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.
The genus Delphinus, in the family Delphinidae, consisting of two species of DOLPHINS. They are multicolored, with a characteristic yellow-tan criss-cross hourglass pattern behind the eyes.
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.
Agents that prevent clotting.
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.
An autosomal dominant inherited form of HYPERTROPHIC CARDIOMYOPATHY. It results from any of more than 50 mutations involving genes encoding contractile proteins such as VENTRICULAR MYOSINS; cardiac TROPONIN T; ALPHA-TROPOMYOSIN.
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 CABG.mp OR exp Thoracic Surgery/ OR exp Cardiac surgical procedures/ OR Coronary art$ bypass.mp. OR Cardiopulmonary bypass.mp OR exp Cardiopulmonary Bypass/ OR exp Cardiovascular Surgical Procedures/ OR exp Thoracic Surgical Procedures/ OR exp Coronary Artery Bypass/ OR cardiac transplantation.mp. OR exp Heart Transplantation/ ] AND [exp Anesthesia, Epidural/ OR Epidural anaesthesia.mp OR exp Analgesia, Epidural/ OR epidural analgesia.mp 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 complications.mp 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 ...
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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Your child needs medicine to manage pain. He or she may have an epidural infusion to get this medicine. This page explains what an epidural infusion is and what will happen when your child has one.
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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. ...
Epidural Catheter directory ☆ Epidural Catheter manufacturers, suppliers ☆ Epidural Catheter buyers, importers, wholesalers, distributors
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
HealthNewsDigest.com) - 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 ...
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. http://accessanesthesiology.mhmedical.com/content.aspx?bookid=572§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 ...
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 ...
OpenAnesthesia™ content is intended for educational purposes only and not intended as medical advice.. Reuse of OpenAnesthesia™ content for commercial purposes of any kind is prohibited. ...
Overall the differences between treatments were not statistically significant (P = 0.11). The differences between the individual variables were statistically significant for HR P = 0.017, DIA P = 0.04 and MAP P = 0.039, but not for SYS and CVP (P = 0.37 and P = 0.3 respectively). The post hoc tests indicated no statistically significant difference between treatments for any of the variables: HR, A-AM P = 0.41; A-AR P = 0.2; AM-AR P = 0.06; SYS, A-AM P = 1.0; A-AR P = 0.48; AM-AR P = 0.65; DIA, A-AM P = 1.0; A-AR P = 0.1; AM-AR P = 0.12, MAP, A-AM P = 0.99; A-AR P = 0.12; AM-AR P = 0.08, CVP, A-AM P = 0.51; A-AR P = 0.97; AM-AR P = 0.35. For within treatments, the differences between procedures (non-abdominal surgery and abdominal surgery) for the A-group were statistically significant (P , 0.05) for HR, SYS, DIA, MAP but not for CVP (P , 0.05, Table 2). For the AM-group differences were statistically significant (P , 0.05) for DIA and MAP, but not for HR, SYS, and CVP (P , 0.05, Table 2). For ...
Epidural anesthesia is an effective form of childbirth pain relief. Epidural anesthesia is the injection of a numbing medicine into the space around the spinal nerves in the lower back. It numbs the area above and below the point of injection and allows you to remain awake during the delivery. It can be used for either...
However the surgery is a major procedure involving cutting of muscle and bone. This leads to a slow and painful recovery. Post surgery pain after knee replacement can be unbearable and remains as a major deterrent to someone who wants to undergo the operation. Traditional methods of pain control include intravenous or intramuscular analgesic injections and epidural pumps. Intravenous medicines have safety issues and are not effective. Epidural pumps involve placing an epidural catheter (a very thin tube) in the epidural space near the spinal cord. Through this tube medicine is administered which numbs the spinal nerves and relieves pain. A well functioning epidural pump is very effective but has certain problems. Firstly, placing an epidural catheter is a blind procedure and many times the catheter is not in an ideal position. As a result it fails to reduce pain. Secondly, epidural pumps may cause a drop in blood pressure in some patients which requires constant monitoring. Lastly, epidural ...
Doughty, Andrew (1980). Epidural Analgesia in Obstetrics: A Second Symposium, University of Warwick, Coventry. London: Lloyd- ... CS1 maint: discouraged parameter (link) Doughty, Andrew (1969). "Selective epidural analgesia and the forceps rate". British ... He was an early promoter of the use of epidural anaesthesia during childbirth. In 1973, he set up an epidural course at ...
Through this needle, he introduced a 3.5 French ureteral catheter made of elastic silk into the lumbar epidural space. He then ... Despite this much higher dose, the onset of analgesia in Corning's human subject was slower and the dermatomal level of ... For many years however, a controversy centered around whether Corning's injection was a spinal or an epidural block. The dose ... Based on Corning's own description of his experiments, it is apparent that his injections were made into the epidural space, ...
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 ...
... 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 ...
An Efficient Alternative to Counteract Hypotension During Combined General/Epidural Anesthesia". Anesthesia & Analgesia. 90 (6 ...
CS1 maint: discouraged parameter (link) "Usefulness of the Tsui Test in Combined Spinal-Epidural Analgesia in Labour". ... 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. ... Tsui is also a guest reviewer for multiple journals including: Anesthesiology Anesthesia and Analgesia British Journal of ...
Nelson, L; Aspegren, D; Bova, C (1997). "The use of epidural steroid injection and manipulation on patients with chronic low ... Dreyfuss, P; Michaelsen, M; Horne, M (1995). "MUJA: Manipulation under joint anesthesia/analgesia: A treatment approach for ... Aspegren, D. D; Wright, R. E; Hemler, D. E (1997). "Manipulation under epidural anesthesia with corticosteroid injection: Two ... Ben-David, B; Raboy, M (1994). "Manipulation under anesthesia combined with epidural steroid injection". Journal of ...
... 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 ...
Marx pioneered the use of epidural analgesia during childbirth, and was the founding editor of the quarterly Obstetric ...
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 ...
Chen YW, Chu CC, Chen YC, Wang JJ, Hung CH, Shao DZ (January 2012). "Nisoxetine produces local but not systemic analgesia ... as well as spinal/epidural anesthesia. Due to nisoxetine's sodium channel blocking effect, it is also possible that it may also ... It has been used to research obesity and energy balance, and exerts some local analgesia effects. Researchers have attempted to ... Nisoxetine elicits local (cutaneous) but not systemic analgesia. Compared to lidocaine, a common anesthetic, nisoxetine is more ...
The mechanism of analgesia when SCS is applied in neuropathic pain states may be very different from that involved in analgesia ... The epidural space is accessed with loss of resistance technique using a 14-gauge Tuohy needle. The lead is fed through ... In the case of ischemic pain, analgesia seems to derive from restoration of the oxygen demand supply. This effect could be ... Barolat, G.; Massaro, F.; He, J.; Zeme, S.; Ketcik, B. (February 1993). "Mapping of sensory responses to epidural stimulation ...
Since it is a unilateral block, it may be chosen over epidurals for patients who can't tolerate the hypotension that follows ... These drugs are often combined with adjuvants (additives) with the end goal of increasing the duration of the analgesia or ... 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. ...
