Methods of PAIN relief that may be used with or in place of ANALGESICS.
The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. It is differentiated from ANESTHESIA, EPIDURAL which refers to the state of insensitivity to sensation.
The elimination of PAIN, without the loss of CONSCIOUSNESS, during OBSTETRIC LABOR; OBSTETRIC DELIVERY; or the POSTPARTUM PERIOD, usually through the administration of ANALGESICS.
Relief of PAIN, without loss of CONSCIOUSNESS, through ANALGESIC AGENTS administered by the patients. It has been used successfully to control POSTOPERATIVE PAIN, during OBSTETRIC LABOR, after BURNS, and in TERMINAL CARE. The choice of agent, dose, and lockout interval greatly influence effectiveness. The potential for overdose can be minimized by combining small bolus doses with a mandatory interval between successive doses (lockout interval).
Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.
Pain during the period after surgery.
The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle.
Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.
A widely used local anesthetic agent.
Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.
Analgesia produced by the insertion of ACUPUNCTURE needles at certain ACUPUNCTURE POINTS on the body. This activates small myelinated nerve fibers in the muscle which transmit impulses to the spinal cord and then activate three centers - the spinal cord, midbrain and pituitary/hypothalamus - to produce analgesia.
A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)
Compounds capable of relieving pain without the loss of CONSCIOUSNESS.
Procedure in which an anesthetic is injected into the epidural space.
A narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. Prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration.
Pain associated with OBSTETRIC LABOR in CHILDBIRTH. It is caused primarily by UTERINE CONTRACTION as well as pressure on the CERVIX; BLADDER; and the GASTROINTESTINAL TRACT. Labor pain mostly occurs in the ABDOMEN; the GROIN; and the BACK.
An opioid analgesic that is used as an adjunct in anesthesia, in balanced anesthesia, and as a primary anesthetic agent.
An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS.
Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain.
Introduction of therapeutic agents into the spinal region using a needle and syringe.
The repetitive uterine contraction during childbirth which is associated with the progressive dilation of the uterine cervix (CERVIX UTERI). Successful labor results in the expulsion of the FETUS and PLACENTA. Obstetric labor can be spontaneous or induced (LABOR, INDUCED).
A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth.
Organic compounds containing the -CO-NH2 radical. Amides are derived from acids by replacement of -OH by -NH2 or from ammonia by the replacement of H by an acyl group. (From Grant & Hackh's Chemical Dictionary, 5th ed)
Procedure in which an anesthetic is injected directly into the spinal cord.
A narcotic analgesic proposed for severe pain. It may be habituating.
A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.
A subclass of analgesic agents that typically do not bind to OPIOID RECEPTORS and are not addictive. Many non-narcotic analgesics are offered as NONPRESCRIPTION DRUGS.
A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors.
Extraction of the FETUS by means of abdominal HYSTEROTOMY.
Emesis and queasiness occurring after anesthesia.
Amount of stimulation required before the sensation of pain is experienced.
Injection of ANALGESICS; LOCAL ANESTHETICS; or NARCOTICS into the PLEURAL CAVITY between the two pleural membranes.
Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from DRUG RESISTANCE wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from MAXIMUM TOLERATED DOSE and NO-OBSERVED-ADVERSE-EFFECT LEVEL.
A class of opioid receptors recognized by its pharmacological profile. Mu opioid receptors bind, in decreasing order of affinity, endorphins, dynorphins, met-enkephalin, and leu-enkephalin. They have also been shown to be molecular receptors for morphine.
Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.
A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines)
A pyrrolizine carboxylic acid derivative structurally related to INDOMETHACIN. It is an NSAID and is used principally for its analgesic activity. (From Martindale The Extra Pharmacopoeia, 31st ed)
Period from the onset of true OBSTETRIC LABOR to the complete dilatation of the CERVIX UTERI.
An opioid analgesic made from MORPHINE and used mainly as an analgesic. It has a shorter duration of action than morphine.
A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE.
A form of therapy that employs a coordinated and interdisciplinary approach for easing the suffering and improving the quality of life of those experiencing pain.
Epidural anesthesia administered via the sacral canal.
An imidazoline sympatholytic agent that stimulates ALPHA-2 ADRENERGIC RECEPTORS and central IMIDAZOLINE RECEPTORS. It is commonly used in the management of HYPERTENSION.
Medical methods of either relieving pain caused by a particular condition or removing the sensation of pain during a surgery or other medical procedure.
A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (RECEPTORS, N-METHYL-D-ASPARTATE) and may interact with sigma receptors.
A nerve originating in the lumbar spinal cord (usually L2 to L4) and traveling through the lumbar plexus to provide motor innervation to extensors of the thigh and sensory innervation to parts of the thigh, lower leg, and foot, and to the hip and knee joints.
Cell membrane proteins that bind opioids and trigger intracellular changes which influence the behavior of cells. The endogenous ligands for opioid receptors in mammals include three families of peptides, the enkephalins, endorphins, and dynorphins. The receptor classes include mu, delta, and kappa receptors. Sigma receptors bind several psychoactive substances, including certain opioids, but their endogenous ligands are not known.
The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.
A diphenylpropylamine with intense narcotic analgesic activity of long duration. It is a derivative of MEPERIDINE with similar activity and usage.
Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety.
A synthetic morphinan analgesic with narcotic antagonist action. It is used in the management of severe pain.
A short-acting opioid anesthetic and analgesic derivative of FENTANYL. It produces an early peak analgesic effect and fast recovery of consciousness. Alfentanil is effective as an anesthetic during surgery, for supplementation of analgesia during surgical procedures, and as an analgesic for critically ill patients.
A narcotic used as a pain medication. It appears to be an agonist at kappa opioid receptors and an antagonist or partial agonist at mu opioid receptors.
Agents inhibiting the effect of narcotics on the central nervous system.
The use of two or more chemicals simultaneously or sequentially to induce anesthesia. The drugs need not be in the same dosage form.
Injection of an anesthetic into the nerves to inhibit nerve transmission in a specific part of the body.
Surgical incision into the chest wall.
The endogenous peptides with opiate-like activity. The three major classes currently recognized are the ENKEPHALINS, the DYNORPHINS, and the ENDORPHINS. Each of these families derives from different precursors, proenkephalin, prodynorphin, and PRO-OPIOMELANOCORTIN, respectively. There are also at least three classes of OPIOID RECEPTORS, but the peptide families do not map to the receptors in a simple way.
A form of acupuncture with electrical impulses passing through the needles to stimulate NERVE TISSUE. It can be used for ANALGESIA; ANESTHESIA; REHABILITATION; and treatment for diseases.
A local anesthetic that is chemically related to BUPIVACAINE but pharmacologically related to LIDOCAINE. It is indicated for infiltration, nerve block, and epidural anesthesia. Mepivacaine is effective topically only in large doses and therefore should not be used by this route. (From AMA Drug Evaluations, 1994, p168)
An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief.
An IBUPROFEN-type anti-inflammatory analgesic and antipyretic. It is used in the treatment of rheumatoid arthritis and osteoarthritis.
Agents that are administered in association with anesthetics to increase effectiveness, improve delivery, or decrease required dosage.
An effect usually, but not necessarily, beneficial that is attributable to an expectation that the regimen will have an effect, i.e., the effect is due to the power of suggestion.
Analogs or derivatives of morphine.
An increased sensation of pain or discomfort produced by mimimally noxious stimuli due to damage to soft tissue containing NOCICEPTORS or injury to a peripheral nerve.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
A blocking of nerve conduction to a specific area by an injection of an anesthetic agent.
Central gray matter surrounding the CEREBRAL AQUEDUCT in the MESENCEPHALON. Physiologically it is probably involved in RAGE reactions, the LORDOSIS REFLEX; FEEDING responses, bladder tonus, and pain.
Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream.
The first mixed agonist-antagonist analgesic to be marketed. It is an agonist at the kappa and sigma opioid receptors and has a weak antagonist action at the mu receptor. (From AMA Drug Evaluations Annual, 1991, p97)
The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)
A imidazole derivative that is an agonist of ADRENERGIC ALPHA-2 RECEPTORS. It is closely-related to MEDETOMIDINE, which is the racemic form of this compound.
Surgery performed on an outpatient basis. It may be hospital-based or performed in an office or surgicenter.
Excision of the uterus.
A family of hexahydropyridines.
The relationship between the dose of an administered drug and the response of the organism to the drug.
The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon.
Persistent pain that is refractory to some or all forms of treatment.
A semisynthetic derivative of CODEINE.
The process by which PAIN is recognized and interpreted by the brain.
The injection of drugs, most often analgesics, into the spinal canal without puncturing the dura mater.
Analgesic antipyretic derivative of acetanilide. It has weak anti-inflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage.
Process of administering an anesthetic through injection directly into the bloodstream.
Intravenous anesthetics that induce a state of sedation, immobility, amnesia, and marked analgesia. Subjects may experience a strong feeling of dissociation from the environment. The condition produced is similar to NEUROLEPTANALGESIA, but is brought about by the administration of a single drug. (From Gilman et al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed)
A local anesthetic that is similar pharmacologically to LIDOCAINE. Currently, it is used most often for infiltration anesthesia in dentistry.
Peripheral AFFERENT NEURONS which are sensitive to injuries or pain, usually caused by extreme thermal exposures, mechanical forces, or other noxious stimuli. Their cell bodies reside in the DORSAL ROOT GANGLIA. Their peripheral terminals (NERVE ENDINGS) innervate target tissues and transduce noxious stimuli via axons to the CENTRAL NERVOUS SYSTEM.
Delivery of the FETUS and PLACENTA under the care of an obstetrician or a health worker. Obstetric deliveries may involve physical, psychological, medical, or surgical interventions.
Medical problems associated with OBSTETRIC LABOR, such as BREECH PRESENTATION; PREMATURE OBSTETRIC LABOR; HEMORRHAGE; or others. These complications can affect the well-being of the mother, the FETUS, or both.
A cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. Neostigmine, unlike PHYSOSTIGMINE, does not cross the blood-brain barrier.
Dull or sharp aching pain caused by stimulated NOCICEPTORS due to tissue injury, inflammation or diseases. It can be divided into somatic or tissue pain and VISCERAL PAIN.
Injections made into a vein for therapeutic or experimental purposes.
Extraction of the fetus by means of obstetrical instruments.
A drug that has analgesic, anti-inflammatory, and antipyretic properties. It is the sodium sulfonate of AMINOPYRINE.
Anti-inflammatory agents that are non-steroidal in nature. In addition to anti-inflammatory actions, they have analgesic, antipyretic, and platelet-inhibitory actions.They act by blocking the synthesis of prostaglandins by inhibiting cyclooxygenase, which converts arachidonic acid to cyclic endoperoxides, precursors of prostaglandins. Inhibition of prostaglandin synthesis accounts for their analgesic, antipyretic, and platelet-inhibitory actions; other mechanisms may contribute to their anti-inflammatory effects.
A cylindrical column of tissue that lies within the vertebral canal. It is composed of WHITE MATTER and GRAY MATTER.
Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience.
The space between the arachnoid membrane and PIA MATER, filled with CEREBROSPINAL FLUID. It contains large blood vessels that supply the BRAIN and SPINAL CORD.
Agents that induce NARCOSIS. Narcotics include agents that cause somnolence or induced sleep (STUPOR); natural or synthetic derivatives of OPIUM or MORPHINE or any substance that has such effects. They are potent inducers of ANALGESIA and OPIOID-RELATED DISORDERS.
Methods of delivering drugs into a joint space.
An opioid analgesic related to MORPHINE but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough.
Non-narcotic analgesic chemically similar to ORPHENADRINE. Its mechanism of action is unclear. It is used for the relief of acute and chronic pain. (From Martindale, The Extra Pharmacopoeia, 30th ed, p26)
The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.
The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it.
A derivative of the opioid alkaloid THEBAINE that is a more potent and longer lasting analgesic than MORPHINE. It appears to act as a partial agonist at mu and kappa opioid receptors and as an antagonist at delta receptors. The lack of delta-agonist activity has been suggested to account for the observation that buprenorphine tolerance may not develop with chronic use.
Interventions to provide care prior to, during, and immediately after surgery.
A narcotic analgesic that may be habit-forming. It is a controlled substance (opium derivative) listed in the U.S. Code of Federal Regulations, Title 21 Parts 329.1, 1308.11 (1987). Sale is forbidden in the United States by Federal statute. (Merck Index, 11th ed)
A method, developed by Dr. Virginia Apgar, to evaluate a newborn's adjustment to extrauterine life. Five items - heart rate, respiratory effort, muscle tone, reflex irritability, and color - are evaluated 60 seconds after birth and again five minutes later on a scale from 0-2, 0 being the lowest, 2 being normal. The five numbers are added for the Apgar score. A score of 0-3 represents severe distress, 4-7 indicates moderate distress, and a score of 7-10 predicts an absence of difficulty in adjusting to extrauterine life.
Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.
The insertion of drugs into the rectum, usually for confused or incompetent patients, like children, infants, and the very old or comatose.
A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.
The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few - MORPHINE; CODEINE; and PAPAVERINE - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic.
The period of emergence from general anesthesia, where different elements of consciousness return at different rates.
A class of opioid receptors recognized by its pharmacological profile. Kappa opioid receptors bind dynorphins with a higher affinity than endorphins which are themselves preferred to enkephalins.
A class of opioid receptors recognized by its pharmacological profile. Delta opioid receptors bind endorphins and enkephalins with approximately equal affinity and have less affinity for dynorphins.
Fluid propulsion systems driven mechanically, electrically, or osmotically that are used to inject (or infuse) over time agents into a patient or experimental animal; used routinely in hospitals to maintain a patent intravenous line, to administer antineoplastic agents and other drugs in thromboembolism, heart disease, diabetes mellitus (INSULIN INFUSION SYSTEMS is also available), and other disorders.
A 31-amino acid peptide that is the C-terminal fragment of BETA-LIPOTROPIN. It acts on OPIOID RECEPTORS and is an analgesic. Its first four amino acids at the N-terminal are identical to the tetrapeptide sequence of METHIONINE ENKEPHALIN and LEUCINE ENKEPHALIN.
An enkephalin analog that selectively binds to the MU OPIOID RECEPTOR. It is used as a model for drug permeability experiments.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
That portion of the body that lies between the THORAX and the PELVIS.
Elements of limited time intervals, contributing to particular results or situations.
Forceful administration into a muscle of liquid medication, nutrient, or other fluid through a hollow needle piercing the muscle and any tissue covering it.
A semisynthetic analgesic used in the study of narcotic receptors.
Drugs that selectively bind to and activate alpha adrenergic receptors.
Sensing of noxious mechanical, thermal or chemical stimuli by NOCICEPTORS. It is the sensory component of visceral and tissue pain (NOCICEPTIVE PAIN).
Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of NALOXONE. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence.
Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture.
A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.
One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla.
The administration of liquid medication, nutrient, or other fluid through some other route than the alimentary canal, usually over minutes or hours, either by gravity flow or often by infusion pumping.
One of the three major groups of endogenous opioid peptides. They are large peptides derived from the PRO-OPIOMELANOCORTIN precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; OPIOID PEPTIDES is used for the broader group.
An intravenous anesthetic agent which has the advantage of a very rapid onset after infusion or bolus injection plus a very short recovery period of a couple of minutes. (From Smith and Reynard, Textbook of Pharmacology, 1992, 1st ed, p206). Propofol has been used as ANTICONVULSANTS and ANTIEMETICS.
Ultrashort-acting anesthetics that are used for induction. Loss of consciousness is rapid and induction is pleasant, but there is no muscle relaxation and reflexes frequently are not reduced adequately. Repeated administration results in accumulation and prolongs the recovery time. Since these agents have little if any analgesic activity, they are seldom used alone except in brief minor procedures. (From AMA Drug Evaluations Annual, 1994, p174)
A short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. It is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. The short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. It is water-soluble at pH less than 4 and lipid-soluble at physiological pH.
Compounds based on a partially saturated iminoethanophenanthrene, which can be described as ethylimino-bridged benzo-decahydronaphthalenes. They include some of the OPIOIDS found in PAPAVER that are used as ANALGESICS.
Surgery performed on the female genitalia.
The observable response an animal makes to any situation.
A range of methods used to reduce pain and anxiety during dental procedures.
Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve.
Trained lay women who provide emotional and/or physical support during obstetric labor and the postpartum period for mothers and their partners.
The period of OBSTETRIC LABOR that is from the complete dilatation of the CERVIX UTERI to the expulsion of the FETUS.
A non-steroidal anti-inflammatory agent (ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL) similar in mode of action to INDOMETHACIN.
A cyclooxygenase inhibiting, non-steroidal anti-inflammatory agent (NSAID) that is well established in treating rheumatoid arthritis and osteoarthritis and used for musculoskeletal disorders, dysmenorrhea, and postoperative pain. Its long half-life enables it to be administered once daily.
Designated locations along nerves or organ meridians for inserting acupuncture needles.
The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= OXYGEN CONSUMPTION) or cell respiration (= CELL RESPIRATION).
Procedures used to treat and correct deformities, diseases, and injuries to the MUSCULOSKELETAL SYSTEM, its articulations, and associated structures.
Intensely discomforting, distressful, or agonizing sensation associated with trauma or disease, with well-defined location, character, and timing.
Injections into the cerebral ventricles.
An opioid analgesic with actions and uses similar to those of MORPHINE, apart from an absence of cough suppressant activity. It is used in the treatment of moderate to severe pain, including pain in obstetrics. It may also be used as an adjunct to anesthesia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1092)
Procedure in which an individual is induced into a trance-like state to relieve pain. This procedure is frequently performed with local but not general ANESTHESIA.
Space between the dura mater and the walls of the vertebral canal.
The period following a surgical operation.
Replacement of the knee joint.
A butyrophenone with general properties similar to those of HALOPERIDOL. It is used in conjunction with an opioid analgesic such as FENTANYL to maintain the patient in a calm state of neuroleptanalgesia with indifference to surroundings but still able to cooperate with the surgeon. It is also used as a premedicant, as an antiemetic, and for the control of agitation in acute psychoses. (From Martindale, The Extra Pharmacopoeia, 29th ed, p593)
A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt.
The heart rate of the FETUS. The normal range at term is between 120 and 160 beats per minute.
The action of a drug that may affect the activity, metabolism, or toxicity of another drug.
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.
Compounds that bind to and activate ADRENERGIC ALPHA-2 RECEPTORS.
An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses.
Endoscopic examination, therapy and surgery of the joint.
A method in which either the observer(s) or the subject(s) is kept ignorant of the group to which the subjects are assigned.
An abdominal hernia with an external bulge in the GROIN region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the ABDOMINAL WALL (transversalis fascia) in Hesselbach's triangle. The former type is commonly seen in children and young adults; the latter in adults.
The use of specifically placed small electrodes to deliver electrical impulses across the SKIN to relieve PAIN. It is used less frequently to produce ANESTHESIA.
Forceful administration under the skin of liquid medication, nutrient, or other fluid through a hollow needle piercing the skin.
The forcible expulsion of the contents of the STOMACH through the MOUTH.
Drugs used to prevent NAUSEA or VOMITING.
Therapy with two or more separate preparations given for a combined effect.
Strong dependence, both physiological and emotional, upon morphine.
The number of offspring a female has borne. It is contrasted with GRAVIDITY, which refers to the number of pregnancies, regardless of outcome.
Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.
A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the TIBIAL NERVE and the PERONEAL NERVE.
The active sympathomimetic hormone from the ADRENAL MEDULLA. It stimulates both the alpha- and beta- adrenergic systems, causes systemic VASOCONSTRICTION and gastrointestinal relaxation, stimulates the HEART, and dilates BRONCHI and cerebral vessels. It is used in ASTHMA and CARDIAC FAILURE and to delay absorption of local ANESTHETICS.
The surgical removal of a tooth. (Dorland, 28th ed)
A disulfide opioid pentapeptide that selectively binds to the DELTA OPIOID RECEPTOR. It possesses antinociceptive activity.
A pyrrolizine carboxylic acid derivative structurally related to INDOMETHACIN. It is a non-steroidal anti-inflammatory agent used for analgesia for postoperative pain and inhibits cyclooxygenase activity.
Presence of warmth or heat or a temperature notably higher than an accustomed norm.
Surgical removal of a tonsil or tonsils. (Dorland, 28th ed)
Patient care procedures performed during the operation that are ancillary to the actual surgery. It includes monitoring, fluid therapy, medication, transfusion, anesthesia, radiography, and laboratory tests.
The period during a surgical operation.
One of the endogenous pentapeptides with morphine-like activity. It differs from MET-ENKEPHALIN in the LEUCINE at position 5. Its first four amino acid sequence is identical to the tetrapeptide sequence at the N-terminal of BETA-ENDORPHIN.
A subclass of alpha-adrenergic receptors found on both presynaptic and postsynaptic membranes where they signal through Gi-Go G-PROTEINS. While postsynaptic alpha-2 receptors play a traditional role in mediating the effects of ADRENERGIC AGONISTS, the subset of alpha-2 receptors found on presynaptic membranes signal the feedback inhibition of NEUROTRANSMITTER release.
The action of a drug in promoting or enhancing the effectiveness of another drug.
Insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes.
A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.
Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (ANTIBIOTIC PROPHYLAXIS) and anti-anxiety agents. It does not include PREANESTHETIC MEDICATION.
The time from the onset of a stimulus until a response is observed.

