdominal operations and in patients with chronic pain. The quadratus lumborum block (QLB) is performed in close proximity to the surface and uses a fascial compartment path to extend the distribution of local anaesthesia into the posterior abdominal wall and paravertebral space...
November 2015: European Journal of Anaesthesiology
Elham Naghshineh, Samira Shiari, Mitra Jabalameli
BACKGROUND: Cesarean section is a major operation that can be the predictor of postoperative pain and discomfort and, therefore, providing the effective postoperative analgesia is an important factor to facilitate sooner movement of the patient, better care of infants. The aim of this study was to determine the preventive effect of ilioinguinal nerve block on pain after cesarean section. MATERIALS AND METHODS: In a randomized clinical trial study, 80 female candidates for cesarean section under general anesthesia were selected and divided into two groups...
2015: Advanced Biomedical Research
Hiroyiki Sumikura, Hidetomo Niwa, Masaki Sato, Tatsuo Nakamoto, Takashi Asai, Satoshi Hagihira
In this review, we describe the current consensus surrounding general anesthetic management for cesarean section. For induction of anesthesia, rapid-sequence induction using thiopental and suxamethonium has been the recommended standard for a long time. In recent years, induction of anesthesia using propofol, rocuronium, and remifentanil have been gaining popularity. To prevent aspiration pneumonia, a prolonged preoperative fasting and an application of cricoid pressure during induction of anesthesia have been recommended, but these practices may require revision...
April 2016: Journal of Anesthesia
Jessica L Booth, Lynnette C Harris, James C Eisenach, Peter H Pan
BACKGROUND: Improved pain control after cesarean delivery remains a challenging objective. Poorly treated acute pain following delivery is associated with an increased risk of chronic pain and depression. This study was conducted to determine whether the addition of systemic acetaminophen and an increased dose of intrathecal morphine would further reduce acute pain. The primary outcome was pain intensity with movement at 24 hours postoperatively. Secondary measures included persistent pain and depression at 8 weeks...
April 2016: Anesthesia and Analgesia
Waleed El-Khayat, Mohamed Elsharkawi, Amr Hassan
OBJECTIVE: To compare extra-abdominal repair of the uterine incision at cesarean delivery with in situ repair. METHODS: The present study was a double-blind randomized controlled trial conducted at a university hospital in Egypt during 2012-2013, and included women with an indication for cesarean delivery. Extra-abdominal repair was used in group 1 (n=500) and in situ repair in group 2 (n=500). The primary outcome measure was the surgery duration. RESULTS: Surgery duration was significantly longer in group 1 than group 2 (49...
November 2014: International Journal of Gynaecology and Obstetrics
Dolores M McKeen, Ronald B George, John Colin Boyd, Victoria M Allen, Aaron Pink
OBJECTIVES: Cesarean delivery is a common surgical procedure with anticipated substantial postoperative pain. The addition of a transversus abdominis plane block (TAPB) to a multimodal analgesic regimen that includes intrathecal morphine may provide improved early pain outcomes and decrease the risk of chronic post-surgical pain. The purpose of this research was to assess the ability of an ultrasound-guided TAPB with low-dose ropivacaine to decrease early postoperative pain, opioid consumption, and risk of developing persistent pain when compared with a placebo block...
July 2014: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
P Fusco, P Scimia, G Paladini, M Fiorenzi, E Petrucci, T Pozone, F Vacca, A Behr, M Micaglio, G Danelli, V Cofini, S Necozione, G Carta, F Petrini, F Marinangeli
Cesarean delivery is a major surgical procedure, after which a woman can experience substantial postoperative discomfort or pain. Inadequate postoperative analgesia is one of the most common reasons for poor patient satisfaction following cesarean delivery. Although spinal or systemic opioids are currently the gold standard to achieve effective analgesia, they are often associated with side effects. In the last few years there has been growing interest in abdominal plane blocks, with promising data on their efficacy...
February 2015: Minerva Anestesiologica
Jennifer E Dominguez, Ashraf S Habib
PURPOSE OF REVIEW: Neuraxial morphine is commonly used for analgesia after cesarean delivery, but is frequently associated with postoperative nausea and vomiting (PONV) and pruritus. This review describes the recent advances in the management of those side-effects. RECENT FINDINGS: Neuraxial-morphine-induced side-effects are dose related; therefore, the minimum effective dose should be used. Dexamethasone, 5HT3 receptor antagonists, antihistamines, and anticholinergics reduce the incidence of PONV, whereas metoclopramide 10 mg does not appear to be effective for PONV prophylaxis in this patient population...
June 2013: Current Opinion in Anaesthesiology
J Y Wong, B Carvalho, E T Riley
INTRODUCTION: Intrathecal morphine is highly effective for post-cesarean analgesia; however, the optimal dose is yet to be established. The aim of this study was to compare analgesia and side effects after a change in institutional practice to give 200 μg rather than 100 μg. METHODS: We conducted a retrospective chart review of 241 patients who had an elective cesarean delivery and received either 100 or 200 μg of intrathecal morphine. The primary outcome variables were mean and peak verbal pain scores (0-10) and analgesic use (milligram-morphine equivalents)...
January 2013: International Journal of Obstetric Anesthesia
Linda Le-Wendling, Barys Ihnatsenka, Allison Haller, Andrea T Esch, André P Boezaart
OBJECTIVE: Transversus abdominis plane blocks have been recently utilized for analgesia after cesarean delivery. However, little data concerning continuous transversus abdominis plane blocks has been reported in the existing literature. Available studies mainly examine the efficacy of single-injection blocks, and only one small case series has been published regarding continuous blocks for analgesia after cesarean delivery. First-hand experiences and observations of three acute pain medicine specialists who received a continuous transversus abdominis plane block for analgesia after cesarean delivery are presented...
February 2013: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Patricia O'Neill, Filipa Duarte, Isabel Ribeiro, Maria João Centeno, João Moreira
BACKGROUND: The infusion of local anesthetic in the surgical wound is helpful in the multimodal management of postoperative pain. We hypothesized that local anesthetic wound infusion after cesarean delivery would provide better pain control than epidural morphine analgesia. METHODS: Healthy, term women scheduled for elective cesarean delivery were included in this assessor-blinded, randomized study. Patients were randomly assigned to receive analgesia through a multiorifice wound catheter placed below the fascia and connected to a 5 mL/h ropivacaine 2 mg/mL infusion or an epidural bolus of morphine 2 mg every 12 hours...
January 2012: Anesthesia and Analgesia
Ghassan E Kanazi, Marie T Aouad, Faraj W Abdallah, Mohamad I Khatib, Al Moataz Billah F Adham, Diala W Harfoush, Sahar M Siddik-Sayyid
BACKGROUND: Ultrasound-guided transversus abdominis plane block is an effective method of providing pain relief after cesarean delivery. Neuraxial morphine is currently the "gold standard" treatment for pain after cesarean delivery. In this study we tested the hypothesis that subarachnoid morphine would provide more prolonged and superior analgesia than would transversus abdominis plane block in patients undergoing elective cesarean delivery. METHODS: In this prospective, double-blind study, 57 patients were randomly assigned to receive either subarachnoid morphine (group SAM; n = 28) or transversus abdominis plane block (group TAP; n = 29)...
August 2010: Anesthesia and Analgesia
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