... (pKa 8.7) is the drug of choice for epidural analgesia and a decompensating fetus, because it does not ... Chloroprocaine is used for regional anaesthesia including spinal anaesthesia, caudal anaesthesia and epidural anesthesia It is ... Philipson EH, Kuhnert BR, Syracuse CD (February 1985). "Fetal acidosis, 2-chloroprocaine, and epidural anesthesia for cesarean ... Anesthesia and Analgesia. 59 (6): 452-4. PMID 7189987. Förster JG, Kallio H, Rosenberg PH, Harilainen A, Sandelin J, Pitkänen ...
Zhang X, Wang D, Shi M, Luo Y (April 2017). "Efficacy and Safety of Dexmedetomidine as an Adjuvant in Epidural Analgesia and ... During this stage, the patient progresses from analgesia without amnesia to analgesia with amnesia. Patients can carry on a ... Mencía SB, López-Herce JC, Freddi N (May 2007). "Analgesia and sedation in children: practical approach for the most frequent ... A variety of drugs may be administered, with the overall aim of ensuring unconsciousness, amnesia, analgesia, loss of reflexes ...
Epidurals may also be used in hind-limb laminitis. Vasodilators Vasodilators are often used with the goal of improving laminar ... For analgesia, NSAIDs are often the first line of defense. Phenylbutazone is commonly used for its strong effect and relatively ...
This is recommended with long term use so as to reduce the chance of any infection at the exit site reaching the epidural space ... Often, low doses are adequate to produce analgesia, thought to be due to reduction in pressure or, possibly, interference with ... Johnson MI, Oxberry SG & Robb K. Stimulation-induced analgesia. In: Sykes N, Bennett MI & Yuan C-S. Clinical pain management: ... Early efforts at interventional pain management date back to the origins of regional analgesia and nerve blocks, and gradually ...
The controversy centers around whether Corning's injection was a spinal or an epidural block. The dose of cocaine used by ... Despite this much higher dose, the onset of analgesia in Corning's human subject was slower and the dermatomal level of ... Based on Corning's own description of his experiments, it is apparent that his injections were made into the epidural space, ... it was Corning who created the experimental conditions that ultimately led to the development of both spinal and epidural ...
Both general and regional anaesthesia (spinal, epidural or combined spinal and epidural anaesthesia) are acceptable for use ... Regional anaesthesia during caesarean section is different from the analgesia (pain relief) used in labor and vaginal delivery ... Regional anaesthesia is used in 95% of deliveries, with spinal and combined spinal and epidural anaesthesia being the most ... The decision whether to perform general anesthesia or regional anesthesia (spinal or epidural anaesthetic) is important and is ...
However, though they produce unconsciousness, they provide no analgesia (pain relief) and must be used with other agents. ... Amides are generally used within regional and epidural or spinal techniques, due to their longer duration of action, which ... Ketamine-anesthetized patients have profound analgesia but keep their eyes open and maintain many reflexes. While opioids can ... provides adequate analgesia for surgery, labor, and symptomatic relief.[citation needed] Only preservative-free local ...
In epidural anesthesia or intrathecal analgesia. *For palliative care (i.e. to lessen pain without curing the underlying reason ...
Concentrated bupivacaine is not recommended for epidural freezing. Epidural freezing may also increase the length of labor. It ... Mont, M. A., Beaver, W. B., Dysart, S. H., Barrington, J. W., & Gaizo, D. J. (2018). "Local Infiltration Analgesia With ... In nerve blocks, it is injected around a nerve that supplies the area, or into the spinal canal's epidural space. It is ... It is the most commonly used local anesthetic in epidural anesthesia during labor, as well as in postoperative pain management ...
Ferrante FM, Lu L, Jamison SB, Datta S (1991). "Patient-controlled epidural analgesia: demand dosing". Anesth. Analg. 73 (5): ... The World Health Organization (WHO) recommends a pain ladder for managing analgesia. It was first described for use in cancer ... This is similar to epidural infusions used in labour and postoperatively. The major differences are that it is much more common ... Caraceni, A; Zecca, E; Martini, C; De Conno, F (June 1999). "Gabapentin as an adjuvant to opioid analgesia for neuropathic ...
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 ...
... epidural, or perineural infusions Invasive monitoring such as arterial lines, central venous lines, and ventriculostomies ... Preparation and education for the use of patient-controlled analgesia (PCA) units Preparation and administration of intravenous ...
... 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.. ...
... which can be performed to induce analgesia in a region of the body. For example, epidural administration of a local anesthetic ... This is performed to permit surgery without the individual responding to pain (analgesia) during surgery or remembering ( ... The field comprises individualized strategies for all forms of analgesia, including pain management during childbirth, ...
MeSH E03.091.048 - acupuncture analgesia MeSH E03.091.080 - analgesia, epidural MeSH E03.091.110 - analgesia, obstetrical MeSH ... epidural MeSH E03.155.086.131.100 - anesthesia, caudal MeSH E03.155.086.231 - anesthesia, local MeSH E03.155.086.331 - ... E03.091.120 - analgesia, patient-controlled MeSH E03.091.214 - audioanalgesia MeSH E03.091.646 - neuroleptanalgesia MeSH ...
... begins with the contraction of the muscles attached to the rib cage; this causes an expansion in the chest cavity. Then takes place the onset of contraction of the diaphragm, which results in expansion of the intrapleural space and an increase in negative pressure according to Boyle's law. This negative pressure generates airflow because of the pressure difference between the atmosphere and alveolus. Air enters, inflating the lung through either the nose or the mouth into the pharynx (throat) and trachea before entering the alveoli.[citation needed] Other muscles that can be involved in inhalation include:[2] ...
Some feel that the term tisane is more correct than herbal tea or that the latter is even misleading, but most dictionaries record that the word tea is also used to refer to other plants beside the tea plant and to beverages made from these other plants.[4][5] In any case, the term herbal tea is very well established and much more common than tisane.[1] The word tisane was rare in its modern sense before the 20th century, when it was borrowed in the modern sense from French. (This is why some people feel it should be pronounced /tɪˈzɑːn/ as in French, but the original English pronunciation /tɪˈzæn/ continues to be more common in US English and especially in UK English).[2] The word had already existed in late Middle English in the sense of "medicinal drink" and had already been borrowed from French (Old French). The Old French word came from the Latin word ptisana, which came from the Ancient Greek word πτισάνη (ptisánē), which meant "peeled" barley, in other words pearl barley, ...
Anesthesia & Analgesia. 104 (4): 763-5. doi:10.1213/01.ane.0000250913.45299.f3. PMID 17377078. Retrieved 2008-12-30.. ... epidural blood patch, plasmapheresis, blood labeling or tagging and platelet gel (autologous) ...
A peripheral cannula is the most common intravenous access method utilized in both hospitals and pre-hospital services. A peripheral IV line (PVC or PIV) consists of a short catheter (a few centimeters long) inserted through the skin into a peripheral vein (any vein not situated in the chest or abdomen). This is usually in the form of a cannula-over-needle device, in which a flexible plastic cannula comes mounted over a metal trocar. Once the tip of the needle and cannula are introduced into the vein via venipuncture, the cannula is advanced inside the vein over the trocar to the appropriate position and secured, the trocar is then withdrawn and discarded. Blood samples may be drawn directly after the initial IV cannula insertion. Any accessible vein can be used although arm and hand veins are used most commonly, with leg and foot veins used to a much lesser extent. In infants, the scalp veins are sometimes used. The caliber of needles and catheters can be given in Birmingham gauge or French ...