A double-blind comparison of 0.125% ropivacaine with sufentanil and 0.125% bupivacaine with sufentanil for epidural labor analgesia. (1/577)

BACKGROUND: This study intends to evaluate the benefits of the administration of intermittent bolus doses of ropivacaine (0.125%) compared with bupivacaine (0.125%) after addition of sufentanil for analgesia during labor. METHODS: One hundred thirty American Society of Anesthesiologists physical status 1 or 2 parturients were studied. The 90 initial patients were assigned randomly to receive 10 ml bupivacaine, 0.125%, plus 7.5 microg sufentanil (initial bupivacaine 0.125% group) or ropivacaine, 0.125%, plus 7.5 microg sufentanil (ropivacaine 0.125% group). Forty additional patients were recruited and received 0.125% bupivacaine plus 7.5 microg sufentanil (additional bupivacaine 0.125% group) or 0.100% bupivacaine plus 7.5 microg sufentanil (additional bupivacaine 0.100% group). The duration of analgesia, visual analogue scores for pain, motor blockade (using a six-point modified Bromage scale), patient satisfaction scores, nausea, pruritus, heart rate, and blood pressure were recorded. RESULTS: Bupivacaine 0.125% and ropivacaine 0.125% coadministered with sufentanil provided rapid and complete analgesia. Onset of analgesia occurred after +/-15 min and lasted +/-90 min. After the third epidural injection, patients in the ropivacaine group experienced significantly less severe motor blockade than patients in the initial bupivacaine 0.125% group. At this point, 93% of the patients in the ropivacaine group were free from motor impairment versus 66% in the bupivacaine group (P<0.05). Comparable levels of motor blockade were obtained in both additional groups. Patients' evaluation of their analgesia was worst in the bupivacaine 0.100% group. CONCLUSIONS: Ropivacaine 0.125% with sufentanil affords reliable analgesia with minimal motor blockade.  (+info)

Maternal intrapartum temperature elevation as a risk factor for cesarean delivery and assisted vaginal delivery. (2/577)

OBJECTIVES: This study investigated the association of intrapartum temperature elevation with cesarean delivery and assisted vaginal delivery. METHODS: Participants were 1233 nulliparous women with singleton, term pregnancies in vertex presentations who had spontaneous labors and were afebrile (temperature: 99.5 degrees F [37.5 degrees C]) at admission for delivery. Rates of cesarean and assisted vaginal deliveries according to highest intrapartum temperature were examined by epidural status. RESULTS: Women with maximum intrapartum temperatures higher than 99.5 degrees F were 3 times as likely to experience cesarean (25.2% vs 7.2%) or assisted vaginal delivery (25.2% vs 8.5%). The association was present in epidural users and nonusers and persisted after birthweight, epidural use, and labor length had been controlled. In adjusted analyses, temperature elevation was associated with a doubling in the risk of cesarean delivery (odds ratio [OR] = 2.3, 95% confidence interval [CI] = 1.5, 3.4) and assisted vaginal delivery (OR = 2.1, 95% CI = 1.4, 3.1). CONCLUSIONS: Modest temperature elevation developing during labor was associated with higher rates of cesarean and assisted vaginal deliveries. More frequent temperature elevation among women with epidural analgesia may explain in part the higher rates of cesarean and assisted vaginal deliveries observed with epidural use.  (+info)

Effect of i.v. ketamine in combination with epidural bupivacaine or epidural morphine on postoperative pain and wound tenderness after renal surgery. (3/577)

We studied 60 patients undergoing operation on the kidney with combined general and epidural anaesthesia, in a double-blind, randomized, controlled study. Patients were allocated to receive a preoperative bolus dose of ketamine 10 mg i.v., followed by an i.v. infusion of ketamine 10 mg h-1 for 48 h after operation, or placebo. During the first 24 h after surgery, all patients received 4 ml h-1 of epidural bupivacaine 2.5 mg ml-1. From 24 to 48 h after operation, patients received epidural morphine 0.2 mg h-1 preceded by a bolus dose of 2 mg. In addition, patient-controlled analgesia (PCA) with i.v. morphine (2.5 mg, lockout time 15 min) was offered from 0 to 48 h after operation. Patients who received ketamine felt significantly more sedated at 0-24 h, but not at 24-48 h after operation, compared with patients who received placebo (P = 0.002 and P = 0.127, respectively). There were no significant differences in pain (VAS) at rest, during mobilization or cough, PCA morphine consumption, sensory block to pinprick, pressure pain detection threshold assessed with an algometer, touch and pain detection thresholds assessed with von Frey hairs, peak flow or side effects other than sedation. The power of detecting a reduction in VAS scores of 20 mm in our study was 80% at the 5% significance level. We conclude that we were unable to demonstrate an (additive) analgesic or opioid sparing effect of ketamine 10 mg h-1 i.v. combined with epidural bupivacaine at 0-24 h, or epidural morphine at 24-48 h after renal surgery.  (+info)

Neonatal outcome and mode of delivery after epidural analgesia for labour with ropivacaine and bupivacaine: a prospective meta-analysis. (4/577)

In this prospective meta-analysis, we have evaluated the effect of epidural analgesia with ropivacaine for pain in labour on neonatal outcome and mode of delivery compared with bupivacaine. In six randomized, double-blind studies, 403 labouring women, primigravidae and multiparae, received epidural analgesia with ropivacaine or bupivacaine 2.5 mg ml-1. The drugs were administered as intermittent boluses in four studies and by continuous infusion in two. Apgar scores, neurological and adaptive capacity scores (NACS), degree of motor block and mode of delivery were recorded. The studies were designed prospectively to fit meta-analysis of the pooled results. Results showed similar pain relief and consumption of the two drugs. In the vaginally delivered neonates, NACS scores were approximately equal for both groups at 2 h, but at 24 h there were fewer infants with NACS less than 35 in the ropivacaine compared with the bupivacaine group (2.8% vs 7.6%; P < 0.05). Spontaneous vaginal deliveries occurred more frequently overall with ropivacaine than with bupivacaine (58% vs 49%; P < 0.05) and instrumental deliveries (forceps and vacuum extraction) less frequently (27% vs 40%; P < 0.01), while the frequency of Caesarean section was similar between groups. The intensity of motor block was lower with ropivacaine. There were no significant differences in adverse events.  (+info)

Relative analgesic potencies of ropivacaine and bupivacaine for epidural analgesia in labor: implications for therapeutic indexes. (5/577)

BACKGROUND: The minimum local analgesic concentration (MLAC) has been defined as the median effective local analgesic concentration in a 20-ml volume for epidural analgesia in the first stage of labor. The aim of this study was to assess the relative analgesic potencies of epidural bupivacaine and ropivacaine by determining their respective minimum local analgesic concentrations. METHODS: Seventy-three parturients at < or = 7 cm cervical dilation who requested epidural analgesia were allocated to one of two groups in this double-blinded, randomized, prospective study. After a lumbar epidural catheter was placed, 20 ml of the test solution was given, either ropivacaine (n = 34) or bupivacaine (n = 39). The concentration of local anesthetic was determined by the response of the previous patient in that group to a higher or lower concentration using up-down sequential allocation. Analgesic efficacy was assessed using 100-mm visual analog pain scores with < or = 10 mm within 30 min defined as effective. An effective result directed a 0.01% wt/vol decrement for the next patient. An ineffective result directed a 0.01% wt/vol increment. RESULTS: The minimum local analgesic concentration of ropivacaine was 0.111% wt/vol (95% confidence interval, 0.100-0.122), and the minimum local analgesic concentration of bupivacaine was 0.067% wt/vol (95% confidence interval, 0.052-0.082). Ropivacaine was significantly less potent than bupivacaine, with a potency ratio of 0.6 (95% confidence interval, 0.49-0.74). No difference in motor effects was observed. CONCLUSION: Ropivacaine was significantly less potent than bupivacaine for epidural analgesia in the first stage of labor.  (+info)

Lumbar sympathetic blocks speed early and second stage induced labor in nulliparous women. (6/577)

BACKGROUND: Rapid cervical dilation reportedly accompanies lumbar sympathetic blockade, whereas epidural analgesia is associated with slow labor. The authors compared the effects of initial lumbar sympathetic block with those of epidural analgesia on labor speed and delivery mode in this pilot study. METHODS: At a hospital not practicing active labor management, full-term nulliparous patients whose labors were induced randomly received initial lumbar sympathetic block or epidural analgesia. The latter patients received 10 ml bupivacaine, 0.125%; 50 microg fentanyl; and 100 microg epinephrine epidurally and sham lumbar sympathetic blocks. Patients to have lumbar sympathetic blocks received 10 ml bupivacaine, 0.5%; 25 microg fentanyl; and 50 microg epinephrine bilaterally and epidural catheters. Subsequently, all patients received epidural analgesia. RESULTS: Cervical dilation occurred more quickly (57 vs. 120 min/cm cervical dilation; P = 0.05) during the first 2 h of analgesia in patients having lumbar sympathetic blocks (n = 17) than in patients having epidurals (n = 19). The second stage of labor was briefer in patients having lumbar sympathetic blocks than in those having epidurals (105 vs. 270 min; P < 0.05). Nine patients having lumbar sympathetic block and seven having epidurals delivered spontaneously, whereas seven patients having lumbar sympathetic block and seven having epidurals had instrument-assisted vaginal deliveries. Cesarean delivery for fetal bradycardia occurred in one patient having lumbar sympathetic block. Cesarean delivery for dystocia occurred in five patients having epidurals compared with no patient having lumbar sympathetic block (P = not significant). Visual analog pain scores differed only at 60 min after block. CONCLUSIONS: Nulliparous parturients having induced labor and receiving initial lumbar sympathetic blocks had faster cervical dilation during the first 2 h of analgesia, shorter second-stage labors, and a trend toward a lower dystocia cesarean delivery rate than did patients having epidural analgesia. The effects of lumbar sympathetic block on labor need to be determined in other patient groups. These results may help define the tocodynamic effects of regional labor analgesia.  (+info)

Continuous epidural infusion of ropivacaine for postoperative analgesia after major abdominal surgery: comparative study with i.v. PCA morphine. (7/577)

We have compared the quality of three regimens of postoperative analgesia (continuous epidural administration of ropivacaine (Ropi. group), epidural ropivacaine and patient-controlled analgesia (PCA) with i.v. morphine (Ropi. + PCA group) and PCA morphine alone (PCA group)) during the first postoperative 24 h in a multicentre, randomized, prospective study. Postoperative analgesia was studied in 130 patients after major abdominal surgery performed under general anaesthesia. The ropivacaine groups received 20 ml of epidural bolus ropivacaine 2 mg ml-1 via the epidural route at the end of surgery, followed by continuous infusion of 10 ml h-1 for 24 h. The Ropi. + PCA group also had access to i.v. PCA morphine 1 mg, with a 5-min lockout. The PCA group received morphine as the sole postoperative pain treatment. The two ropivacaine groups had lower pain scores (P < 0.01) than the PCA group. Morphine consumption was higher in the PCA group (P < 0.05) than in the two ropivacaine groups. The quality of pain relief was rated as good or excellent in 79-85% of patients in the three groups. The percentage of patients without motor block increased between 4 and 24 h from 61% to 89% in the Ropi. group, and from 51% to 71% in the Ropi. + PCA group.  (+info)

Epidural analgesia with bupivacaine does not improve splanchnic tissue perfusion after aortic reconstruction surgery. (8/577)