Thoracic epidural analgesia or paravertebral blockade have shown to be the most effective methods for post-thoracotomy pain ... Treatment to aid pain relief for this condition includes intra-thoracic nerve blocks/opiates and epidurals, although results ... Assessing the effects of transcutaneous electrical nerve stimulation (TENS) in post-thoracotomy analgesia. Rev Bras Anestesiol ... "Local anaesthetics and regional anaesthesia versus conventional analgesia for preventing persistent postoperative pain in ...
Three main kinds of oxygen masks are used by pilots and crews who fly at high altitudes: continuous flow, diluter demand, and pressure demand.[3] In a continuous-flow system, oxygen is provided to the user continuously. It does not matter if the user is exhaling or inhaling as oxygen is flowing from the time the system is activated. Below the oxygen mask is a rebreather bag that collects oxygen during exhalation and as a result allows a higher flow rate during the inhalation cycle.[4] Diluter-demand and pressure-demand masks supply oxygen only when the user inhales.[5] They each require a good seal between the mask and the user's face. In a diluter-demand system, as the altitude increases (ambient pressure, and therefore the partial pressure of ambient oxygen, decreases), the oxygen flow increases such that the partial pressure of oxygen is roughly constant. Diluter-demand oxygen systems can be used up to 40,000 ft (12,000 m).[4] In a pressure-demand system, oxygen in the mask is above ambient ...
Congenital analgesia (insensitivity to pain). Notes[edit]. *^ Anonymous (1990). Cancer pain relief and palliative care; report ... Epidural, IV, intrathecal, transdermal.. Protein binding = 90%; half-life = 2.5 hours; excretion = urine (80%).. Adjunct to ... Analgesia and fever reduction.. As per paracetamol. Ziconotide. Peptide.. N-type calcium-channel blocker.. Intrathecal.. ... Analgesia, especially postoperative; hiccups.. Has antimuscarinic and sympathomimetic effects.[119] Paracetamol. Comes in free ...
A new method of drug administration". Current Researches in Anesthesia and Analgesia. 26 (6): 221-230. PMID 18917536.. ...
A medication's potency often is changed with its base. For example, some topical steroids will be classified one or two strengths higher when moving from cream to ointment. As a rule of thumb, an ointment base is more occlusive and will drive the medication into the skin more rapidly than a solution or cream base.[6] The manufacturer of each topical product has total control over the content of the base of a medication. Although containing the same active ingredients, one manufacturer's cream might be more acidic than the next, which could cause skin irritation or change its absorption rate. For example, a vaginal formulation of miconazole antifungal cream might irritate the skin less than an athlete foot formulation of miconazole cream. These variations can, on occasion, result in different clinical outcomes, even though the active ingredient is the same. No comparative potency labeling exists to ensure equal efficacy between brands of topical steroids (percentage of oil vs water dramatically ...
In 2009, Teva Pharmaceuticals filed an ANDA to market a generic EpiPen in collaboration with Antares Pharma Inc, a maker of injection systems; Pfizer and King sued them for infringing US Patent 7,449,012 that was due to expire in 2025;[33] Pfizer, Mylan, and Teva settled in April 2012 in a deal that allowed Teva to start selling the device in mid-2015, pending FDA approval.[34] In 2009, Intelliject, a US startup developing a new epinephrine autoinjector, licensed their product to Sanofi.[35] King was acquired by Pfizer in 2010 for $3.6 billion in cash.[36] In 2010, Sciele/Shionogi faced a recall of Twinject devices[37] and launched Adrenaclick, a modified version of the Twinject that could deliver only one dose.[38][39] In 2010, European regulators approved Twinject,[40] and also approved a new epinephrine autoinjector made by ALK and sold under the brand name Jext.[41][42] Jext was launched in the European Union in September 2011.[43][44] Also in 2010, Shionogi authorized Greenstone, the ...
Medical management of pain is rarely found in home births, but analgesia (i.e. epidural) is prevalent in the hospitals. Touch, ...
1 Anesthesia and Analgesia in Rodents, Washington College, 2012, ss. 1-2, 4 August 2013 tarihinde kaynağından arşivlendi, ... Düşük dozlarda spinal veya epidural anestezi/analjeziyi desteklemek için.. Ağrı kesici[değiştir , kaynağı değiştir]. Ameliyat ...
... , literally "under the lip", from Latin, refers to the pharmacological route of administration by which the active substance is placed between the lip and the gingiva (gum). Sublabial administration should not be confused with sublingual administration, which is under the tongue. The frenulum of the tongue may be irritated when in contact with corrosive materials but can be avoided with this route. It is usually used for medications such as glyceryl trinitrate, for example, in angina pectoris.[1] ...
A softgel is an oral dosage form for medicine similar to capsules. They consist of a gelatin based shell surrounding a liquid fill. Softgel shells are a combination of gelatin, water, opacifier and a plasticiser such as glycerin or sorbitol. Softgels are produced in a process known as encapsulation using the Rotary Die Encapsulation process invented by Robert Pauli Scherer. The encapsulation process has been described as a form/fill/seal process. Two flat ribbons of shell material are manufactured on the machine and brought together on a twin set of rotating dies. The dies contain recesses in the desired size and shape, which cut out the ribbons into a two-dimensional shape, and form a seal around the outside. At the same time a pump delivers a precise dose of fill material through a nozzle incorporated into a filling wedge whose tip sits between the two ribbons in between two die pockets at the point of cut out. The wedge is heated to facilitate the sealing process. The wedge injection causes ...
Intravitreal is a route of administration of a drug or other substance, in which the substance[1] is delivered into the eye. Intravitreal administration of drugs is used to treat various conditions of the eye. The following methods are known. ...
For many patients, the main treatment is analgesia. Physicians specializing in pain management can develop a medication and ...
... s are commonly used on horses following exercise, applied either by rubbing on full-strength, especially on the legs; or applied in a diluted form, usually added to a bucket of water and sponged on the body. They are used in hot weather to help cool down a horse after working, the alcohol cooling through rapid evaporation, and counterirritant oils dilating capillaries in the skin, increasing the amount of blood releasing heat from the body.[17] Many horse liniment formulas in diluted form have been used on humans, though products for horses which contain DMSO are not suitable for human use, as DMSO carries the topical product into the bloodstream.[18] Horse liniment ingredients such as menthol, chloroxylenol, or iodine are also used in different formulas in products used by humans.[19] Absorbine, a horse liniment product manufactured by W.F. Young, Inc., was reformulated for humans and marketed as Absorbine Jr.[20] The company also acquired other liniment brands including Bigeloil and ...