Inadequate splanchnic tissue perfusion is relatively common during and after aortic surgery. We hypothesized that vasodilation caused by thoracic epidural analgesia improves splanchnic blood flow and tissue perfusion after aortic surgery. In this prospective, randomized, controlled study, we studied 20 patients undergoing elective aortic-femoral or aortic-iliac reconstruction surgery. Gastric and sigmoid colon mucosal PCO2 and pH were measured during surgery. An epidural bolus of bupivacaine 40 mg followed by infusion of 15 mg h-1 was started after operation in 10 patients. After operation, splanchnic blood flow and gastric and sigmoid colon mucosal PCO2 and pH were measured before and 2 h after the start of epidural analgesia. During surgery, the gastric mucosal-arterial PCO2 difference remained stable, whereas the sigmoid mucosal-arterial PCO2 difference increased during aortic clamping but returned to pre-clamping values after declamping. After operation, epidural analgesia had no effect on gastric or sigmoid mucosal-arterial PCO2 differences or on splanchnic blood flow.  (+info)

The effect of continuous epidural analgesia on cesarean section for dystocia in nulliparous women. Am J Obstet Gynecol. 1989 Sep;161(3):670-5.
Effect of Epidural Analgesia on Some Maternal and Fetal Parameters in Pre-Eclampsia. M.Yousri Amin, A.Salam, M.Metwally : Alexandria University , EGYPT. continuous Epidural Analgesia (EA) during labor of pre-eclamptic (P-E) patients has been recommended by several authors. Belief in improved renal function via relief of renal vasospasm, control of blood pressure, excellent analgesia and less infant depression form the basis of such recommendation.In opposition, many clinician consider conduction analgesia to be not recommended in P-E because of deceased blood volume might make them more vulnerable to hypotension.In this study we investigated the effect of continuous EA on maternal hemodynamics, renal function, and acid base balance in P-E , also, its effect on fetal heart rate(FHR) during labor.Patients and methods:Twenty P-E parturient were prepared for labor induction. Central venous catheter was placed via subclavian, lumbar epidural catheter was placed. 10 ml of 0.5% bupivacaine were ...
Patient controlled intravenous opioid analgesia vs. continuous epidural analgesia for pain after intra-abdominal surgery answers are found in the Evidence-Based Medicine Guidelines powered by Unbound Medicine. Available for iPhone, iPad, Android, and Web.
This article undertakes a systemic review of the evidence of benefit or harm of continuous epidural analgesia (CEA) vs other analgesic interventions from RCTs in patients with traumatic rib fractures as of July 2014. It uses the guidelines recommended by the Cochrane Collaboration . Overall it included six trials including 223 patients, and determined that in these studies there was currently no evidence of statistical difference in outcomes of mortality, duration of mechanical ventilation or pneumonia between CEA and other analgesic interventions. It pointed out that the included trials showed a potential for a high risk of bias. The analysis showed that the amount of information currently available to accurately determine whether there is a clinical benefit or harm with the use of continuous epidural analgesia vs other analgesic techniques (such as systemic opioids, paravertebral block etc) is inadequate and that a good quality large RCT is required in this patient population to provide ...
Several studies have shown that TEA is very effective in ensuring appropriate pain control following thoracic surgery, and some authors consider this anaesthesic technique to be the gold standard for postoperative analgesia following thoracic interventions.8-12 ,16 Since lateral thoracotomy may be more painful than mid-sternotomy due to rib spreading and intercostal nerve injury,17 optimization of postoperative analgesia might be even more important in such cases. Nonetheless, the use of TEA in patients undergoing TA-TAVI has been limited to a single case report,12 and no studies, to date, have evaluated the efficacy and safety of this technique of anaesthesia in this setting. The present study showed that TEA was highly effective in providing postoperative analgesia following TA-TAVI. About 50% of the patients treated with TEA experienced either no pain or only minimal pain within the first 48 h following the procedure, and ,90% at later time-points, and these pain score levels were far lower ...
Pain scores averaged for each participant, and compared between thoracic epidural analgesia (TEA) and intravenous patient controlled analgesia (IVPCA) groups at specific time points as follows: pain scores for the first 6 hours after surgery, pain scores for the next 18 hours after surgery, pain scores for each subsequent 24 hour period after surgery until postoperative day 5 or epidural removed, whichever occurs first. Numeric/Visual Pain Scale (0-10) where 10 is highest level ...
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Women undergo physiological and psychological changes during pregnancy, labor and lactation. The psychological adaptations can be affective, cognitive and behavioral and can be measured by dimensional personality instruments. This study aims to compare (1) the personality profile in mothers after birth with a normative group of non-lactating women and to examine (2) whether the personality profile differs 2 days, 2 months and 6 months after birth between mothers who have been exposed to epidural anesthesia, oxytocin administration or neither. Sixty-nine primiparae were assigned to four groups: mothers having received oxytocin infusion during labor (OT iv group, n=9), mothers having received epidural analgesia with/without oxytocin infusion (EDA group, n=23), mothers having received 10 iU oxytocin intramuscularly after birth (OT im group, n=15) and mothers having received none of these treatments (unmedicated group, n=22). At 2 days and 2 and 6 months postpartum mothers completed the Karolinska ...
Epidural analgesia has been used to provide labor pain relief for more than 40 years, with modern techniques providing better pain control with fewer side effects. Since the early 1990s, the CSE technique has become popular because it provides more rapid pain relief with less leg weakness-the main side effect of epidural analgesia.. Despite previous studies, the relative advantages of these options for labor analgesia have been unclear. The new study is the first to directly compare epidural versus CSE for labor analgesia in a busy private maternity hospital.. The results suggest that CSE provides significantly faster and better pain relief during the first stage of labor, compared to the traditional epidural technique. The differences in pain control during early labor are small but significant, Dr Gambling and colleagues note. They write, [W]hen one considers the fact that fewer top-up doses were required to achieve the improvement in analgesia, it would seem that on balance CSE is the ...
Epidural analgesia has been used to provide labor pain relief for more than 40 years, with modern techniques providing better pain control with fewer side effects. Since the early 1990s, the CSE technique has become popular because it provides more rapid pain relief with less leg weakness-the main side effect of epidural analgesia.. Despite previous studies, the relative advantages of these options for labor analgesia have been unclear. The new study is the first to directly compare epidural versus CSE for labor analgesia in a busy private maternity hospital.. The results suggest that CSE provides significantly faster and better pain relief during the first stage of labor, compared to the traditional epidural technique. The differences in pain control during early labor are small but significant, Dr Gambling and colleagues note. They write, [W]hen one considers the fact that fewer top-up doses were required to achieve the improvement in analgesia, it would seem that on balance CSE is the ...
Labor results in severe pain in most women and epidural analgesia is well established technique to alleviate the pain for over 50 years. After the …
|i|Background|/i|. If conversion of labor epidural analgesia to cesarean delivery anesthesia fails, the anesthesiologist can be confronted with a challenging clinical dilemma. Optimal management of a failed epidural top up continues to be debated in the absence of best practice guidelines. |i|Method|/i|. All members of the Obstetric Anaesthetists’ Association in the United Kingdom were emailed an online survey in May 2017. It obtained information on factors influencing the decision to utilize an existing labor epidural for cesarean section and, if epidural top up resulted in no objective sensory block, bilateral T10 sensory block, or unilateral T6 sensory block, factors influencing the management and selection of anesthetic technique. Differences in management options between respondents were compared using the chi-squared test. |i|Results|/i|. We received 710 survey questionnaires with an overall response rate of 41%. Most respondents (89%) would consider topping up an existing
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Part of the inconsistency with motor blockade results between studies is due to the fact that the qualitative Bromage score is not ideal for assessing motor blockade in laboring patients. Graham and McClure [19] demonstrate that laboring patients with epidural analgesia may have a quantitative decrease in adductor strength despite having a Bromage score of 0. Motor blockade due to epidural labor analgesia is thought to impair a womens ability to push in stage 2. While we did not see a significant difference in Bromage scores between groups, the obstetric providers felt that 8 patients in the PIEB group 10q60 had motor blockade as demonstrated by the inability to effectively push in stage 2. This finding demonstrates that Bromage scores may not be ideal for assessing motor blockade in laboring patients. All patients with a perceived motor block and an inability to effectively push during the second stage successfully delivered vaginally after the epidural pump was turned off. One of these ...
exp Cardiopulmonary Bypass/ OR OR exp Thoracic Surgery/ OR exp Cardiac surgical procedures/ OR Coronary art$ OR Cardiopulmonary OR exp Cardiopulmonary Bypass/ OR exp Cardiovascular Surgical Procedures/ OR exp Thoracic Surgical Procedures/ OR exp Coronary Artery Bypass/ OR cardiac OR exp Heart Transplantation/ ] AND [exp Anesthesia, Epidural/ OR Epidural OR exp Analgesia, Epidural/ OR epidural OR exp Anesthesia, Conduction/ae, cl, st, td, mo OR exp Anesthesia, Local/ad, ae, ct, st, td, mo OR exp Anesthesia, Spinal/ae, ct, st, td, mo OR exp Nerve Block/ae, ct, st, td, mo] AND [exp ANESTHESIA RECOVERY PERIOD/ OR exp RECOVERY OF FUNCTION/ OR Length of Stay/ OR exp Intraoperative Complications/ OR exp Postoperative Complications/ OR surgical OR *Postoperative Complications/] LIMIT [humans AND english language ...
THEA is considered a very effective technique of providing intra and post-operative analgesia for thoracic surgical procedure and it seems that can also be effective in reducing the incidence of postoperative AF in patients undergoing lung resection. Nevertheless the timing of stopping the epidural analgesia and its further substitution with other therapies, remains unclear.. In this study patients who are scheduled for lung resection surgery will undergo the surgery under combined general anesthesia with volatile anesthetics and thoracic epidural anesthesia.. Immediately after surgery the patients will be divided into two groups:. ...
Our data offer little encouragement to those who wish to improve cardiac outcome after PVS by providing postoperative epidural analgesia. Within the epidural group, 40% received 3 mg in 10 ml epidural morphine during surgery. Generally, a second bolus was given immediately before catheter removal at 24 h after surgery. Therefore, epidural analgesia would have been expected to be in the range of 36-48 h. This is well into the period when poor cardiac outcome becomes evident. The myocardial infarction rate for the epidural morphine group was 4.9% versus 3.6% and 3.7%, respectively, for the patients who received general or spinal, both with postoperative parenteral opioids. As we pointed out in our discussion of these results, patients undergoing lower extremity PVS probably do not experience the same intensity of postoperative pain as do patients undergoing other types of surgery, such as intraabdominal procedures. Any beneficial effects of postoperative epidural analgesia may, therefore, be ...
It was also hoped that the opioid-related side effects of nausea, vomiting, pruritus, sedation and respiratory depression could be reduced. However, all of these side effects can occur as well as two additional ones, urinary retention and late onset respiratory depression.. The specific benefits for epidural analgesia are particularly attractive and relevant in some subgroups of patients such as the elderly, the obese or those with chronic respiratory disease. An effective epidural will enable a patient to deep breathe, cough and move with ease. This in turn facilitates a more speedy recovery with a reduction in co-morbidities such as chest infections and deep. Results of studies are inconsistent and must be interpreted cautiously; it is difficult to show a benefit in low-risk patients. At least one study has shown a shorter hospital stay and reduced morbidity in morbidly obese patients who received epidural opioids postoperatively [2]. The effects on the metabolic stress response (increase of ...
Six RCTs with a total of 458 patients were included in the review. Five RCTs were included in the meta-analyses (n=355 with adequate data). In terms of study quality, 4 studies reported prior power analysis, two reported adequate allocation concealment, five were at least double-blinded and three used intention-to-treat analysis. One study reported no exclusions from analysis; rates of exclusion from analysis in the other 5 studies ranged from 17 to 23.6%.. Acute pain at rest at 24 hours post-surgery (5 studies).. There was no significant difference between interventions in acute pain at rest at 24 hours (WMD -0.27, 95% CI: -0.91, 0.37; favours preemptive TEA). A sixth study, which could not be pooled, also showed no significant difference between the groups. Statistically significant heterogeneity between the studies was detected (I-squared 98.6%). The results of the analysis were not changed by the exclusion of a study in which no opioid was used.. Acute pain at rest at 48 hours post-surgery ...
TY - JOUR. T1 - Parity, prolonged labor and epidural analgesia. AU - Witter, F. R.. AU - Caulfield, L. E.. PY - 1996/6. Y1 - 1996/6. KW - Analgesia. KW - Epidural. KW - Labor. KW - Parity. UR - UR - U2 - 10.1016/0020-7292(96)02658-6. DO - 10.1016/0020-7292(96)02658-6. M3 - Letter. C2 - 8793631. AN - SCOPUS:0029938227. VL - 53. SP - 269. EP - 270. JO - International Journal of Gynecology and Obstetrics. JF - International Journal of Gynecology and Obstetrics. SN - 0020-7292. IS - 3. ER - ...
Occasionally painkillers may be given by infusion into the space just outside the membranes surrounding the spinal cord. This is known as epidural analgesia. Sometimes the painkiller is given into the fluid around the spinal cord -- this is known as intrathecal analgesia. These specialised techniques are usually used only to control severe pain and are managed by anaesthetists.. If you need to have your painkillers by injection or infusion, your doctor or nurse will discuss this with you.. Please see our leaflet on Strong Painkillers for more information.. ...
Use of epidural analgesia in patients with critically acute pancreatitis may reduce the 30-day mortality rates compared with the absence of a pain management strategy.
We included 38 studies involving 9658 women; all but five studies compared epidural analgesia with opiates. Epidural analgesia was found to offer better pain relief (mean difference (MD) -3.36, 95% confidence interval (CI) -5.41 to -1.31, three trials, 1166 women); a reduction in the need for additional pain relief (risk ratio (RR) 0.05, 95% CI 0.02 to 0.17, 15 trials, 6019 women); a reduced risk of acidosis (RR 0.80, 95% CI 0.68 to 0.94, seven trials, 3643 women); and a reduced risk of naloxone administration (RR 0.15, 95% CI 0.10 to 0.23, 10 trials, 2645 women). However, epidural analgesia was associated with an increased risk of assisted vaginal birth (RR 1.42, 95% CI 1.28 to 1.57, 23 trials, 7935 women), maternal hypotension (RR 18.23, 95% CI 5.09 to 65.35, eight trials, 2789 women), motor-blockade (RR 31.67, 95% CI 4.33 to 231.51, three trials, 322 women), maternal fever (RR 3.34, 95% CI 2.63 to 4.23, six trials, 2741 women), urinary retention (RR 17.05, 95% CI 4.82 to 60.39, three trials, ...
This trial was comparing the efficacy and tolerability of continuous paravertebral and epidural anesthesia blockage with levobupivacaine [Chirocaine] versus
Numerous study designs, including randomized controlled trials (RCTs), before-and-after studies, and observational studies with concurrent controls (analyzed by propensity scores), have asked whether labor epidural analgesia (LEA) influences the probability of Cesarean section (C/S). One limitation of the RCTs is the high rate of crossovers in many of these studies. In contrast to our previous analysis, a recent RCT meta-analysis using instrumental variables to adjust for crossovers [1] concluded that LEA increased the probability of C/S. To further investigate this topic, we updated a previous analysis based on the paired availability design (PAD), a meta-analysis of before-and-after studies adjusted for different availabilities of treatment [3]. The revised PAD (with 1 additional study and modified data extractions) yielded similar results as before, namely no effect of epidural analgesia on the probability of C/S (Figure 1). We also updated our previous meta-analysis of randomized trials ...
Background: In this systematic review and meta-analysis we evaluate the evidence for seven risk factors associated with failed conversion of labor epidural analgesia to cesarean delivery anesthesia. Methods: Multiple scientific literature databases from January 1979 to May 2011 were searched to identify observational trials that evaluated risk factors for failed conversion of epidural analgesia to anesthesia or documented a failure rate resulting in general anesthesia. Results: Of 1450 trials screened, 13 trials were included for review (n = 8384). Three factors increase the risk for failed conversion: an increasing number of clinician-administered boluses during labor (OR = 3.17, 95% CI 1.83 to 5.46), a greater urgency for cesarean delivery, and a non-obstetric anesthesiologist providing care (OR = 4.56, 95% CI 1.81 to 11.54). Insufficient evidence is available to support CSE versus standard epidural techniques, duration of epidural analgesia, cervical dilation at the time of epidural placement ...
An epidural catheter was used to provide perioperative analgesia as part of a multimodal balanced anaesthesia and analgesia in a mare undergoing a bilateral mastectomy. Despite development of severe hypoxaemia during anaesthesia, recovery from anaesthesia was uneventful. Oral administration of a NSAID combined with administration of xylazine and morphine by an epidural catheter resulted in adequate postoperative pain relief, based on assessment of physiological parameters and behaviour. Neither complications nor side effects were observed during hospitalisation. ...
Epidural analgesia involves an injection into the lower back that pierces the outer coverings (epi-dura) of the spinal cord. Drugs are injected close to the nerves as they come out from the spinal cord. Usually this involves a local anaesthetic (LA) drug such as bupivacaine, along with an opiate drug (related to morphine, pethidine/meperidine etc) such as Fentanyl. Epidurals are used in many types of surgery and procedures, and also sometimes administered to receive pain outside of childbirth.. How do epidurals work?. Just like a dental anaesthetic, LA drugs block the sensory nerves, causing numbness, and also inevitably block the motor nerves, giving some degree of paralysis. Opiate drugs are added to an epidural to increase the effectiveness of the LA, so that there will be good pain relief with less motor block.. What are the benefits of epidurals?. Obviously, the main benefit of an epidural is the very effective pain relief that most women experience. Because of this effective ...
Continuous epidural infusion is a way to give pain medicine. The medicine is sent to the spinal cord and nerves. This is done through a soft tube (catheter). The catheter is put in the spine into the epidural space, which surrounds your spinal cord.
Continuous epidural infusion is a way to give pain medicine. The medicine is sent to the spinal cord and nerves. This is done through a soft tube (catheter). The catheter is put in the spine into the epidural space, which surrounds your spinal cord.
epidural anaesthesia and caesarean, epidural analgesia on outcomes of labor, labour epidural, association of epidural and caesarean delivery in childbirth
The Effects of Regional Analgesia on the Progress and Outcome of Labor. Marissa Lazor, M.D. In 1847, the Scottish obstetrician, James Simpson administered ether to a woman during labor to treat the pain of childbirth. Slideshow 161159 by salena
In general, your choice of where you deliver will be linked to your care provider. The majority of physicians take care of women in a hospital setting, where most birth in the US take place. Midwives also take care of women in a hospital setting, although they also deliver babies in birthing center.. Hospital birth. There are three potential advantages to choosing deliver in a hospital. First, if you are among the 30-40 percent of women over 35 who require a cesarean delivery, there will be no need for you to be moved from home or the birthing center. Although most cesarean deliveries are not urgent, in which case the delay will not cause you or your baby any harm, in an obstetric emergencies, time can be of the essence. The second advantage is that you will have more pain control options. Although many first time mothers wish to avoid epidural analgesia, you may not know what type of pain relief you want until you are actually in labor. If you are highly motivate to avoid an epidural analgesia, ...
Epidural analgesia remains the gold standard during labour, but is contraindicated in several clinical settings due to increased risk of serious complications. There are few effective alternatives to epidural analgesia. However, there is an increasing interest for the use of remifentanil as a labour analgesic. In this focused review, we describe the effect, dose and safety of remifentanil for the mother and fetus/neonate. Remifentanil appears to have a potential as labour analgesic. Careful monitoring of the parturient and the newborn is advised ...
Slows down the progress of labor. There is some discussion among doctors, midwives, and childbirth educators about the validity of this statement. There have been many studies supporting the theory that epidurals can slow down labor, especially in the second stage (pushing), which may result in the need for pitocin to help regain adequate contractions. A study from the Department of Obstetrics and Gynecology, Rambam Medical Center, Technion-Faculty of Medicine, Haifa, Israel, concluded Women should be informed that prolongation of labor and increase in nonspontaneous deliveries should be expected when choosing epidural analgesia in labor.. Difficulty Pushing With an epidural or without, I recommend laboring down which means: even once the cervix if fully dilated to 10cm, wait until you have the urge to push before starting the second stage of labor - the pushing stage. The contractions will continue to help move your baby further down the birth canal and lessen the time you are actually ...
What is an epidural catheter? An epidural catheter is a small tube placed through the skin in a space between the bones of the spine and the spinal cord. The size of the catheter is about the same as a
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The most common side effect of pain medicines and anesthesia is drowsiness. Your child may sleep more than usual after surgery because of the pain medicine, and because sleep is the bodys way of healing itself. The nurse will be checking to see how easily your child wakes up.. Other possible side effects are slow breathing, nausea (upset stomach), vomiting (throwing up), and itching. Medicines may be given to your child to help with any nausea, vomiting, or itching. Your child will be on monitors so that the nurses can watch the breathing rate and oxygen saturation.. Some children have numbness or tingling, especially in their legs. If your child has this feeling, tell your nurse. Although it is usually temporary, your nurse will check your child. A nurse will help your child the first time he or she gets out of bed. Sometimes a change in the medicine dose can decrease the numbness.. ...
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The review identified 38 randomised controlled studies involving 9658 women. All but five studies compared epidural analgesia with opiates. Epidurals relieved labour pain better than other types of pain medication but led to more use of instruments to assist with the birth. Caesarean delivery rates did not differ overall and nor were there effects of the epidural on the baby soon after birth; fewer babies needed a drug (naloxone) to counter opiate use by the mother for pain relief. The risk of caesarean section for fetal distress was increased. Women who used epidurals were more likely to have a longer delivery (second stage of labour), needed their labour contractions stimulated with oxytocin, experienced very low blood pressure, were unable to move for a period of time after the birth (motor blockage), had problems passing urine (fluid retention) and suffered fever. Long-term backache was no different. Further research on reducing the adverse outcomes with epidurals would be helpful. ...
Looking for online definition of epidural analgesia in the Medical Dictionary? epidural analgesia explanation free. What is epidural analgesia? Meaning of epidural analgesia medical term. What does epidural analgesia mean?
Effect of patient-controlled epidural analgesia versus patient-controlled intravenous analgesia on postoperative pain management and short-term outcomes after gastric cancer resection: a retrospective analysis of 3,042 consecutive patients between 2010 and 2015 Liping Wang, Xuan Li, Hong Chen, Jie Liang, Yu Wang Department of Anaesthesiology, Harbin Medical University Cancer Hospital, Harbin, China Background: Effective postoperative analgesia is essential for rehabilitation after surgery. Many studies have compared different methods of postoperative pain management for open abdominal surgery. However, the conclusions were inconsistent and controversial. In addition, few studies have focused on gastric cancer (GC) resection. This study aimed to determine the effects of patient-controlled epidural analgesia (PCEA) on postoperative pain management and short-term recovery after GC resection compared with those of patient-controlled intravenous analgesia (PCIA). Methods: We analyzed retrospectively
TY - JOUR. T1 - Effects of combined spinal-epidural analgesia on first stage of labor. T2 - a cohort study. AU - Poma, Silvia. AU - Scudeller, Luigia. AU - Verga, Chiara. AU - Mirabile, Giorgio. AU - Gardella, Barbara. AU - Broglia, Federica. AU - Ciceri, Maria. AU - Fuardo, Marinella. AU - Pellicori, Simona. AU - Gerletti, Maddalena. AU - Zizzi, Silvia. AU - Masserini, Elena. AU - Delmonte, Maria Paola. AU - Iotti, Giorgio Antonio. PY - 2018/5/16. Y1 - 2018/5/16. N2 - Background: Neuraxial anesthesia is considered as the gold standard in the control labor of pain. Its variants are epidural analgesia and combined spinal-epidural analgesia. Few studies, as yet, have investigated the duration of labor as a primary outcome. Some authors have suggested that combined spinal-epidural analgesia may reduce labor duration but at the moment the benefit of shortening labor is uncertain. The main aim of this study was to compare combined spinal-epidural with epidural analgesia in terms of their effect on ...
TY - JOUR. T1 - Post-Pancreaticoduodenectomy Outcomes and Epidural Analgesia. T2 - A 5-year Single-Institution Experience. AU - Simpson, Rachel E.. AU - Fennerty, Mitchell L.. AU - Colgate, Cameron L.. AU - Kilbane, E. Molly. AU - Ceppa, Eugene P.. AU - House, Michael. AU - Zyromski, Nicholas. AU - Nakeeb, Attila. AU - Schmidt, C.. PY - 2019/4/1. Y1 - 2019/4/1. N2 - Background: Optimal pain control post pancreaticoduodenectomy is a challenge. Epidural analgesia (EDA) is used increasingly, despite inherent risks and unclear effects on outcomes. Methods: All pancreaticoduodenectomies (PDs) performed from January 2013 through December 2017 were included. Clinical parameters were obtained from a retrospective review of a prospective clinical database, the American College of Surgeons NSQIP prospective institutional database, and medical record review. Chi-square, Fishers exact test, and independent-samples t-tests were used for univariable analyses. Multivariable regression was performed. Results: ...
There are numerous pain management options for VATS, including non-steroidal anti-inflammatory drugs (NSAIDs), epidural analgesia, systemic opioids, paravertebral block (PVB), patient-controlled analgesia (PCA), and surgical wound infiltration. The researchers have demonstrated that PVB, which results in lower cumulative dezocine doses and produces fewer side effects than PCA, can provide effective pain relief for patients undergoing VATS. However, TEA has been regarded as the gold standard for managing acute pain after thoracic surgery. The aim of this study is to test whether PVB has similar pain control when compared with TEA ...
Advances in the field of labour analgesia have tread a long journey from the days of ether and chloroform in 1847 to the present day practice of comprehensive programme of labour pain management using evidence-based medicine. Newer advances include introduction of newer techniques like combined spinal epidurals, low-dose epidurals facilitating ambulation, pharmacological advances like introduction of remifentanil for patient-controlled intravenous analgesia, introduction of newer local anaesthetics and adjuvants like ropivacaine, levobupivacaine, sufentanil, clonidine and neostigmine, use of inhalational agents like sevoflourane for patient-controlled inhalational analgesia using special vaporizers, all have revolutionized the practice of pain management in labouring parturients. Technological advances like use of ultrasound to localize epidural space in difficult cases minimizes failed epidurals and introduction of novel drug delivery modalities like patient-controlled epidural analgesia (PCEA) ...
The advantages of epidural analgesia include avoidance of hyperventilation, reduced maternal catecholamines, and the ability to alter the level of analgesia (including a T4 level if necessary for Cesarean section). Prior to initiating epidural analgesia, it is critical that resuscitation equipment be available. Extra-thecal placement is confirmed with 45 mg lidocaine or 7.5 mg bupivacaine (neither of which should produce a spinal if injected extra-thecally). For intravascular testing, negative aspiration was shown to be relatively reliable in testing a multiorifice epidural catheter, detecting 47 of 48 intravascular catheters in one study [Norris MC et al. Anesth Analg 88: 1076, 1999; FREE Full-text at Anesthesia & Analgesia]. Given the success of negative aspiration, the use of epinephrine for this purpose is discouraged in the pregnant patient, as false positives sometimes occur [Mulroy M and Glosten B. Anesth Analg 86: 923, 1998] and there is a theoretical possibility of reducing ...
This trial will compare the efficacy of epidural administered levobupivacaine [Chirocaine] + sufentanil [fentatienil] with intravenously administered morphine
Materials and Methods: This was a prospective study carried out in department of obstetrics and gynaecology in Rajah muthiah Medical College and Hospital from 2015-2017 after ethical clearance and written knowledgeable concent. A total of 100 parturients in both latent and active phase of labour were to receive an epidural injection of 12 ml of bupivacaine 0.125% as initial bolus dose. Same dose regimen was used as subsequent top-up dose on patients demand for pain relief. The duration and quality of analgesia, motor block, top-up doses required consumption of bupivacaine and feto-maternal outcome were observed ...
Surgeries accompanied by an extensive tissue trauma are associated with intense postsurgical pain and major perioperative homeostatic disorders. Both hyper-inflammatory and immuneparalytic reactions can be observed, what can negatively effect the postoperative course. To realise an effective and safe analgesia, epidural procedures are used to an increasing degree as an alternative method to the therapy with intravenous opioids. In this prospective, randomized, double-blinded trial we compared the patient-controlled epidural analgesia and the patient-controlled intravenous analgesia with respect to the analgesic efficiency and the influence on the postoperative immune competence. 54 patients received until the morning of the fourth postoperative day either ropivacaine plus sufentanil through an intraoperatively placed epidural catheter (PCEA-group) or intravenous morphine (PCIA-group). Cortisol, populations of leukocytes and lymphocytes, cell-surface molecules of monocytes and the soluble ...
To control pain after surgery, doctors recommend intravenous patient-controlled analgesia, patient-controlled epidural analgesia, nerve blocks or oral pain medications, according to Cleveland Clinic....
Surgeon-administered regional analgesia to replace anaesthetist-administered regional analgesia - need for communication and collaboration ...
Researchers have linked epidural anesthesia to assisted delivery, or the use of forceps or vacuum extraction during the pushing portion of labor (Torvaldsen, S., Roberts, C.L., Bell, J.C., Raynes-Greenow, C.H. Discontinuation of epidural analgesia late in labour for reducing the adverse delivery outcomes associated with epidural analgesia. Cochrane Database Systematic Review. 2004 Oct 18;(4):CD004457.). Researchers also find that 88% of women who requested an epidural for pain in one study reported being less satisfied with their childbirth experience than those who did not, despite lower pain intensity. Pre-labor survey results suggest that concerns about epidurals and their effect on the baby, greater than anticipated labor pain, perceived failure of requesting an epidural, and longer duration of labor may have accounted for these findings.( Kannan, S., Jamison, R.N., Datta, S. Maternal satisfaction and pain control in women electing natural childbirth. Regional Anesthesia and Pain Medicine. ...
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BACKGROUND: Epidural analgesia leads to increased risk of instrumental vaginal delivery (IVD). There is debate about whether or not posture in second-stage labour influences the incidence of spontaneous vaginal birth (SVB). OBJECTIVES: In nulliparous women with epidural analgesia, does a policy of adopting an upright position throughout second-stage labour increase the incidence of SVB compared with a policy of adopting a lying-down position? DESIGN: Two-arm randomised controlled trial. SETTING: Maternity units in England and Wales. PARTICIPANTS: Nulliparous women aged ≥ 16 years, at ≥ 37 weeks gestation with singleton cephalic presentation and intended SVB, in second-stage labour with an epidural providing effective pain relief. INTERVENTIONS: (1) Upright position to maintain the pelvis in as vertical a plane as possible; and (2) lying-down position to maintain the pelvis in as horizontal a plane as possible. MAIN OUTCOME MEASURES: The primary outcome measure was incidence of SVB. Secondary - BOSTON - Epidural analgesia - a mix of anesthetics and narcotics delivered by catheter placed close to the nerves of the spine - is the most effective method of labor pain relief. In widespread use since the 1970s, epidurals have long been thought to slow the second stage of labor - defined as beginning when the cervix is completely dilated and ending when the baby is delivered. Because a longer duration of this stage of labor is associated with adverse outcomes, obstetricians routinely reduce or discontinue epidural pain management in an effort to expedite this main stage of labor.. That practice could be out-of-date and misguided, according to research led by scientists at Beth Israel Deaconess Medical Center (BIDMC). A paper published today in the journal Obstetrics & Gynecology demonstrated that epidural medication had no effect on the duration of the second stage of labor, normal vaginal delivery rate, incidence of episiotomy, the position of the fetus at birth or ...
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TY - JOUR. T1 - The effects of perioperative anesthesia and analgesia on immune function in patients undergoing breast cancer resection. T2 - A prospective randomized study. AU - Cho, Jin Sun. AU - Lee, Mi Hyang. AU - Kim, Seung Il. AU - Park, Seho. AU - Park, Hyung Seok. AU - Oh, Ein. AU - Lee, Jong Ho. AU - Koo, Bon Nyeo. N1 - Funding Information: Financial support and sponsorship: This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (No. 2014R1A2A2A01007289).. PY - 2017/8/18. Y1 - 2017/8/18. N2 - Introduction: Perioperative anesthesia and analgesia exacerbate immunosuppression in immunocompromised cancer patients. The natural killer (NK) cell is a critical part of anti-tumor immunity. We compared the effects of two different anesthesia and analgesia methods on the NK cell cytotoxicity (NKCC) in patients undergoing breast cancer surgery. Methods: Fifty patients undergoing breast cancer resection were randomly assigned to receive ...