A 2008 study compared 121 Japanese patients who experienced PONV after being given the general anesthetic propofol to 790 people who were free of post-operative nausea after receiving it. Those with a G at both copies of rs1800497 were 1.6 times more likely to experience PONV within six hours of surgery compared to those with the AG or AA genotypes. But they were not significantly more likely to experience PONV more than six hours after surgery.[1] Postoperative nausea and vomiting results from patient factors, surgical & anesthetic factors. Surgical factors that confer increased risk for PONV include procedures of increased length, gynecological, abdominal and laparoscopic procedures, ENT procedures, strabismus procedures in children. Anesthetic risk factors include the use of volatile anesthetics, Nitrous Oxide (N2O), Opioids, and longer duration of anesthesia. Patient factors that confer increased risk for PONV include female gender, Obesity, age less than 16 years, past history of motion ...
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 ...
... it is still a useful alternative when continuous interscalenic analgesia cannot be performed.[13] Interscalenic analgesia is ... and inadvertent spinal/epidural anesthesia could occur and therefore, patients should be carefully monitored during the ... Post-operative analgesiaEdit. Shoulder replacement can cause severe to very severe pain especially during shoulder mobilization ... Single shot interscalenic analgesia is preferably used during minor arthroscopic surgery because of its short duration but ...
... and the use of epidural/spinal analgesia. It is also associated with a lower rate of cesarean delivery and stress urinary ... A Cochrane Review found that immersion during the first stage of childbirth reduces the use of epidurals, though it could not ... A 2009 Cochrane Review of water immersion in the first stages of labor found evidence of fewer epidurals and few adverse ... A 2014 review comparing immersion during the first stage of labor to regional analgesia found that "immersion during the labor ...
Epidural anesthesia is an LA injected into the epidural space, where it acts primarily on the spinal nerve roots; depending on ... Gow-Gates GA (April 1998). "The Gow-Gates mandibular block: regional anatomy and analgesia". Australian Endodontic Journal. 24 ... Heart and lung surgery (epidural anesthesia combined with general anesthesia). *Abdominal surgery (epidural anesthesia/spinal ... making epidural anesthesia still a highly successful technique. Besides its many uses for surgery, epidural anesthesia is ...
When a chemical comes in contact with the mucous membrane beneath the tongue, it is absorbed. Because the connective tissue beneath the epithelium contains a profusion of capillaries, the substance then diffuses into them and enters the venous circulation. In contrast, substances absorbed in the intestines are subject to "first-pass metabolism" in the liver before entering the general circulation.. Sublingual administration has certain advantages over oral administration. Being more direct, it is often faster,[quantify] and it ensures that the substance will risk degradation only by salivary enzymes before entering the bloodstream, whereas orally administered drugs must survive passage through the hostile environment of the gastrointestinal tract, which risks degrading them, either by stomach acid or bile, or by the many enzymes therein, such as monoamine oxidase (MAO). Furthermore, after absorption from the gastrointestinal tract, such drugs must pass to the liver, where they may be extensively ...
The main ingredient in a standard lollipop is sugar. Sugars are fully hydrated carbon chains meaning that there is a water molecule attached to each carbon. Sugars come in two forms; straight-chain and ring form. When sugars are in straight-chain form, aldehyde and ketone groups are open which leaves them very susceptible to reaction. In this state, sugars are unstable. In ring form, sugars are stable and therefore exist in this form in most foods, including lollipops.. Sugar is a very versatile ingredient and is used in many of food and products we consume every single day. What makes sugar different is the way it interacts with the other ingredients and systems within the food as well as how it is treated. When it is heated enough to break the molecules apart, it generates a complex flavor, changes the color, and creates a pleasing aroma.[10] Sugar can form two types of solids in foods; crystalline and glassy amorphous. Crystalline solids can be found in food products like fondant, fudge, and ...
Analgesia and fever reduction.. As per paracetamol. Ziconotide. Peptide.. N-type calcium-channel blocker.. Intrathecal.. ... Epidural, IV, intrathecal, transdermal.. Protein binding = 90%; half-life = 2.5 hours; excretion = urine (80%).. Adjunct to ... Analgesia and fever reduction.. Haematologic, nephrotoxicity, cancer and paracetamol AEs. Pregabalin. Comes in free form.. As ... Analgesia, especially postoperative; hiccups.. Has antimuscarinic and sympathomimetic effects.[117]. Paracetamol. Comes in free ...
It has long been believed that general anaesthetics exert their effects (analgesia, amnesia, immobility) by modulating the ...
... or lip salve is a wax-like substance applied topically to the lips of the mouth to moisturize and relieve chapped or dry lips, angular cheilitis, stomatitis, or cold sores. Lip balm often contains beeswax or carnauba wax, camphor, cetyl alcohol, lanolin, paraffin, and petrolatum, among other ingredients. Some varieties contain dyes, flavor, fragrance, phenol, salicylic acid, and sunscreens. The primary purpose of lip balm is to provide an occlusive layer on the lip surface to seal moisture in lips and protect them from external exposure. Dry air, cold temperatures, and wind all have a drying effect on skin by drawing moisture away from the body. Lips are particularly vulnerable because the skin is so thin, and thus they are often the first to present signs of dryness. Occlusive materials like waxes and petroleum jelly prevent moisture loss and maintain lip comfort while flavorants, colorants, sunscreens, and various medicaments can provide additional, specific benefits. Lip balm can be ...
In the United States, the term "Certified Registered Nurse Anesthetist" (CRNA) is used to denote advanced practice registered nurses with a doctorate or master's, specializing in the administration of anesthesia.[4] CRNA's account for approximately half of the anesthesia providers in the United States and are the main providers of anesthesia in rural America, administering approximately 43 million anesthetics to patients each year.[5] Historically, nurse anesthetists have been providing anesthesia care to patients since the American Civil War more than 150 years ago. The CRNA credential came into existence in 1956 and approximately 40% of nurse anesthetists are male.[6] Scope of practice limitations and practitioner oversight requirements vary between healthcare facility and state, with 17 states and Guam granting complete autonomy as of 2016. In states that have opted out of supervision, the Joint Commission and CMS recognize CRNA's as licensed independent practitioners.[7] In states requiring ...
... A patient-controlled analgesia infusion pump, configured for epidural administration of fentanyl ... Epidural[edit]. Patient-controlled epidural analgesia (PCEA) is a related term describing the patient-controlled administration ... Fast Fact and Concept #085: Epidural Analgesia, End of Life/Palliative Education Resource Center, Medical College of Wisconsin ... A patient-controlled analgesia infusion pump, configured for intravenous administration of morphine for postoperative analgesia ...
The available data clearly indicates that epidural analgesia with a local anesthetic-based regimen provides superior analgesia ... The use of perioperative epidural anesthesia-analgesia provides superior postoperative analgesia [1-3] versus conventional ... The use of perioperative epidural anesthesia-analgesia may confer many benefits including superior postoperative analgesia, ... patient-controlled epidural analgesia with morphine intravenous patient-controlled analgesia for perioperative analgesia and ...
Epidural is of course the best form of labour analgesia. Aim is to find out an alternative method of labour analgesia where ... epidural analgesia for the management of acute pain associated with labour. Systematic review and meta-analysis. González ... Use of epidural analgesia in post-operative pain management. Weetman, Caroline; Allison, Wendy // Nursing Standard;7/12/2006, ... Patient-controlled epidural analgesia is superior to nitrous oxide inhalation in controlling childbirth pain. Xiaoming Feng; ...
Epidural analgesia. What is epidural analgesia?. Analgesia means pain relief. The word epidural refers to a place in the back ... Compared to other methods of pain control, less pain medicine is usually needed when epidural analgesia has been used. Good ... Studies have shown that epidural analgesia provides excellent pain control for children. ... Children are usually on the epidural medicine for 2 to 5 days. Your nurses and anesthesiologist will talk to you and your child ...
Researchers have shown that epidural analgesia administered in the early stage of labor compared to later use does not increase ... epidural analgesia provides better pain relief than systemic analgesia and is also more effective than systemic analgesia in ... The researchers compared the group of women who had received epidural analgesia early in labor with the group of women who ... Women in the other group received systemic hydromorphone at the first request for pain relief and epidural analgesia at either ...
Periosteal Entrapment of an Epidural Catheter in the Intrathecal Space * The Effects of the Reverse Trendelenburg Position on ... Home , December 1992 - Volume 75 - Issue 6 , Removal of a Tenacious Epidural Catheter ... Thought you might appreciate this item(s) I saw at Anesthesia & Analgesia.. ... Thought you might appreciate this item(s) I saw at Anesthesia & Analgesia.. ...
... did not demonstrate significant benefit of epidural analgesia on mortality, ICU, and hospital length of stay compared with ... What is the role of epidural analgesia in the treatment of rib fractures?) and What is the role of epidural analgesia in the ... Effect of epidural analgesia in patients with traumatic rib fractures: a systematic review and meta-analysis of randomized ... Effect of epidural analgesia in patients with traumatic rib fractures: a systematic review and meta-analysis of randomized ...
Corticosteroid Lumbar Epidural Analgesia for Radiculopathy. The safety and scientific validity of this study is the ...
Epidural analgesia had no statistically significant impact on the risk of caesarean section, maternal satisfaction with … ... Epidural analgesia appears to be effective in reducing pain during labour. However, women who use this form of pain relief are ... Epidural versus non-epidural or no analgesia in labour Cochrane Database Syst Rev. 2011 Dec 7;(12):CD000331. doi: 10.1002/ ... all but five studies compared epidural analgesia with opiates. Epidural analgesia was found to offer better pain relief (mean ...
Why women prefer epidural analgesia during childbirth: the role of beliefs about epidural analgesia and pain catastrophizing. ... Diseases : Analgesia, Cesarean Section. Anti Therapeutic Actions : Cesarean Delivery, Epidural Analgesia, Obstetric ... Labor involving epidural analgesia is associated with a 2-fold increase in reports of partial breast feeding or formula feeding ... 7 Abstracts with Epidural Analgesia Research. Filter by Study Type. Human Study. ...
... will report findings which suggest remifentanil patient controlled analgesia is not equivalent to epidural analgesia for pain, ... Patient-controlled analgesia not as effective as epidural for labor pain Study finds remifentanil patient-controlled analgesia ... study-finds-remifentanil-patient-controlled-analgesia-not-as-effective-as-epidural-analgesia-in-managing-pain-relief-during- ... "Recent studies suggest that remifentanil patient controlled analgesia (RPCA) is equivalent to epidural analgesia (EA) with ...
If conversion of labor epidural analgesia to cesarean delivery anesthesia fails, the anesthesiologist can be confronted with a ... Optimal management of a failed epidural top up continues to be debated in the absence of best practice guidelines. ,i,Method,/i ... In evaluating whether or not to top up an existing labor epidural, the factors influencing decision-making were how effective ... i,Discussion,/i,. Our survey revealed variations in the clinical management of a failed epidural top up for cesarean delivery, ...
Epidural Injections of Autologous Blood for Postlumbar-Puncture Headache Anesthesia & Analgesia49(2):268-271, March-April 1970 ... Epidural Injection of Autologous Blood For Postlumbar-Puncture Headache: II. Additional Clinical Experiences and Laboratory ... Finding Cerebrospinal Fluid during Epidural Blood Patch: How to Proceed * Spinal Subdural Epiarachnoid Hematoma: A Complication ... Thought you might appreciate this item(s) I saw at Anesthesia & Analgesia.. ...
Labor analgesia: Comparison of epidural patient-controlled analgesia and intravenous patient-controlled analgesia].. [Article ... However, we believe that PCIVA is a good alternative to epidural analgesia in cases where epidural analgesia is contraindicated ... In our study, patient controlled epidural analgesia (PCEA) and patient controlled intravenous remifentanil analgesia (PCIVA) ... In this study, 37 pregnant women with a single fetus, who had labor analgesia, were divided into groups of PCIVA (Group 2) and ...
... had ruled out foot injury and concluded that the pain was radicular and secondary to nerve damage from the epidural analgesia. ... Following an uneventful delivery under epidural analgesia, a 17 year old female patient was referred to the Pain Clinic because ... Following an uneventful delivery under epidural analgesia, a 17 year old female patient was referred to the Pain Clinic because ... B. Mansour, G. Wienecke, J. Cure, J. Almon and A. Armendi, "Myofascial Foot Pain Following Uneventful Epidural Analgesia for ...
Few studies evaluated epidural analgesia in induced labors. ... epidurals offered better pain relief, but were associated with ... Compared with other types of analgesia or no analgesia, ... Epidural versus non-epidural or no analgesia in labour Cochrane ... all but five studies compared epidural analgesia with opiates. Epidural analgesia was found to offer better pain relief (mean ... singleton vaginal deliveries occur with epidural or spinal analgesia.3 Few dispute that epidural analgesia provides good pain ...
Epidural analgesia or epidural injection is a form of labour pain management. Pain relief medications are injected into the ... Types of analgesia used in Epidural Analgesia. There are different types of analgesia used in epidural analgesia, for instant ... What is Epidural Analgesia used for?. Epidural analgesia provides a reliable and excellent analgesia during childbirth without ... What is Epidural Analgesia?. Epidural analgesia is an injection of local anaesthetic alone, or more commonly in combination ...
Procedure: Analgesia without doula Epidural analgesia in the latent phase of first stage of labor without doula accompany in ... Procedure: Doula combined analgesia Doula combined epidural analgesia in the latent phase of first stage of labor in primiparas ... Doula Combined Latent Phrase Epidural Analgesia in Primiparous Women (DCLEAP). The safety and scientific validity of this study ... Epidural analgesia in the latent phase of the first stage of labor without doula accompany ...
Active Comparator: single epidural catheter Drug: epidural catheter epidural catheter with 0.3% ropivacaine ... Active Comparator: double epidural catheter Drug: epidural catheter epidural catheter with 0.3% ropivacaine ... Single vs Double Epidural Catheter Analgesia for Scoliosis Surgery. The safety and scientific validity of this study is the ... This is a study comparing pain control utlilizing one or two epidural catheters, along with a hydromorphone PCA, for analgesia ...
... J Obstet Gynecol Neonatal Nurs. May-Jun 2003 ... One group was born to mothers who received epidural analgesia, and one group was born to mothers who received no pain ... whether a difference in breastfeeding behaviors could be observed between newborns whose mothers received epidural analgesia ...