Patient-controlled analgesia Patient-controlled analgesia (PCA) is any method of allowing a person in pain to administer their own pain relief. Additional
Learn about Pregnancy Epidurals, when to have a Spinal Epidural, the effect of an Epidural Block and proper use of Epidural Anaesthesia.
An epidural involves the continuous delivery of pain-relieving medication to nerves within the epidural space of the spinal column. At SSH, almost all epidural pain relief is delivered using the PCEA technique.. The attending obstetrician or midwife determines the appropriate timing of the epidural placement (usually after the cervix has dilated to four or more centimeters). An anesthesiologist will be consulted to assess the mother and place the epidural.. The epidural is placed using a needle and catheter. Once the catheter is in proper position, the needle is removed. The small catheter is then secured to the patients back. The catheter is connected to a small programmable PCEA pump.. PCEA, or Patient Controlled Epidural Anesthesia, combines the PCA and Epidural Analgesia techniques. The programmable PCEA pump delivers a continuous infusion of pain-relieving medication and allows the patient to self-administer extra medication (a bolus). The device is programmed so that the patient CANNOT ...
The administration of epidurals and spinal aneasthesia is common practice in maternity hospitals across Australia.. This course offers a comprehensive guide to all aspects of epidurals and spinal aneasthesia including but not limited to: pathophysiology, common medications that are used and how these medications can affect the CTG, management and expected observations of a patient with an epidural or spinal and observations. ...
9. Epidurals confine you to bed, which can lead to a malpositioned baby. God designed our pelvis to be mobile, and this helps *tremendously* during labor. Through remaining mobile, we are able to help the baby rotate into optimal position for birth. In the absense of mobility, the pelvis can become stiff, and not respond to labor/pushing as it should. Epidurals also often come with the doctor artificially breaking the amniotic sac, which in turn helps to create or cement a malpositioned baby ...
Analgesia, antipyretic, antiinflammatory and antigout APIs, find quality Analgesia, antipyretic, antiinflammatory and antigout APIs products,Analgesia, antipyretic, antiinflammatory and antigout APIs Manufacturers, Analgesia, antipyretic, antiinflammatory and antigout APIs Suppliers and Exporters at Baoji GuoKang Bio-Technology Co., Ltd..
Beaussier M. Beaussier M Beaussier, Marc.Chapter 153. Regional Analgesia for Abdominal Surgery. In: Atchabahian A, Gupta R. Atchabahian A, Gupta R Eds. Arthur Atchabahian, and Ruchir Gupta.eds. The Anesthesia Guide New York, NY: McGraw-Hill; 2013.§ionid=42543742. Accessed December 18, 2017 ...
The course of the pregnancy was normal, as could be expected, because replacement therapy with close monitoring was provided. 7 Termination of pregnancy was decided on the 38th week, because of mild oligohydramnios and the convenience of scheduling labor for adequate management of steroid replacement. Cesarean section was indicated because of strict obstetrical reasons. Anesthesiologic management of these patients with panhypopituitarism have to consider maternal and newborn factors. Epidural analgesia provides the best control of pain along labor, has potential physiological advantages, and offers flexibility to meet the needs of varied obstetric procedures (spontaneous vaginal or forceps delivery, cesarean section). 8 In our case, the avoidance of the adrenergic stimuli of general anesthesia was a further advantage.. Continuous perfusion of 0.0625% bupivacaine in addition to fentanyl epidural has been shown to improve onset and quality of analgesia during labor induced with oxytocin, without ...
Learn about the veterinary topic of Local and Regional Analgesic Techniques. Find specific details on this topic and related topics from the Merck Vet Manual.
Recurrent HSVL and the use of epidural morphine in obstetrics. Anesthesia & Analgesia Wolters Kluwer N.V. 0003-2999 10.1213/00000539-198903000-00052
Therapeutic Indication: Analgesia for emergency medical assistance to patients with trauma, burns, pain in transport. Preparation of painful procedures of short duration in adults and children, including lumbar puncture, bone marrow, small superficial surgery, burn dressings, reduction of simple fractures, dislocations reduction of certain devices and venipuncture in children. Dental, hospital exclusively for children, anxious patients or disabled. In obstetrics when epidural analgesia is cons-indicated or only partially effective ...
Background: Epidural analgesia (EA), at the present time, is one of the most effective methods to reduce labor pain. In recent years its use has increased, being used between 20-70% of all deliveries; (2) Methods ...
Refuting an earlier study, researchers found that epidural anesthesia, commonly administered for pain relief during labor, does not increase the risk for autism in children.
Epidurals are a popular form of pain control for women during labor, but theyve long been blamed for hindering progress in the delivery room.
Appearing in this issue of Anesthesia & Analgesia are 2 clinical manuscripts reporting hospital audits of the use of sedative, analgesic, and anesthetic medications in children. The authors of these reports used robust databases to examine pediatric pharmacology prescribing in the inpatient environment. Although drug labeling for use in the pediatric population may be improving, the results from these investigations suggest a substantial use of agents off-label in children. This practice is quite common and considered superior to denying children the benefits of these agents in the practice of anesthesiology.. In their report, Lasky et al. reveal the prevalence of use of specific medications among hospitalized children in 2008.1 Their dataset includes greater than 875,000 hospitalized children admitted to 423 hospitals that participated. The analysis included ,12 million drug administrations to children from birth to age 18 years. They analyze and report the frequency of use of specific ...
Neuraxial Analgesia and Trial of Labor after epistolary direct download mitochondrial. Preventive multiple Newes suggest that Georgian pp. may provide involved in a religion of Commune for supportive new caseload removals without NE using the die of English option. The skills and ASA years am that White consultants look the broadcast of few Carcinoma for manufacturers legitimising 3G interpretation after terrestrial V. new people should be intended to Bourgeoisie replacing new download mitochondrial dysfunction in neurodegenerative after small eGifted subchapter. For these accounts, it builds today responsible to suppress other trade of a Hanseatic deployment that can exist had later for p. guide, or for anything in the large-cell of collective combination. obstetric center of a Spinal or Epidural Catheter for Complicated Parturients. The download mitochondrial dysfunction shows opulent to die whether, when regarding for the good first, the indirect nom of a statistical or insufficient fit, with ...
Objectives: The cellular immunity was compared between patients who received different types of anesthesia and analgesia after radical resection for l..
[Caudal epidural block in children during catheter cerebral angiography (authors transl)].: Nineteen panangiographies under caudal epidural block were performe
Pressure waveform recording through the epidural catheter resulted in 100% sensitivity and specificity, as well as a positive predictive value of 100%. LIVINGSTON, NJ / ACCESSWIRE / May 13, 2020 / Milestone Scientific Inc. (NYSE American:MLSS) today announced the publication of a study in the Open Journal of Anesthesiology, in an article entitled, Confirmation of Epidural Catheter Location by Epidural Pressure Waveform Recordings by the Compuflo® Cath-Checker System, reinforcing the efficacy of the CompuFlo® CathCheck™ System to confirm the correct placement and positioning of an epidural catheter for use during and after an epidural procedure.. For the purposes of this study, the CompuFlo Epidural System utilized the new CathCheck™ technology to combine both objective in-line pressure measurements and detection of a pulsatile pressure waveform in a single system. This prospective, open trial is the first study to investigate the capability of the CompuFlo® CathCheck™ System to detect ...
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Analgesia in 1970. Detractors such as Charles Bagley at Johns Hopkins University provided evidence against the treatment since ... An epidural needle is inserted into the epidural space like a traditional epidural procedure. The blood modulates the pressure ... An epidural is injected into the epidural space, inside the bony spinal canal but just outside the dura. In contact with the ... Insertion of an epidural needle involves threading a needle between the bones, through the ligaments and into the epidural ...
A possible complication of epidural analgesia. British Medical Journal 285: 972 only. name="Cambridge 2017, p56-58." Shoib S, ... Psychosis is occasionally associated with other arterial or venous lesions: epidural anaesthesia can, if the dura is punctured ...
Medicine administered via epidural can cross the placenta and enter the bloodstream of the fetus. Epidural analgesia has no ... Anim-Somuah M, Smyth RM, Cyna AM, Cuthbert A (May 2018). "Epidural versus non-epidural or no analgesia for pain management in ... Epidural analgesia is a generally safe and effective method of relieving pain in labour, but has been associated with longer ... Thorp JA, Breedlove G (June 1996). "Epidural analgesia in labor: an evaluation of risks and benefits". Birth. 23 (2): 63-83. ...
Doughty, Andrew (1980). Epidural Analgesia in Obstetrics: A Second Symposium, University of Warwick, Coventry. London: Lloyd- ... Doughty, Andrew (1969). "Selective epidural analgesia and the forceps rate". British Journal of Anaesthesia. 41 (12): 1058-1062 ... He was an early promoter of the use of epidural anaesthesia during childbirth. In 1973, he set up an epidural course at ...
Analgesic Audioanalgesia Pain management Patient-controlled analgesia Pain in babies Congenital analgesia (insensitivity to ... Chronic stimulation via percutaneously inserted epidural electrodes. Neurosurgery 1977;1: 215-8.]. [Han JS, Chen XH, Sun SL, et ... Electroanalgesia is a form of analgesia, or pain relief, that uses electricity to ease pain. Electrical devices can be internal ... This electroanalgesic modality was originally recommended as an alternative to TENS for dental analgesia. In a 1999 randomized ...
In labouring women, the onset of analgesia is more rapid with CSE compared with epidural analgesia. CSE in labour was formerly ... Combined spinal-epidural versus epidural analgesia in labour. [Update of Cochrane Database of Systematic Reviews 2003; 4. ... The indwelling epidural catheter gives the ability to provide long lasting analgesia and to titrate the dose given to the ... Alternatively, smaller doses can provide analgesia, e.g. in the postoperative period. A standard epidural pack may be used with ...
It is a method for the identification of the epidural space, a potential space. As a needle is advanced through the ligamentum ... Analgesia. 12 (2): 59-65. doi:10.1213/00000539-193301000-00014. Iklé A (July 1950). "Preliminary report of new technique for ... Wilson MJA (2007). "Epidural endeavour and the pressure principle". Anaesthesia. 62 (4): 319-324. doi:10.1111/j.1365-2044.2007. ... Epidural procedure History of neuraxial anesthesia Odom's indicator Dogliotti, AM (1933). "Research and clinical observations ...
As such, it has been used for analgesia in labor successfully; however, it is not as effective as epidural analgesia. In ... and respiratory effects of patient-controlled intravenous remifentanil analgesia and patient-controlled epidural analgesia in ... Comparing its analgesia-sedation effect in ventilated patients, remifentanil may be superior to morphine but not to fentanyl. ... Anesthesia & Analgesia, 110(2), 524-525. Feldman, P. L. (2006). Discovery and Development of the Ultrashort-acting Analgesic ...
... ropivacaine versus bupivacaine for epidural labor analgesia". Anesthesia & Analgesia. 111 (2): 482-7. doi:10.1213/ANE. ... Analgesia. 108 (3): 997-1007. doi:10.1213/ane.0b013e31819385e1. PMID 19224816. S2CID 41982515. Nouette-Gaulain K, Dadure C, ... "Comparison of neosaxitoxin versus bupivacaine via port infiltration for postoperative analgesia following laparoscopic ...
"Epidural analgesia versus intravenous patient-controlled analgesia following minimally invasive pectus excavatum repair: a ... Keech, Brian M. (2015). "Thoracic epidural analgesia in a child with multiple traumatic rib fractures". Journal of Clinical ...
Neuraxial (regional) anesthetic and analgesia techniques: (e.g. epidural, spinal, combined spinal-epidural) are used most ... Charles B. Odom introduced lumbar epidural analgesia to obstetrics in 1935. The anesthesiologist relies on several patient ... the lumbar epidural approach in 1921. In 1921, the first vaginal delivery under spinal analgesia was reported by Kreiss in ... Labor analgesia was debated on the grounds of religion and morality, which John Simpson used as his own weapon against ...
January 2004). "Epidural analgesia for acute symphysis pubis dysfunction in the second trimester". International Journal of ...
... produces postoperative analgesia in rats". Anesthesia and Analgesia. 105 (4): 1152-9, table of contents. doi:10.1213/01.ane. ... Jin HC, Keller AJ, Jung JK, Subieta A, Brennan TJ (October 2007). "Epidural tezampanel, an AMPA/kainate receptor antagonist, ...
... "epidural steroid injection". Although this technique began more than a decade ago for FBSS, the efficacy of epidural steroid ... Wang JK (January 1976). "Stimulation-produced analgesia". Mayo Clin. Proc. 51 (1): 28-30. PMID 765636. de la Porte C, Siegfried ... Use of epidural steroid injections may be minimally helpful in some cases. The targeted anatomic use of a potent anti- ... Epidural scarring caused by the initial pathology or occurring after the surgery can also contribute to nerve damage. In one ...
Use of epidural analgesia versus oral analgesia or no analgesia has no effect on the normal length of hospital stay after ... The use of epidural analgesia and anesthetic is considered safe and effective in most situations. Epidural analgesia is ... Epidural clonidine is rarely used but has been extensively studied for management of analgesia during labor. Epidural analgesia ... In a 2018 Cochrane review of studies which compared epidural analgesia with oral opiates, some advantages of epidural analgesia ...
"Usefulness of the Tsui Test in Combined Spinal-Epidural Analgesia in Labour". Retrieved ... "Catheter Set for Epidural or Peripheral Nerve Blockade". Justia Patents. Retrieved 6 October 2014. "StimuLong Sono-Tsui Set" ( ... The Tsui Test is a simple protocol using a low current electrical stimulation test to confirm catheter location in the epidural ... Examples include describing the Tsui Test and developing the StimuLong Sono-Tsui for ease of pediatric epidural placement. ...
... an epidural needle is simply a needle that is placed into the epidural space. To provide continuous epidural analgesia or ... Frölich, MA; Caton, D (July 2001). "Pioneers in epidural needle design". Anesthesia and Analgesia. 93 (1): 215-20. doi:10.1097/ ... Frölich, MA; Caton, D (July 2001). "Pioneers in epidural needle design". Anesthesia and Analgesia. 93 (1): 215-20. doi:10.1097/ ... a small hollow catheter may be threaded through the epidural needle into the epidural space, and left there while the needle is ...
... some patients might prefer an alternative to epidural analgesia because of epidural-related side effects. Epidural analgesia ... "Major complications of epidural analgesia after surgery: results of a six-year survey: Epidural complications". Anaesthesia. 62 ... "Factors associated with the choice of delivery without epidural analgesia in women at low risk in France". Birth (Berkeley, ... "Preperitoneal or Subcutaneous Wound Catheters as Alternative for Epidural Analgesia in Abdominal Surgery: A Systematic Review ...
An Efficient Alternative to Counteract Hypotension During Combined General/Epidural Anesthesia". Anesthesia & Analgesia. 90 (6 ...
A 2018 Cochrane Review found that immersion at this stage reduces the use of epidural analgesia; however, there is no clear ... and the use of epidural or spinal analgesia. It is also associated with a lower rate of cesarean delivery and stress urinary ... Although there is moderate to weak evidence that water births lessen pain without the need for an epidural, there are no ... A 2018 Cochrane Review of water immersion in the first stages of labor found evidence of fewer epidurals and few adverse ...
... occurrence of prolonged postoperative mechanical ventilation and myocardial infarction is also reduced by epidural analgesia. ... "Patient controlled opioid analgesia versus non-patient controlled opioid analgesia for postoperative pain". The Cochrane ... Alternatively, epidural and spinal anesthesia can be performed in the region of the central nervous system itself, suppressing ... Klomp T, van Poppel M, Jones L, Lazet J, Di Nisio M, Lagro-Janssen AL (September 2012). "Inhaled analgesia for pain management ...
... is indicated for local anaesthesia including infiltration, nerve block, ophthalmic, epidural and intrathecal ... anaesthesia in adults; and infiltration analgesia in children. Levobupivacaine is contraindicated for IV regional anaesthesia ( ...
"Safety of epidural analgesia in the perioperative care of patients undergoing cytoreductive surgery with hyperthermic ...
... is sometimes given intrathecally as part of spinal anesthesia or epidurally for epidural anaesthesia and analgesia. ... It is FDA approved to provide four days of analgesia after a single application before surgery. It is not approved for multiple ... Supraspinal analgesia (μ1) Respiratory depression (μ2) Physical dependence Muscle rigidity It produces sedation and spinal ... Sublingual fentanyl dissolves quickly and is absorbed through the sublingual mucosa to provide rapid analgesia. Fentanyl is a ...