It is differentiated from ANESTHESIA, EPIDURAL which refers to the state of insensitivity to sensation. ... The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the ... Epidural Analgesia. Subscribe to New Research on Epidural Analgesia The relief of pain without loss of consciousness through ... epidural analgesia provides safe and effective labor pain control.". 03/01/2008 - "Epidural analgesia (EA) is an effective and ...
Does postoperative epidural analgesia increase the risk of peroneal nerve palsy after total knee arthroplasty?. Horlocker TT1, ... Postoperative epidural analgesia was used in 108 cases and was not a significant risk factor for the development of peroneal ... Since diagnosis of peroneal nerve palsy may be delayed in patients with postoperative epidural analgesia, these patients must ... occurred in patients receiving postoperative epidural analgesia and were diagnosed after discontinuation of the epidural ...
We conducted a retrospective study to determine whether bupivacaine or fentanyl is a better adjuvant to epidural morphine for ... epidural morphine bupivacaine fentanyl post-operative analgesia This is a preview of subscription content, log in to check ... 1991) Combination of epidural morphine and fentanyl for postoperative analgesia. Reg Anesth 16:214-217PubMedGoogle Scholar ... 1989) Effect of diluent on analgesia produced by epidural fentanyl. Anesth Analg 68:808-810PubMedCrossRefGoogle Scholar ...
Morton, S., Williams, M., Keeler, E., Gambone, J., & Kahn, K. (1994). In Reply: Effect of Epidural Analgesia for Labor on ... In Reply: Effect of Epidural Analgesia for Labor on Cesarean Section Rate. ... In Reply: Effect of Epidural Analgesia for Labor on Cesarean Section Rate ...
To compare efficacy of tramadol injection as an opioid analgesia versus epidural analgesia on governing labor pain, progress ... Group B (epidural group) received Epidural - 0.125% bupivacaine with fentanyl 5 mcg. Epidural analgesia is adjusted to least ... Aim of the study: To compare efficacy of tramadol injection as an opioid analgesia versus epidural analgesia on governing labor ... epidural catheter was fixed with adhesive plaster at back. Epidural analgesia is adjusted to least analgesic dose (10-15 ml/hr ...
In patients without epidural analgesia, 7.4% had OVD, versus 9.5% of patients with epidural analgesia (Table 3). χ2 testing did ... Epidural analgesia and severe perineal laceration in a community-based obstetric practice. J Am Board Fam Pract 2003;16:1-6. ... Epidural Analgesia and Any Vaginal Laceration Message Subject (Your Name) has sent you a message from American Board of Family ... Epidural analgesia and severe perineal tears: A literature review and large cohort study. J Matern Fetal Neonatal Med 2014;27: ...
... clinicaltrials.gov The objectives of this study will be to compare epidural infusion management, specifically looking at ... Patients who require a decrease in their basal labor analgesia epidural infusion rate will have an increased incidence of ... The database will be queried for the following; maternal age, parity, gestational age, type of analgesia, changes in epidural ... Home » Topics » Anesthesiology » Research » The Association Between Decreasing Labor Analgesia Epidural Infusion and Forceps ...
Can Women in Labor Give Informed Consent to Epidural Analgesia?. This is a Wiley-Blackwell Publishing paper. Wiley-Blackwell ... Can Women in Labor Give Informed Consent to Epidural Analgesia?. Bioethics, Vol. 33, Issue 4, pp. 475-486, 2019 ... Wada, Kyoko and Charland, Louis and Bellingham, Geoff, Can Women in Labor Give Informed Consent to Epidural Analgesia? (May ... Keywords: decision‐making capacity, epidural analgesia, feminism, informed consent, labor pain, mental competence ...
Postoperative analgesia with epidural fentanyl. The Journal of the American Osteopathic Association, June 1991, Vol. 91, 547. ... Postoperative analgesia with epidural fentanyl You will receive an email whenever this article is corrected, updated, or cited ... Lytle S, Goldsmith D, Neuendorf T, Lowry M. Postoperative analgesia with epidural fentanyl. J Am Osteopath Assoc 1991;91(6):547 ... A retrospective analysis of 133 patients who received continuous epidural fentanyl for postoperative analgesia is presented. ...
Keywords: adverse effect, age, elderly, epidural analgesia, pain management, patient-controlled analgesia ... data of 2,435 patients who received fentanyl and ropivacaine-based patient-controlled epidural analgesia (PCEA) for pain relief ... Differences in postoperative pain, incidence of patient-controlled analgesia (PCA)-related adverse effects, and risk factors ... rescue analgesia, and antiemetic administration. Upon multivariate analysis, low fentanyl dosage and history of smoking were ...
Keywords: gastrectomy, gastric cancer, patient-controlled analgesia, epidural analgesia, short-term outcomes, pain treatment, ... This study aimed to determine the effects of patient-controlled epidural analgesia (PCEA) on postoperative pain management and ... Effective postoperative analgesia is essential for rehabilitation after surgery. Many studies have compared different methods ... short-term recovery after GC resection compared with those of patient-controlled intravenous analgesia (PCIA). Methods: We ...
  • Anesthesia and Analgesia 128(2): 315-327, February 2019. (upenn.edu)
  • Anesthesia and analgesia , 75 (2), 287-290. (elsevier.com)
  • Clinical indications for epidural anesthesia and analgesia have expanded significantly over the past several decades. (mhmedical.com)
  • This chapter covers the essentials of epidural anesthesia and analgesia. (mhmedical.com)
  • Anesthesia and analgesia , 88 (5), 971-972. (elsevier.com)
  • Anesthesia and analgesia , 98 (3), 875-876. (elsevier.com)
  • Comparative Safety of Morphine Delivered via Intravenous Route vs. Patient-Controlled Analgesia Device for Pediatric Inpatients. (upenn.edu)
  • PCA stands for patient-controlled analgesia. (nationwidechildrens.org)
  • patient controlled analgesia (PCA) an apparatus used to relieve acute pain. (thefreedictionary.com)
  • patient controlled epidural analgesia patient controlled analgesia in which a narcotic or local anesthetic is administered into the epidural space via a catheter. (thefreedictionary.com)
  • Few reports have evaluated continuous thoracic epidural analgesia effects on common abdominal surgeries as compared to more traditional intravenous pain control methods. (fsahq.org)
  • Our study indicates that for patients undergoing common major abdominal surgical procedures, continuous thoracic epidural analgesia is a viable alternative to intravenous pain control. (fsahq.org)
  • Incidence of epidural catheter-associated infections after continuous epidural analgesia in children. (harvard.edu)
  • It is injected into the spine after placing a catheter into the epidural space before the woman goes into labour. (kuenselonline.com)
  • Each dose of epidural analgesia costs about Nu 3,000 including the cost of the catheter set. (kuenselonline.com)
  • An epidural catheter was inserted but not dosed until women requested further analgesia. (contemporaryobgyn.net)
  • The epidural is administered through a small catheter in the back, and the medication is pumped into the spinal membranes until the baby has been delivered successfully. (babymed.com)
  • You are likely to need a urinary catheter for a shorter time than you would with an epidural. (babycenter.in)
  • Interventions A CADD-Solis Pain Management System v3.0 with Programmed Intermittent Bolus Model 2110 was connected via a 3-way adapter to an epidural catheter and a digital pressure transducer. (northwestern.edu)
  • METHODS: A prospective randomized trial investigating the effect of epidural analgesia on the outcome of labour in nulliparae, mothers were randomized to receive either epidural analgesia or meperidine. (afar.info)