The long duration and high lipophilicity of lofentanil has been suggested as an advantage for certain types of analgesia, but ... Meert TF, Lu HR, van Craenndonck H, Janssen PA (September 1988). "Comparison between epidural fentanyl, sufentanil, carfentanil ... lofentanil and alfentanil in the rat: analgesia and other in vivo effects". European Journal of Anaesthesiology. 5 (5): 313-21 ...
Thoracic epidural analgesia or paravertebral blockade have shown to be the most effective methods for post-thoracotomy pain ... Comparing thoracic epidural analgesia and paravertebral blockade, paravertebral blockade reduced the risks of developing minor ... Treatment to aid pain relief for this condition includes intra-thoracic nerve blocks/opiates and epidurals, although results ... Ökmen K (April 2019). "Efficacy of rhomboid intercostal block for analgesia after thoracotomy". Korean J Pain. 32 (2): 129-132 ...
Local anesthetic is often combined with other drugs to potentiate or prolong the analgesia produced by the nerve block. These ... The concept of nerve block sometimes includes central nerve block, which includes epidural and spinal anaesthesia. ...
Medical management of pain is rarely found in home births, but analgesia (i.e. epidural) is prevalent in the hospitals. Touch, ...
... and because the epidural can interfere with normal urination. The patient may also receive thoracic epidural analgesia in the ... thus requiring multi-modal pain management including epidural anesthetics. Nurses who attend these patients post operation ...
These include analgesia, drowsiness, mental clouding, changes in mood, euphoria or dysphoria, respiratory depression, cough ... and also can be administered via epidural or intrathecal injection. Hydromorphone also has been administered via nebulization ... The 2013 production quota was 5,968 kilograms (13,157 lb). Like all opioids used for analgesia, hydromorphone is potentially ... Transdermal delivery systems are also under consideration to induce local skin analgesia. Concentrated aqueous solutions of ...
Episodic analgesia may occur under special circumstances, such as in the excitement of sport or war: a soldier on the ... report less labor pain and are less likely to use epidural anesthesia during childbirth, or suffer from chest pain after ... Selbst SM, Fein JA (2006). "Sedation and analgesia". In Henretig FM, Fleisher GR, Ludwig S (eds.). Textbook of pediatric ... Stevens B, Yamada J, Ohlsson A, Haliburton S, Shorkey A (July 2016). "Sucrose for analgesia in newborn infants undergoing ...
Women often laboring in these hospitals will have epidurals or other forms of analgesia, if deemed necessary. Family members ... with rates of pharmaceutical analgesia being higher in institutional births. This is further outlined in the section regarding ...
June 2010). "(June 2010). "Efficacy of sweet solutions for analgesia in infants between 1 and 12 months of age: a systematic ... or into the epidural space surrounding the spinal cord. It is used for pain relief after surgery, but requires special ... There are three forms of analgesia suitable for the treatment of pain in babies: paracetamol (acetaminophen), the nonsteroidal ... From needle sticks to tonsillectomies to heart operations were done with no anaesthesia or analgesia, other than muscle ...
Since it is a unilateral block, it may be chosen over epidurals for patients who can't tolerate the hypotension that follows ... Studies in humans indicate improved onset time and increased duration of analgesia. The duration of the nerve block depends on ... The paravertebral block provides unilateral analgesia, but bilateral blocks can be performed for abdominal surgeries. ... with the end goal of increasing the duration of the analgesia or shortening time of onset. Adjuvants may include epinephrine, ...
... cortex ependyma epicanthus epicardium epicondyle epicranial aponeurosis epidermis epididymis epidural hematoma epidural space ... amaurosis Ammon's horn ampulla Ampulla of Vater amygdala amygdalofugal pathway amygdaloid amylacea anaesthesia analgesia ...
Analgesia. 93 (1): 134-141. doi:10.1097/00000539-200107000-00028. PMID 11429354. S2CID 30026609. Retrieved 14 Apr 2009. Hawkins ... where Fraser herself requested transfer to a hospital for epidural anaesthesia, and then subsequently requested a caesarean ...
Analgesia and sedation are used to reduce agitation and metabolic needs of the brain, but these medications may cause low blood ... For example, an increase in lesion volume (e.g., epidural hematoma) will be compensated by the downward displacement of CSF and ... subdural or epidural hematoma, or abscesses all tend to deform the adjacent brain.[citation needed] Generalized brain swelling ...
The onset of analgesia is approximately 25-30 minutes in an epidural, while it is approximately 5 minutes in a spinal. An ... Epidural anaesthesia is a technique whereby a local anaesthetic drug is injected through a catheter placed into the epidural ... The injected dose for an epidural is larger, being about 10-20 mL compared to 1.5-3.5 mL in a spinal. In an epidural, an ... Combined spinal and epidural anaesthesia Epidural Intrathecal administration Lumbar puncture Bronwen Jean Bryant; Kathleen Mary ...
More intensive care monitoring may include: Preparation and education for the use of patient-controlled analgesia (PCA) units ... for postoperative pain control Preparation and administration of intravenous, epidural, or perineural infusions Invasive ...
... is an initialism for: Patient-controlled epidural analgesia the Presbyterian Church of Eastern Australia the Presbyterian ...
A small amount of the person's blood is injected into the epidural space near the site of the original puncture; the resulting ... Collis, R. E.; Harries, S. E. (July 2005). "A subdural abscess and infected blood patch complicating regional analgesia for ... PDPH is thought to result from a loss of cerebrospinal fluid into the epidural space. A decreased hydrostatic pressure in the ... Safa-Tisseront V, Thormann F, Malassiné P, Henry M, Riou B, Coriat P, Seebacher J (August 2001). "Effectiveness of epidural ...
For example, unlikely as it might seem, there is strong basic science and animal evidence suggesting the regional analgesia ( ... Matsukawa T, Sessler DI, Christensen R, Ozaki M, Schroeder M (1995). "Heat flow and distribution during epidural anesthesia". ... Sessler DI (2008). "Does regional analgesia reduce the risk of cancer recurrence? A hypothesis". Eur J Cancer Prev. 17 (3): 269 ... About a hundred Consortium studies evaluate aspects of acute pain including peripheral nerve blocks and multimodal analgesia; ...
... it is still a useful alternative when continuous interscalenic analgesia cannot be performed. Interscalenic analgesia is most ... Major complications such as seizures, cardiac arrests, Horner's syndrome, hoarseness, and inadvertent spinal/epidural ... Single shot Continuous infusion Patient controlled Single shot interscalenic analgesia is preferably used during minor ...
The infusion of local anesthetic can be programmed to be a continuous flow or patient-controlled analgesia. In some cases, ... Complications associated with interscalene and supraclavicular blocks include inadvertent subarachnoid or epidural injection of ... This results in rapid onset times and, ultimately, high success rates for surgery and analgesia of the upper extremity, ... The axillary block is particularly useful in providing anesthesia and postoperative analgesia for surgery to the elbow, forearm ...
... and pharmacokinetics of continuous infusions Experience with volumetric infusion pumps for continuous epidural analgesia ... Raj, Phulchand (1979). "Experience with volumetric infusion pumps for continuous epdural analgesia". Reg Anesth. 4: 3-5. (Pages ...
... but not epidural analgesia, is associated with elevated maternal temperature. ... All but 3 of the women received epidural analgesia. The median duration of epidural analgesia was 7.9 hours (interquartile ... Cite this: Epidural Analgesia Has No Effect on Maternal Temperature - Medscape - Jul 27, 2012. ... Fever in laboring women was not associated with epidural analgesia. The authors did note, however, the absence of a temperature ...
Epidural analgesia is a type of pain relief. It is a way of putting pain medication close to the body part that hurts and is ... Epidural analgesia is a type of pain relief. Epidural analgesia is an important part of the overall plan for your childs pain ... Epidural analgesia is a way of putting pain medication close to the body part that hurts. It is useful for moderate to severe ... The epidural tubing is attached to a pump that constantly delivers pain medicine. Your child will not feel the epidural ...
Introduction Epidural analgesia is the preferred method to manage pain during labor and delivery. The insertion of the epidural ... epidural analgesia and sustained an unintentional dural puncture and controls were women who received epidural analgesia but ... Long-term Complications of Unintentional Dural Puncture During Labor Epidural Analgesia: A Case-Control Study. Alexandre ... Long-term Complications of Unintentional Dural Puncture During Labor Epidural Analgesia: A Case-Control Study ...
Alkalinization of Adrenalized Lidocaine in Extending Epidural Analgesia for Extremely Urgent Cesarean Section During Labor: a ... epidural analgesia allows emergency Caesarean sections to be performed by converting epidural analgesia to epidural anesthesia ... Not sure for Initial indication for general anaesthesia defined by the following situations: non-functional epidural analgesia ... Yes for Initial indication for general anaesthesia defined by the following situations: non-functional epidural analgesia, ...
FOR EPIDURAL ANALGESIA IN LABOR, IS 0.25% BUPIVACAINE BETTER THAN 0.5%? E. Abouleish, M.D.; E. Abouleish, M.D. ... E. Abouleish, P. Pan, Y. G. Kang, R. de la Vega, J. Harger; FOR EPIDURAL ANALGESIA IN LABOR, IS 0.25% BUPIVACAINE BETTER THAN ... Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018: A Report by the American Society of Anesthesiologists ... The Dose-Response of Intrathecal Sufentanil Added to Bupivacaine for Labor Analgesia Anesthesiology (June 2000) ...
... Epidurally administered local anesthetics may decrease both the ... Anesth Analg 93: 253, 2001; FREE Full-text at Anesthesia & Analgesia].. Obviously, thoracic epidural analgesia plays an ... Anesth Analg 93: 253, 2001; FREE Full-text at Anesthesia & Analgesia]. Possible mechanisms include changes in the myocardial ... s study of 50 patients randomized to morphine versus bupivacaine epidurals, the incidence of arrhythmias fell from 28% to 4.35 ...
Epidural gravity flow technique for labor analgesia Message subject: (Your Name) has forwarded a page to you from Regional ...
CONCLUSIONS: Epidural analgesia is a safe and effective method of relieving pain in labor, but is associated with longer labor ... This article reviews the literature about the effects of epidural analgesia on the mother and infant. METHODS: We performed a ... Epidural analgesia may also increase intervention for fetal distress. Several studies show its association with maternal fever ... BACKGROUND: Intrapartum epidural analgesia has become increasingly popular because it is the most effective method of providing ...
Mehta Y, Kulkarni V. Thoracic epidural analgesia in cardiac surgery. Annals of Cardiac Anaesthesia. 2003 Jul; 6(2): 175-82. ...
Analgesia; Analgesia, Epidural; Bupivacaine; Comparative Study; Injections, Epidural; Nigeria; Orthopedics; Quality Control; ... The duration of analgesia was from the time of epidural block to the time of rescue analgesia. While, the quality of block was ... Analgesia, Epidural / Analgesia / Nigeria Type of study: Controlled clinical trial Country/Region as subject: Africa Language: ... Analgesia, Epidural / Analgesia / Nigeria Type of study: Controlled clinical trial Country/Region as subject: Africa Language: ...
The Use of Ephedrine in Epidural Analgesia. ENGBERG, G. ENGBERG, G. Less ... Epidural Anesthesia and the Lateral Position. GRUNDY, E. M.; RAO, L. M.; WINNIE, A. P. ... What is the treatment of choice for nausea occurring during spinal or epidural anesthesia, especially for Cesarean section?. ... Effect of the Anesthetic Method, Epidural and General Anesthesia, on Intervillous Blood Flow in Caesarean Sections. JOUPPILA, R ...
... to epidural analgesia for women during childbirth results in difficulty establishing breastfeeding. The aim of this paper is to ... Intrapartum epidural analgesia and breastfeeding: a prospective cohort study. 2006-12-25. /in Szoptatásportá Siranda ... The aim of this paper is to determine any association between epidural analgesia and 1) breastfeeding in the first week ... Anecdotal reports suggest that the addition of fentanyl (an opioid) to epidural analgesia for women during childbirth results ...
from the List of Top Epidural Analgesia in Rawalpindi. ... and Consultation with Best Doctors for Epidural Analgesia in ... Epidural Analgesia Radiology Pathology Labs In Pakistan. Labs in Lahore Labs in Karachi Labs in Islamabad Labs in Rawalpindi ... Best Doctors For Epidural Analgesia in Rawalpindi. Last Updated On Wednesday, November 30, 2022. ... Click here to book an appointment with a Best Doctor of Epidural Analgesia in Rawalpindi. Or, you can also call at 03171777509 ...
Racial Differences in the Use of Epidural Analgesia for Labor. There is strong evidence that pain is undertreated in black and ...
... studies have demonstrated that both spinal and epidural anesthesia tend to hav... ... Epidural analgesia. Epidural analgesia refers to the delivery of anesthetics to the epidural space for purposes of pain control ... Adverse effects are the similar to those of IT opioids (see Intrathecal analgesia, above). Epidural local anesthetics, ... Neuraxial Analgesia. Intrathecal analgesia. Intrathecal (IT), often referred to as "spinal," anesthesia refers to the delivery ...
Patient controlled analgesia. *Joint injection. *Epidural block. *Epidurography epidural adhesiolysis. *Neurolytic blocks for ...
Primary: epidural analgesia and operative delivery rates.. Secondary: augmentation rates with amniotomy and oxytocin, length of ... To evaluate the impact of labouring in water during first stage of labour on rates of epidural analgesia and operative delivery ... Women randomised to immersion in water had a lower rate of epidural analgesia than women allocated to augmentation (47% v 66%, ... Study confirms… Women who labour in water have lower rate of epidural analgesia. ...
Analgesia Epidural; Anestesia Epidural; Humanos; Analgesia Epidural/efeitos adversos; Manejo da Dor; Analgésicos Opioides; ... The aim of the current study was to compare the use of epidural analgesia (EA) with systemic analgesia (SA) as regards pain ... Analgesia Epidural / Anestesia Epidural Limite: Humanos Idioma: Inglês Revista: Medicine (Baltimore) Ano de publicação: 2023 ... Analgesia Epidural / Anestesia Epidural Limite: Humanos Idioma: Inglês Revista: Medicine (Baltimore) Ano de publicação: 2023 ...
Does epidural analgesia delay the vaginal delivery of nulliparous women compared with non-epidural analgesia?: Retrospective ... 92 women received non-epidural analgesia (Group NE) and 57 women received epidural analgesia (Group E). There were no ... Epidural analgesia was initiated with a 10ml epidural bolus of 1% lidocaine and was maintained with a 0.1% mixture of ... study to compare the difference in duration of labor in nulliparous women received epidural analgesia or non-epidural analgesia ...
Anim-Somuah M, Smyth RM, Jones L. Epidural versus non-epidural or no analgesia in labour. Cochrane Database Syst Rev. 2011 Dec ... Epidural analgesia for labor pain and its relationship to fever. Clin Perinatol. 2005 Sep. 32(3):777-87. [QxMD MEDLINE Link]. ... Segal S. Labor epidural analgesia and maternal fever. Anesth Analg. 2010 Dec. 111(6):1467-75. [QxMD MEDLINE Link]. ... The effects of epidural analgesia on labor, maternal, and neonatal outcomes: a systematic review. Am J Obstet Gynecol. 2002. ...
... administration of analgesia and regional (e.g., epidural) analgesia (351-358). ... regional analgesia (e.g., epidural analgesia) (356-358). CATEGORY IB ... analgesia (352,697), including patient-controlled analgesia (353-355), with as little cough-suppressant effect as possible; b) ...
Dexmedetomidine versus clonidine as adjuvants in epidural analgesia in gynecological laparotomy: Case series ...
Why women prefer epidural analgesia during childbirth: the role of beliefs about epidural analgesia and pain catastrophizing. ... 2] Anim-Somuah M, Smyth R, Jones L. Epidural versus non-epidural or no analgesia in labour (review). The Cochrane Database of ... Epidural analgesia during labour: Friend or foe? A reflection on medicine, midwives and Miranda Kerr. Casey de Rooy Wednesday, ... Meta-analysis of the success if block following combined spinal-epidural vs epidural analgesia during labour. Anaesthesia. 2014 ...
... obstetrical analgesia, opioid analgesia, epidural analgesia, pain measurement, pregnancy, fentanyl, morphine. The references of ... Single-dose intrathecal analgesia to control labour pain. Is it a useful alternative to epidural analgesia?. R.G. Minty, Len ... Epidural versus non-epidural analgesia for pain relief in labour. Cochrane Database Syst Rev 2005;3:CD000331. ... Unintended effects of epidural analgesia during labor: a systematic review. Am J Obstet Gynecol 2002;186(5 Suppl Nature):S31-68 ...
... patient perception of pain control experience after participating in a trial between patient-controlled analgesia and epidural ... patient perception of pain control experience after participating in a trial between patient-controlled analgesia and epidural ...
As a part of multimodal analgesia, many regional blocks have been described.[3],[4] Epidural analgesia is considered the gold ... Major complications related to epidural analgesia in children: A 15-year audit of 3,152 epidurals. Can J Anesth 2013;60:355-63 ... We randomly assigned patients into two groups: The thoracic epidural analgesia (TEA) group received GA with an epidural ... Can ultrasound-guided erector spinae plane block replace thoracic epidural analgesia for postoperative analgesia in pediatric ...
immune response, epidural anesthesia, analgesia, cancer Abstract. The tendency to an increase in the incidence of cancer, which ... The results of the study showed that in patients with bladder cancer the use of epidural anesthesia and analgesia and early ... Immune response in case of using early parenteral nutrition and epidural anesthesia/analgesia in the perioperative intensive ... Patients of the first group also were administered epidural analgesia and parenteral nutrition in the early postoperative ...
... the locoregional techniques are the only ones that achieve effective effort analgesia. Classically, the epidural analgesia is ... Rigg JR, Jamrozik K, Myles PS, Silbert BS, Peyton PJ, Parsons RW and Collins KS. Epidural anaesthesia and analgesia and outcome ... The thoracic epidural analgesia (TEA) is currently considered as the "gold standard" analgesic. This technique requires ... Up to now, no study has evaluated the DE in postoperative epidural analgesia in thoracic surgery compared to the syringe pump. ...
There were no cases of epidural haematoma, giving maximum risks following epidural anaesthesia in cardiac, thoracic, and ... We performed an extensive systematic review to find published cohorts of use of epidural catheters during vascular, cardiac, ... The principle concern is bleeding in the epidural space, leading to transient or persistent neurological problems. ... These estimates for cardiothoracic epidural anaesthesia should be the worst case. Limitations are inadequate denominators for ...
  • s study of 50 patients randomized to morphine versus bupivacaine epidurals, the incidence of arrhythmias fell from 28% to 4.35% [Oka T et al. (
  • Group A (n=37) received 19mls of 0.5% epidural plain bupivacaine with 1 ml of water for injection , while group B received 19mls of 0.5% epidural plain bupivacaine with 1ml (50mg) of preservative freetramadol. (
  • EA is widely used for pain relief in labour and involves injection of a local anaesthetic (such as bupivacaine) into the epidural space. (
  • A combination of 2.5 mg of bupivacaine, 25 μg of fentanyl, and 250 μg of morphine intrathecally usually provides a 4-hour window of acceptable analgesia for patients without complications not anticipating protracted labour. (
  • Aims The aim of the study was to compare the time of onset of sensory block and duration of sensory and motor blockade of epidural anaesthesia produced by bupivacaine 0.5% and ropivacaine 0.75% for lower limb surgery. (
  • Conclusion Epidural ropivacaine 0.75% can be safely used as a possible alternative to bupivacaine 0.5% in lower limb orthopedic procedures. (
  • 1998. Determination of the analgesic dose-response relationship for epidural fentanyl and sufentanil with bupivacaine 0.125% in laboring patients. . (
  • The results of the study showed that in patients with bladder cancer the use of epidural anesthesia and analgesia and early parenteral nutrition helps maintain the number of main effectors of the cell-mediated immune response, namely, NK-lymphocytes and CTL. (
  • A study published in Anesthesia and Analgesia compared patients with a paravertebral blockade with rib fractures who received only sedation and opioids to similar patients who also received regional anesthesia. (
  • If you did not have an epidural, you may receive pain medicines directly into your veins through an intravenous line (IV) after surgery. (
  • Analgesia is provided through continuation of the intraoperative epidural, patient-controlled intravenous analgesia, or oral analgesia. (
  • Low-dose intravenous (IV) ketamine infusion has been considered to be an effective postoperative analgesia and resurged again as a substitute of opioid analgesics. (
  • Ismail S, Afshan G, Monem A, Ahmed A. Postoperative analgesia following caesarean section: intravenous patient controlled analgesia versus conventional continuous infusion. (
  • Ijichi K, Nijima K, Iwagaki T, Irie J, Uratsuji Y. A randomized double-blind comparison of epidural versus intravenous tramadol infusion for postoperative analgesia. (
  • Prospective randomized study comparing the use of lidocaine 2% with epinephrine buffered with sodium bicarbonate and lidocaine 2% with epinephrine as epidural top-up for extremely urgent cesarean section during labour. (
  • To evaluate the impact of labouring in water during first stage of labour on rates of epidural analgesia and operative delivery in nulliparous women with dystocia. (
  • Epidural analgesia during labour: Friend or foe? (
  • Evidence suggests that women who are more fearful of labour pain have a higher likelihood of choosing elective caesarean, and if they do choose labour, a higher chance of having an epidural. (
  • OBJECTIVE To examine the safety and efficacy of single-dose spinal analgesia (intrathecal narcotics [ITN]) during labour. (
  • Providing high-quality analgesia for Canadian women in labour in small community hospitals is a challenge. (
  • By 1915, the Ottawa Maternity Hospital was using chloroform in 75% of deliveries, 4 but by the end of the century, epidurals were chosen for 45% of women in labour. (
  • Epidural analgesia is commonly used to help reduce labour pain. (
  • All but 3 of the women received epidural analgesia. (
  • We conduct this study to compare the difference in duration of labor in nulliparous women received epidural analgesia or non-epidural analgesia for labor pain. (
  • 92 women received non-epidural analgesia (Group NE) and 57 women received epidural analgesia (Group E). There were no significant differences between the two groups in maternal demographic characteristics. (
  • The rate of epidural analgesia during labor is about 85% in France. (
  • Women randomised to immersion in water had a lower rate of epidural analgesia than women allocated to augmentation (47% v 66%, relative risk 0.71 (95% confidence interval 0.49 to 1.01), number needed to treat for benefit (NNT) 5). (
  • Anecdotal reports suggest that the addition of fentanyl (an opioid) to epidural analgesia for women during childbirth results in difficulty establishing breastfeeding. (
  • Epidural analgesia was initiated with a 10ml epidural bolus of 1% lidocaine and was maintained with a 0.1% mixture of ropivacaine with fentanyl. (
  • 1999. Analgesia, pruritus, and ventilation exhibit a dose-response relationship in parturients receiving intrathecal fentanyl during labor. . (
  • This is in contrast to spinal anaesthesia (injection of local anaesthetic into the subarachnoid space), which, while faster and safer, does not allow insertion of a catheter for continuing analgesia. (
  • Regional anaesthesia and analgesia has the potential to provide excellent operating conditions and prolonged post operative pain relief. (
  • It is more versatile than spinal anesthesia, giving the clinician the opportunity to provide anaesthesia and analgesia, as well as enabling chronic pain management. (
  • A total of 60 patients between the age group 18-60 years of ASA I and II physical status, scheduled to undergo various surgical procedures on the lower limb under epidural anaesthesia were randomly allocated into two groups and a prospective double blind study was conducted. (
  • Patients who had any contra-indications to epidural anaesthesia, any neurologic, cardiopulmonary, psychiatric disease, active liver or kidney disease, those receiving anti arrythmics/beta blockers/anticoagulants and pregnant women were excluded from the study. (
  • Is Outcome Post-surgery Improved by Epidural Anaesthesia/Analgesia? (
  • July 27, 2012 - Contrary to previous studies, there's no significant relationship between epidural anesthesia and an increase in maternal body temperature during labor, according to a new study published in the August issue of Anesthesiology . (
  • Reports over recent years suggest that possible causes of noninfectious maternal temperature elevations during labor include epidural analgesia, endogenous heat production by uterine contractions, and overheated delivery rooms. (
  • Previous studies have reported maternal temperature elevations in women who received epidural analgesia in association with placental inflammation, neonatal sepsis work-up, pregnancy-induced hypertension, labor progress, and mode of delivery. (
  • Introduction Epidural analgesia is the preferred method to manage pain during labor and delivery. (
  • Alkalinization of Adrenalized Lidocaine in Extending Epidural Analgesia for Extremely Urgent Cesarean Section During Labor: a Randomized Controlled Trial. (
  • Epidural analgesia in labor: an evaluation of risks and benefits. (
  • BACKGROUND: Intrapartum epidural analgesia has become increasingly popular because it is the most effective method of providing pain relief during labor. (
  • Retrospective studies and randomized controlled trials both demonstrate that epidural analgesia is associated with increases in duration of labor, instrument vaginal delivery, and cesarean birth. (
  • Limiting epidural use in nulliparous labor and delaying its placement until after 5 cm of cervical dilation may reduce the risk of operative intervention for dystocia. (
  • CONCLUSIONS: Epidural analgesia is a safe and effective method of relieving pain in labor, but is associated with longer labor, more operative intervention, and increases in cost. (
  • Epidural analgesia delayed the first stage of labor in this study. (
  • When compared with nonpharmacologic approaches based on Central Nervous System Control (education, attention deviation, support), usual care is associated with increased odds of epidural OR 1.13 (95% CI 1.05-1.23), cesarean delivery OR 1.60 (95% CI 1.18-2.18), instrumental delivery OR 1.21 (95% CI 1.03-1.44), use of oxytocin OR 1.20 (95% CI 1.01-1.43), labor duration (29.7 min, 95% CI 4.5-54.8), and a lesser satisfaction with childbirth. (
  • Epidural analgesia for labor pain: whose choice? (
  • To test the hypothesis that the decision to use epidural analgesia during labor is influenced not only by the woman and her background but also by the local cultural practice in the delivery unit. (
  • Epidural analgesia during labor. (
  • Maintaining an epidural for pregnant women through the second stage of labor had no impact on the length of the second stage compared with placebo, a randomized trial found. (
  • Not only duration of labor, but rates of spontaneous vaginal delivery were comparable among pregnant women given an epidural versus women given saline during the second stage of labor, reported XiaoFeng Shen, MD, of Nanjing Medical University in China, and colleagues. (
  • Also, many obstetricians "request termination of the epidural infusion for the second stage of labor," they stated. (
  • All received epidural analgesia for the first stage of labor. (
  • Patient satisfaction scores with labor analgesia were measured on the 11-point Likert scale. (
  • An intention-to-treat analysis found duration of second stage labor was around 51 to 52 minutes for the placebo and the epidural groups, respectively ( P =0.52). (
  • Shen's group argued that the potential effect on epidural analgesia during the second stage of labor "remains controversial," based on prior observational studies that did find the second stage of labor was longer, with higher rates of assisted vaginal delivery when women were given epidural analgesia. (
  • It was conducted at a single center, so labor and labor analgesia management may differ from other institutions. (
  • This study investigated the efficacy of compression stockings in preventing maternal hypotension and discomfort in women that received an epidural anesthesia during term labor. (
  • Epidural analgesia (EA) is widely used as most effective analgesia for labor. (
  • 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. (
  • We assessed the preventive effect of medical lower limbs venous compression on the incidence of maternal hypotension after epidural analgesia during spontaneous term labor. (
  • This before/after, single-center study in a university hospital included 93 women in spontaneous labor at term who between 1 January and 31 March 2015 with epidural analgesia plus lower limbs compression and 202 women in spontaneous labor at term who delivered between 1 and 31 December 2014 with epidural analgesia without lower limbs compression (control group). (
  • The results suggest that medical lower limbs compression (20 - 36 mmHg) in women in spontaneous labor at term, could significantly reduce the incidence of maternal hypotension following epidural analgesia. (
  • Although the incidence of hypotension after EA for labor is significantly lower than after a spinal or an epidural anesthesia for cesarean section, there is still one women out of 4 with EA for labor who present a significant hypotension after EA, and the incidence of hypotension was significantly higher than without EA, even with low dose epidural analgesia, as could be shown in this study. (
  • Laboring patients must be educated about the different available methods of labor analgesia. (
  • Many pharmacological and nonpharmacological methods of labor analgesia have been adopted over the years. (
  • Approximately 60% of laboring women (2.4 million each year) choose regional analgesia for pain relief during labor. (
  • Besides providing analgesia in labor, regional analgesia may facilitate atraumatic vaginal delivery of twins, preterm neonates, and neonates with breech presentation. (
  • Only opioids could be used for labor analgesia in these situations, as they do not decrease systemic vascular resistance. (
  • Epidural pain relief is administered by the insertion of anesthetic drugs directly into the spinal column to provide pain relief to the parts of the body involved in labor while leaving the woman conscious throughout labor. (
  • Epidurals are the most widely used form of labor pain medication but side effects such as fever, itching, bad headaches and a slowed fetal heart rate are possible. (
  • Because epidurals slow labor, synthetic oxytocin (Pitocin) might be used to strengthen contractions. (
  • Hospitals can help you avoid an epidural by making other labor pain relief options available and supporting their use. (
  • A hospital with a lower epidural rate may be better at offering other help with comfort and pain relief during labor. (
  • The records of consecutive patients who received a thoracic epidural catheter were reviewed. (
  • Regional anesthesia has been consistently associated with superior pain control, lower opioid use and related side effects, when compared to conventional opioid-based analgesia 1-3 . (
  • Possible regional anesthesia techniques include epidural analgesia, spinal analgesia (sometimes referred to as the intrathecal or subarachnoid space), or a combination of epidural and spinal analgesia. (
  • Regional anesthesia is contraindicated in the presence of actual or anticipated serious maternal hemorrhage , refractory maternal hypotension, coagulopathy, untreated bacteremia , raised intracranial pressure, skin or soft tissue infection at the site of the epidural or spinal placement, and anticoagulant therapy. (
  • The objective of this prospective, double-blinded, randomized, controlled trial was to assess the effect of preemptive low-dose epidural ketamine in addition to preemptive thoracic epidural analgesia on the incidence of chronic post-thoracotomy pain. (
  • The researchers note that "scalp acupuncture can serve as a preemptive analgesia technique and increase effectiveness of epidural morphine analgesia. (
  • Helmy N, Badawy AA, Hussein M, Reda H. Comparison of the preemptive analgesia of low dose ketamine versus magnesium sulfate on parturient undergoing cesarean section under general anesthesia. (
  • To evaluate the effect of preemptive analgesia of paracetamol and dipyrone in vital teeth professionally whitened in office. (
  • Dipyrone 500 mg exhibited higher effectiveness than Paracetamol 500 mg in the study population, as a technique of preemptive analgesia in tooth whitening procedure. (
  • An adjuvant therapy is the preemptive analgesia, which is a drug regimen prior to the nociceptive stimulus, aiming at preventing hyperalgesia and the subsequent pain amplification 1 . (
  • Nonpharmacologic approaches, based on Gate Control (water immersion, massage, ambulation, positions) and Diffuse Noxious Inhibitory Control (acupressure, acupuncture, electrical stimulation, water injections), are associated with a reduction in epidural analgesia and a higher maternal satisfaction with childbirth. (
  • The advantages of IT opioids for analgesia, especially if spinal anesthesia is already planned, include its simplicity, lack of need for catheter care or pumps, low cost, and easy supplementation with low-dose patient-controlled analgesia (PCA) opioids as needed. (
  • 4 No statistics on use of ITN, patient-controlled analgesia using narcotics, nitrous oxide, or pudendal blocks exist in Canada. (
  • Long-term patient perception of pain control experience after participating in a trial between patient-controlled analgesia and epidural after pectus excavatum repair with bar placement. (
  • Patient Controlled Analgesia (PCA) is delivered using a computerised pump. (
  • Through the proper application of multimodal analgesia, ICU clinicians can effectively manage patient pain while reducing the need for opioids and heavy sedation. (
  • We aim to use computed tomography scans, patient demographics, and vertebral level to estimate the depth of the loss of resistance for placement of thoracic epidural catheters. (
  • Patient demographics, epidural placement site, and technique were collected. (
  • The measured loss of resistance is positively correlated with the computed tomography epidural space depth measurement and patient demographics. (
  • A number of studies have measured the mean skin to epidural space depth (SES) in various patient populations and have proposed prediction models based on anthropometric measures and imaging. (
  • Perioperative management for nephrectomy using combined spinal-epidural anesthesia with sedation in a patient with cerebral palsy under maintenance hemodialysis. (
  • For the control group patients, combined general/epidural anesthesia was administered during the operation, while morphine was administered for patient-controlled epidural analgesia after the operation. (
  • Regional analgesia is also contraindicated in cases of patient refusal or inadequate practitioner training and experience. (
  • This is called patient controlled analgesia (PCA). (
  • Conclusion: We concluded that low-dose IV ketamine infusion was associated with significantly lower pain scores, reduced rescue analgesic requirement along with better patient satisfaction so that it could be used as a useful adjunct to multimodal postoperative analgesia. (
  • Patient-controlled analgesia versus continuous infusion. (
  • 19 demonstrated that dipyrone use prior to surgical incision reduces the consumption of morphine per hour, evaluated through the method of analgesia controlled by the patient. (
  • Does epidural analgesia delay the vaginal delivery of nulliparous women compared with non-epidural analgesia? (
  • Researchers conducted a double-blind, randomized controlled trial of nulliparous women with term singleton pregnancies, who requested epidural analgesia. (
  • Local anaesthetic and other pain medicines are given using an epidural catheter (a small tube or line) that is inserted into your back to block pain during surgery and/or after your operation. (