  • continuous epidural analgesia continuous injection of an anesthetic solution into the sacral and lumbar plexuses within the epidural space to relieve the pain of childbirth, in general surgery to block the pain pathways below the navel, or to relieve chronic unremitting pain. (thefreedictionary.com)
  • Epidurals block the nerve impulses from the lower spinal segments resulting in decreased sensation in the lower half of the body. (kuenselonline.com)
  • Spinal/epidural pain relief provided to women in active labor during afternoon hours lasts about 27% longer than when the same pain relief is provided at night, according to a study of about 70 nulliparous women. (contemporaryobgyn.net)
  • The study looked at combined spinal-epidural analgesia achieved with an injection of 20 µg of subarachnoid fentanyl. (contemporaryobgyn.net)
  • A spinal is a single painkilling injection that works faster than an epidural . (babycenter.in)
  • You can have a spinal during the first stage of labour , as part of a combined spinal epidural (CSE) if your hospital uses this technique of anaesthesia. (babycenter.in)
  • Unlike an epidural, a spinal can't be topped up. (babycenter.in)
  • For many women, regional anesthesia (epidural, spinal, or combined spinal-epidural) will be the most suitable anesthetic. (umc.edu)
  • These include controversies about epidural space anatomy, the traditional epinephrine test dose, methods used to identify the epidural space, and whether particular clinical outcomes may be improved with epidural techniques when compared to GA. More detailed information about local anesthetics (LAs), the mechanism of neuraxial blockade, the combined spinal-epidural (CSE) technique, obstetric anesthesia, and complications of central neuraxial blockade is provided elsewhere in this textbook. (mhmedical.com)
  • Despite coining the term spinal anesthesia , he may unknowingly have been investigating the epidural space. (mhmedical.com)
  • Background and purpose: Blind interlaminar epidural steroid injection (BESI) is one of the treatment modalities for lumbar spinal stenosis (LSS). (kbco.hr)
  • A continuous background infusion improved maternal analgesia and reduced unscheduled clinician interventions. (anaesthesia-intensivecare.com)
  • Study objective Programmed intermittent bolus injection of epidural anesthetic solution results in decreased anesthetic consumption and better patient satisfaction compared with continuous infusion, presumably by better spread of the anesthetic solution in the epidural space. (northwestern.edu)
  • The objective of this in vitro study was to determine the pressure generated by a programmed intermittent bolus pump at 4 infusion delivery speeds through open-ended, single-orifice and closed-end, multiorifice epidural catheters. (northwestern.edu)
  • Conclusion Using a pump designed for programmed intermittent infusion boluses, the delivery speed of saline solution through epidural catheters was directly related to the peak pressures. (northwestern.edu)
  • Effects of intrapartum epidural analgesia at high altitudes: maternal, fetal, and neonatal outcomes. (pubfacts.com)
  • Severity of pain, onset and duration of analgesia, and occurrence of motor blockade were primary outcomes. (pubfacts.com)
  • The outcomes of interest were maternal analgesia, satisfaction, motor block, and the incidence of unscheduled clinician interventions. (anaesthesia-intensivecare.com)
  • Women who planned a home birth had a significantly lower risk of obstetric interventions and adverse outcomes, including augmentation of labour, electronic fetal monitoring, epidural analgesia, assisted vaginal delivery, cesarean section, hemorrhage, and infection. (medindia.net)
  • It is not known whether the delivery speed of the bolus injection influences analgesia outcomes. (northwestern.edu)
  • The outcomes we studied included admission-to-delivery intervals, use of epidural analgesia, maternal perineal trauma, route of delivery, and several potential indices of neonatal condition at birth. (elsevier.com)
  • Shortage of anaesthesiologists at the Thimphu referral hospital has hindered administration of epidural labour analgesia that was introduced free of cost since February last year. (kuenselonline.com)
  • The French physicians Jean Sicard and Fernand Cathelin are credited with the first intentional administration of epidural anesthesia. (mhmedical.com)
  • The UK currently has a severe shortage of midwives 1 and the impact of this on the delivery of labour analgesia would be a particularly important area to assess. (oaa-anaes.ac.uk)
  • As of last week, 56 women were administered epidural labour analgesia for painless childbirth. (kuenselonline.com)
  • To investigate whether intrapartum epidural analgesics (bupivacaine or ropivacaine) have an influence (safety and efficacy) on mothers, fetuses, or newborns at high altitudes (2,200 m above the sea level). (pubfacts.com)
  • Eighty parturient women with normal full term pregnancy (37-40 weeks) were randomly allocated to a group receiving epidural bupivacaine 0.125% and the other receiving ropivacaine 0.2%, with fentanyl 100 microg given to both groups. (pubfacts.com)
  • The onset of analgesia was relatively more rapid for ropivacaine group (p = 0.067). (pubfacts.com)
  • At high altitudes, no major advantage was found for epidural ropivacaine over bupivacaine in addition to fentanyl for labor analgesia and no harmful effects of the medications were found on mothers, fetuses, or newborns. (pubfacts.com)
  • Low concentrations of bupivacaine or ropivacaine provide excellent analgesia without significant motor block. (anaesthesia-intensivecare.com)
  • 310 were randomly allocated to receive i.m. meperidine up to 300 mg and 301 to receive epidural bupivacaine. (afar.info)
  • Any unusual pain or increased requirement for pain relief in people who receive epidural analgesia should command immediate medical attention, because this may be indicative of a pending uterine rupture. (hqontario.ca)
  • Data were obtained from retrospective chart review following IRB approval from the University of South Florida and evaluated for the effects of intravenous analgesia compared to continuous bupivicaine T10 epidural analgesia. (fsahq.org)
  • Anaesthesia-Intensive care.com: Patient-controlled epidural analgesia for labor. (anaesthesia-intensivecare.com)
  • Patient-controlled epidural analgesia for labor. (anaesthesia-intensivecare.com)
  • Many strategies with PCEA can provide effective labor analgesia. (anaesthesia-intensivecare.com)
  • The combination of low‐dose local anesthesia and lipophilic opioids such as fentanyl is established as a standard solution for labor epidural analgesia. (ntnu.no)
  • To facilitate intravenous infusions, epidurals, and maternal and fetal monitoring, women often spend much of the first stage of labor in supine or recumbent positions. (aafp.org)
  • Other Cochrane reviews have documented the benefit of continuous intrapartum support from early labor in decreasing labor duration, likelihood of spontaneous vaginal birth, likelihood of intrapartum analgesia, and dissatisfaction with childbirth experiences. (aafp.org)
  • It's relatively common knowledge that an epidural is an effective and popular method of pain relief for women who are in labor. (babymed.com)
  • While 50% of women in labor elect to have an epidural, the side effects are not usually well known. (babymed.com)
  • Usually, the doses used for an epidural during labor are small, so your side effects won't be very significant at all. (babymed.com)
  • Epidurals are safe and effective in relieving pain during labor, and the side effects are minimal. (babymed.com)
  • Source: Anu Jaitley et al: A Comparison Between Epidural and IV Tramadol for Painless Labor and Effect on Perinatal Outcome. (babymed.com)