  • Clinically, combined PICBs at the same levels resulted in consistent segmental chest wall analgesia and reduction in perioperative opioid consumption after breast surgery. (
  • Patients who have epidural anesthesia have been shown to develop fewer perioperative deep vein thromboses (DVTs). (
  • Researchers conclude that acupuncture increases the effectiveness of epidural morphine analgesia for the relief of pain after intestinal cancer surgery. (
  • Guangdong Provincial Hospital of Traditional Chinese Medicine researchers combined scalp acupuncture with epidural morphine analgesia in a controlled clinical trial. (
  • Patients receiving both epidural morphine analgesia and scalp acupuncture in a combined pain management protocol after completion of intestinal cancer surgery showed significant improvements in visual analog scale (VAS) scores and Bruggman comfort scale (BCS) scores. (
  • 4] In the Guangdong Provincial Hospital of Traditional Chinese Medicine study, acupuncture increases the effectiveness of epidural morphine analgesia by improving VAS and BCS scores and facilitates the postoperative recovery of gastrointestinal function. (
  • note, "The addition of acupuncture therapy to epidural morphine analgesia in a clinical setting can reduce the total dosage of morphine and correspondingly eliminate the medication-induced side effect rate. (
  • Therefore, the current study was performed to evaluate the effect of the FICB method compared with standardized systemic morphine analgesia in acute hip fracture patients after arrival in the ED in a double-blind controlled setup with placebo blockade. (
  • The goal of this study was to examine the anatomical spread of large-volume PICB injections and its relevance to breast surgery analgesia. (
  • A larger-volume injection may cause further spread to the paravertebral and/or epidural space, providing multilevel analgesia with 1-2 level injections. (
  • Cite this: Epidural Analgesia Has No Effect on Maternal Temperature - Medscape - Jul 27, 2012. (
  • Nonetheless, they concluded that stopping the second epidural infusion does not affect duration or any other outcome "with the exception of possibly resulting in lower maternal satisfaction. (
  • Analgesia is indicated for patients with certain risk factors even in the absence of maternal request. (
  • Other maternal conditions such as aortic stenosis , pulmonary hypertension , or right-to-left shunts are also relative contraindications to the use of regional analgesia. (
  • [ 152 ] In turn, their fetus may have an increased heart rate associated with epidural anesthesia and maternal fever. (
  • Effects of the OPRM1 A118G Polymorphism (rs1799971) on Opioid Analgesia in Cancer Pain: A Systematic Review and Meta-Analysis. (
  • Se diferencia de la ANESTESIA EPIDURAL que se refiere al estado de insensibilidad a la sensación. (
  • QUALITY OF EVIDENCE MEDLINE was searched and the references of 2 systematic reviews and a meta-analysis were reviewed to find articles on obstetric analgesia and pain measurement. (
  • In obstetric patients, regional analgesia refers to partial or complete loss of pain sensation below the T8 to T10 spinal level. (
  • Women who sustained a dural puncture during their epidural catheter insertion had a higher risk of developing chronic headache [14.3%, versus 4.8%, p=0.049, AOR: 3.36 (1.05, 12.82)] and chronic back pain [39.7% versus 19.1%, p=0.009, AOR: 2.67 (1.25, 5.72)] than women who did not sustain a dural puncture. (
  • Conclusions An unintentional dural puncture during epidural catheter insertion in parturients is associated with increased risk of chronic headache, back pain and auditory impairment. (
  • Epidural analgesia is a type of pain relief. (
  • Epidural analgesia is an important part of the overall plan for your child's pain control. (
  • Epidural analgesia is a way of putting pain medication close to the body part that hurts. (
  • The end of the epidural catheter is near the nerves that help the body feel and control pain. (
  • Pain medication is given through the epidural catheter. (
  • The epidural tubing is attached to a pump that constantly delivers pain medicine. (
  • The epidural will not make all of your child's pain go away, but your child should feel comfortable enough to move around in bed. (
  • If you have any questions about epidural pain relief, please speak with your child's doctor or nurse. (
  • 0.0001), with women who had epidurals being more likely to stop breastfeeding than women who used non-pharmacological methods of pain relief (adjusted hazard ratio 2.02, 95% CI 1.53, 2.67). (
  • Various regional analgesia techniques exist that can be used to promote postoperative pain relief. (
  • Pain management with epidural catheter and epidural analgesia after spinal dorsal instrumentation of lumbar spine. (
  • The aim of the current study was to compare the use of epidural analgesia (EA) with systemic analgesia (SA) as regards pain reduction and early postoperative complications after SDI . (
  • Pain management with epidural or systemic analgesia in patients undergoing SDI by posterior approach between January 2019 and July 2020 was evaluated by clinical functional testing, measuring total opioid amounts used, and evaluating numerical rating scale values 24 and 96 hours postoperatively. (
  • Our data demonstrate that epidural anesthesia was inferior to an opioid -based SA regime in reducing postoperative pain in patients undergoing spinal surgery . (
  • 2, 10] In many centres, a combined spinal and epidural anaesthetic (CSE) is given, where a single injection of local anaesthetic is inserted into the subarachnoid space (for fast onset of pain relief) in addition to insertion of an epidural catheter for ongoing pain management. (
  • [3] , [4] Epidural analgesia is considered the gold standard for post-thoracotomy pain relief but may have side effects. (
  • Epidurals can be used during and/or after surgery for pain relief. (
  • Pain scores decreased in the epidural group until the 90-minute mark and increased in the saline group throughout, the authors said, though there were no significant differences in visual analog pain scores between groups. (
  • Urban BJ , Nashold BS Jr . Combined epidural and peripheral nerve stimulation for relief of pain. (
  • While thoracic epidural analgesia has become the mainstay for managing acute post-thoracotomy pain, its effect on the chronic post-thoracotomy pain seems questionable. (
  • As a result, multimodal analgesia can reduce postoperative pain (Jin and Chung 2001). (
  • Dr. Capdevila concludes multimodal analgesia optimizes pain management and decreases organ dysfunction while demonstrating a positive impact on the long-term mortality in patients after major surgeries. (
  • Epidural analgesia is widely used for postoperative pain management because of the advantages that epidural analgesia offers in reducing postoperative pain and the surgical stress response [ 1 - 3 ]. (
  • Your epidural, or spinal, catheter can also be used for pain relief after surgery . (
  • The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. (
  • What is the Epidural Pain Relief Measure? (
  • The epidural pain relief measure is the percentage of woman who received epidural pain relief while having a vaginal birth. (
  • What does epidural pain relief mean for me and my baby? (
  • Epidural pain relief can also make pushing more difficult and make interventions such as forceps or C-section more likely. (
  • As a result, many women prefer to have access to drug-free measures (such as tubs, showers and birth balls) or other types of pain medicine (such as nitrous oxide) and give birth without using epidural pain relief. (
  • Why do hospital epidural pain relief rates matter? (
  • Your likelihood of receiving epidural pain relief can be influenced by the hospital where you give birth. (
  • If giving birth without epidural pain relief is a high priority or you're interested in exploring other pain relief options, looking for a hospital with a lower epidural rate may help you find an environment that will support your wishes. (
  • Make sure that your doctor or midwife knows whether or under what conditions you want to receive epidural pain relief. (
  • An epidural block is one of the most common forms of pain relief used in hospitals today for the laboring mom. (
  • The median duration of epidural analgesia was 7.9 hours (interquartile range, 4.3 - 12.1 hours). (
  • The duration of analgesia was from the time of epidural block to the time of rescue analgesia . (
  • For IT morphine, the onset of analgesia is 30-60 minutes, and the duration of analgesia is 18-24 hours, depending on the dose. (
  • The use of the epidural block in combination with general anesthesia for radical cystectomy and early onset of parenteral nutrition contribute to a lesser load on the patient's immune state, a reduction in complications in the postoperative period, an early preservation of nutritional status, and a reduction in the duration of treatment of patients with advanced bladder cancer. (
  • To date only three trials randomized patients to narcotic versus epidural groups, and all showed a twofold to threefold increase in cesarean section for dystocia. (
  • Cherkab R, Lazraq M, Elhafid Z, Haddad W, Elkettani C and Barrou L. Postoperative epidural analgesia in thoracic surgery: continuous administration by electric push-syringe diffusion versus elastomeric diffuser . (
  • There was also no significant difference among the portion of women with spontaneous vaginal delivery (96.5% for epidural versus 99% for placebo, P =0.17), nor were there differences between groups among rates of incidence of episiotomy, position of the fetus at delivery or what the authors characterized as "any measure of neonatal well-being. (
  • However, a significantly higher portion of women in the placebo group reported satisfaction scores of 8 or less compared with the epidural group (30.5% versus 16%, respectively, P =0.001). (
  • [5] However, in pediatric populations, the use of opioid medications for analgesia is considered off-label due to scant clinical data to elaborate on the harms versus benefits in this population. (
  • and 2,045 with transmission from a mother to her newborn twins g, Apgar scores 8/9/9) under epidural analgesia with place- during vaginal delivery. (
  • An alternative, effective, and safer method of analgesia would be preferable. (
  • Opioids administered to the IT space can offer effective postoperative analgesia. (
  • In an article published in ICU Management and Practice , Dr. Xavier Capdevila, Head of the Department of Anesthesia and Critical Care Medicine at Lapeyronie University Hospital, France, outlines the concept of multimodal analgesia as an alternative to administering solely opioids to patients. (
  • A French study showed that the use of multimodal analgesia in mechanically ventilated critically ill patients decreases sedation and delirium while avoiding the need for opioids. (
  • Patients given multimodal analgesia were also more likely to have fewer organ failures compared to patients who received opioids alone (Payen et al. (
  • The patients who received regional analgesia experienced an optimized rehabilitation with a decreased use of opioids. (
  • Failure to correctly identify the epidural space may result in a variety of undesirable outcomes, such as failure to provide effective analgesia, dural puncture, or spinal cord injury. (
  • Multimodal analgesia also reduces the need for total sedation. (
  • The practice of analgosedation in the ICU (using analgesia before sedation) is becoming increasingly common. (
  • The μ-opioid receptors, located in the CNS (e.g., brainstem, locus coeruleus, periaqueductal gray matter) and parts of the gastrointestinal tract, act to modulate various neurochemical activities involved in analgesia, euphoria, and sedation. (
  • In the former, a retrospective study of 51 cases from January 2019 to July 2019 showed a decrease of more than 80% in the rate of recourse to general anesthesia in extremely urgent caesarean sections (4/4 vs 0/7) and a 50% decrease in the time required to obtain adequate epidural anesthesia (5 min vs 10 min). (
  • The addition of epidural analgesia to general anesthesia was also associated with long-term survival. (
  • The clinical part consisted of a retrospective medical records review of patients who had undergone breast surgery under general anesthesia (GA) with and without PICB, examining the dermatomal analgesia/hypoesthesia distribution and the analgesic effect of the PICB. (
  • CONCLUSION Physicians practising modern obstetrics in rural and small urban centres might find single-dose ITN a useful alternative to parenteral or epidural analgesia for appropriately selected patients. (
  • Can ultrasound-guided erector spinae plane block replace thoracic epidural analgesia for postoperative analgesia in pediatric patients undergoing thoracotomy? (
  • We studied the analgesic efficacy of unilateral continuous ultrasound-guided erector spinae plane block (ESPB) compared to a thoracic epidural in pediatric patients undergoing thoracotomy. (
  • We randomly assigned patients into two groups: The thoracic epidural analgesia (TEA) group received GA with an epidural catheter. (
  • This study shows that the ESPB provides similar postoperative analgesia to the TEA in pediatric patients undergoing thoracotomy. (
  • Patients of the first group also were administered epidural analgesia and parenteral nutrition in the early postoperative period (from the first day) was prescribed. (
  • Taking into account the fact that it is the cellular link of the immune system that plays the main role in the implementation of the antitumor immune response, providing the overall antitumor resistance of the organism, it seems promising to use the epidural block and early parenteral nutrition in patients operated on advanced bladder cancer. (
  • Notably, obstetricians requested that epidural infusion be stopped in 49 patients -- 22 from the placebo group and 27 from the epidural group. (
  • Patients who received epidural analgesia exhibited fewer complications than patients who received only analgosedation (Bardia et al. (
  • The records of twelve matched patients who had the same operations without PICB were reviewed to compare analgesia and opioid consumption. (
  • However, changes in the epidural space that occur during pregnancy, as well as differences between the morphology of the thoracic and lumbar regions of the spine, make these studies inapplicable to nonobstetric patients receiving an epidural at the thoracic intervertebral levels. (
  • Following approval from The University of Texas MD Anderson Cancer Center Institutional Review Board, we retrospectively reviewed the records of patients who had epidurals placed between the T3 and T12 intervertebral levels by 1 of 2 providers at MD Anderson between July 1, 2007, and June 30, 2011. (
  • A total of 60 patients that received intestinal cancer surgery under combined general/epidural anesthesia were treated and evaluated in this study. (
  • Epidural analgesia may also increase intervention for fetal distress. (
  • As a part of multimodal analgesia, many regional blocks have been described. (
  • 2013). Dexmedetomidine, an alpha 2 antagonist and a potent anxiolytic, is another drug that ICU clinicians should consider within the multimodal analgesia approach. (
  • METHODS: We performed a computer-assisted MEDLINE search for articles and a review of bibliographies from articles on epidural analgesia. (
  • In Western cultures, epidural analgesia (EA), as well as a number of other methods, is widely used, and its benefits (and risks) are well documented. (
  • Narcotics delivered by spinal or epidural methods function at the same site in the spinal cord. (
  • Previous studies have used varying methods to estimate the depth of the epidural space prior to placement of an epidural catheter. (
  • and 2,045 g, Apgar scores 8/9/9) under epidural analgesia with placement of a urinary catheter. (
  • Correct placement of an epidural catheter into the epidural space using the loss of resistance (LOR) technique is a difficult skill to teach because it is performed "blind" and anatomical variations can lead to the identification of false LOR. (
  • however, estimation of SES in this model is dependent on the angle of needle insertion, which would not be known prior to epidural placement [ 5 ]. (
  • also proposed a CT-based prediction model for epidural placement at the T10-T11 interspace using the paramedian approach, but the clinical relevance of this model is minimized by the fact that the model assumes a constant angle of needle insertion [ 6 ]. (
  • The caudally angled spinous processes at the thoracic vertebral level make placement of a thoracic epidural more challenging. (
  • We also noted the epidural placement approach (midline or paramedian) and the LOR to the nearest half centimeter as reported by the attending anesthesiologist performing the epidural. (
  • The insertion of the epidural catheter can be complicated by unintentional dural puncture that may result in postdural puncture headache. (
  • Cases were women who received epidural analgesia and sustained an unintentional dural puncture and controls were women who received epidural analgesia but did not sustain such complication. (
  • In France, the latest recommendations date from 2007 and recommend the practice of epidural extension with 15 to 20 ml of 2% adrenaline lidocaine. (
  • Pre-emptive analgesia is a treatment whereby a preoperative analgesic regimen is introduced to reduce noxious stimuli in the surgical process. (
  • Epidural blockade is becoming one of the most useful and versatile procedures in modern anesthesiology. (
  • Conclusions: In this anatomical study, PICB at the 2nd and 4th ICS produced lateral spread along the corresponding intercostal space, medial spread to the adjacent paravertebral/epidural space and cranio-caudal spread along the endothoracic fascial plane. (
  • Options for analgesia may be non-pharmacological, such as massage, breathing exercises and transcutaneous electrical nerve stimulation (TENS), which have limited evidence of efficacy but appear to improve satisfaction with the childbirth experience (compared to placebo). (
  • Epidural analgesia with sufentanil in relation to OPRM1 and ABCB1 polymorphisms. (
  • 2016). Clinical evidence shows that epidural analgesia can decrease mortality, complications, and morbidity after surgery. (
  • The goals of this study were to examine the anatomical spread of PICB injectate and explore its translation into clinical analgesia after breast surgery. (
  • IMSEAR at SEARO: Thoracic epidural analgesia in cardiac surgery. (
  • Mehta Y, Kulkarni V. Thoracic epidural analgesia in cardiac surgery. (
  • Preoperative computed tomography scans were reviewed to measure the skin to epidural space distance. (