  • A Canadian study of more than 123,000 births found no association between epidural labor analgesia exposure and an increased risk for autism spectrum disorder in children. (healthmag.top)
  • An overview of that most sought-after of childbirth labor relief, the Epidural. (buzzsprout.com)
  • The two common pharmaceutical pain-relief analgesia used during labor. (buzzsprout.com)
  • Unlike an epidural, it can be given in a single injection, so there is no tube left in your back. (babycenter.in)
  • The course provides a solid foundation in epidural anesthesia, to prepare the learner to perform an epidural injection. (cornell.edu)
  • Background Epidural analgesia is the commonest mode for providing pain relief in labour, with a combination of bupivacaine and fentanyl most often used in practice. (bmj.com)
  • The addition of adrenaline to an epidural solution containing fentanyl lowered maternal systemic serum fentanyl concentration during the first 2 hours, but did not lower serum fentanyl concentration in the umbilical vein and mother at delivery. (ntnu.no)
  • Comparison of lumbar epidural bupivacaine with fentanyl or clonidine for postoperative analgesia in children with cerebral palsy after single-event multilevel surgery. (edu.au)
  • Objective To test whether late-preterm and term neonates exposed to opioids in epidural analgesia in labour are more likely to develop respiratory distress in the immediate neonatal period. (bmj.com)
  • Multimodal analgesia: Optimal pain management while avoiding opioids is a key enabler of patient recovery. (sages.org)
  • The APS employs a multimodal regimen to control postoperative pain, and provides daily 24-hour coverage and management of patients with postoperative, post-traumatic and other types of acute pain requiring specialized intervention such as epidural analgesia, continuous peripheral nerve blockade and complex pharmacological management. (umc.edu)
  • Epidural blockade may also reduce the surgical stress response, the risk of cancer recurrence, the incidence of perioperative thromboembolic events, and, possibly, the morbidity and mortality associated with major surgery. (mhmedical.com)
  • and (6) major and minor complications associated with epidural blockade. (mhmedical.com)
  • Duration of analgesia after the first bolus dose was longer and the need for supplemental epidural analgesic doses was lesser in the bupivacaine group (p = 0.041 and 0.045, respectively). (pubfacts.com)
  • Larger bolus doses (more than 5 mL) may provide better analgesia compared with small boluses. (anaesthesia-intensivecare.com)
  • Future work should evaluate whether differences in the delivery speed of anesthetic solution into the epidural space correlate with differences in the duration and quality of analgesia during programmed intermittent epidural bolus delivery. (northwestern.edu)
  • CONCLUSIONS: Epidural analgesia in labour was not associated with an increase in the prevalence or incidence of backache. (afar.info)
  • The neurologist J. Leonard Corning proposed injecting an anesthetic solution into the epidural space in the 1880s, but devoted his research primarily to subarachnoid blocks. (mhmedical.com)
  • The trial investigated whether lying down or being upright during the second stage of labour made a difference to the need for a caesarean section or the use of instruments (forceps and ventouse) during vaginal delivery for women having their first baby with a low-dose epidural. (ox.ac.uk)
  • In the UK approximately 30% of women choose epidural analgesia, a procedure which prolongs the second stage of labour and increases the risk of instrumental vaginal delivery. (ox.ac.uk)
  • The results clearly show that for women having their first baby with epidural analgesia, lying down during the second stage of labour increases the chances of a spontaneous vaginal birth. (ox.ac.uk)
  • The epidural test dose in obstetric patients: Has it outlived its usefulness? (elsevier.com)
  • Epidural group data were collected from January 2017 to July 2017. (fsahq.org)
  • Exposure to epidural analgesia was present in 146 (70.9%) cases as compared with 131 (63.6%) of the controls. (bmj.com)
  • epidural analgesia analgesia induced by introduction of the analgesic agent into the epidural space of the vertebral canal. (thefreedictionary.com)
  • relative analgesia in dental anesthesia, a maintained level of conscious sedation short of general anesthesia, usually induced by inhalation of nitrous oxide and oxygen. (thefreedictionary.com)
  • The 2018 BMJ research paper of the year award was won by the BUMPES trial conducted by The Epidural and Position Trial Collaborative Group. (ox.ac.uk)
  • BACKGROUND: Concern has been expressed that epidural analgesia for labour may be associated with a higher incidence of backache. (afar.info)
  • Women who received an epidural were randomly allocated to two groups: either an upright or lying down position in the second stage of labour. (ox.ac.uk)
  • Epidural analgesia is a medical technique of relieving pain administered to pregnant mothers during delivery. (kuenselonline.com)
  • In addition, epidural techniques are used increasingly for diagnostic procedures, acute pain therapy, and management of chronic pain. (mhmedical.com)
  • Some women report itching in the legs as the epidural medication starts to fade away, which is actually a common side effect of many large doses of local anesthetics. (babymed.com)
  • Epidural analgesia and backache: a randomized controlled comparison with intramuscular meperidine for analgesia during labour. (afar.info)
  • While the cost implication would not be much, the workload on the hospital staff especially of the birthing centre increases when women are administered epidurals. (kuenselonline.com)
  • The information on e xposure to epidural analgesia and on potential confounding variables was obtained from the standardised delivery record, routinely filled out on all women admitted to the labour wards. (bmj.com)
  • Meanwhile, records show that of the 56 women who were administered epidural, 10 delivered through emergency caesarean sections while one underwent a vacuum delivery. (kuenselonline.com)
  • Herein is described the fatal case of a patient that developed transverse myelitis after a Caesarean delivery, probably related to the epidural analgesia. (uwi.edu)
  • Pressures generated by delivery speeds of 100, 175, 300, and 400 mL/h of saline solution were tested with 4 epidural catheters (2 single orifice and 2 multiorifice). (northwestern.edu)
  • Most epidurals have been shown to be a safe and useful way for women to manage their pain during labour and delivery. (fraserhealth.ca)
  • Also, women who received caseload midwifery care were ten times less likely to ask for a caesarean or for pain relief medicine, like analgesia and epidural. (thepregnancyzone.com)
  • An epidural is a way of giving pain relief. (fraserhealth.ca)
  • 2 Within a decade and seemingly without the knowledge of Pagés's work, the Italian surgeon Achille Dogliotti popularized a reproducible loss-of-resistance (LOR) technique to identify the epidural space. (mhmedical.com)
  • Blind" epidural in corresponding interspace was performed with 18G Tuohy needle, using loss of resistance. (kbco.hr)
  • Headaches are more common after accidental puncture during an epidural (about one in 100). (babycenter.in)
  • The OAA fully supports the NICE guidance that if a woman in labour requests an epidural, this should be offered, even in the latent stage of labour. (oaa-anaes.ac.uk)
  • In the second stage of labour (when the cervix is 10cm dilated) as long as the woman can maintain the position needed to insert an epidural, she should be able to have one. (oaa-anaes.ac.uk)
  • There are many key aspects of ERPs under the primary responsibility of the anesthesiology team including attenuation of surgical stress, fluid therapy, analgesia, and maintenance of normothermia and euglycemia. (sages.org)