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).
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.
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.
Receptors, Opioid, mu
Labor Stage, First
Anesthesia and Analgesia
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.
Hypnotics and Sedatives
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.
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 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)
Ambulatory Surgical Procedures
Dose-Response Relationship, 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.
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)
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.
Obstetric Labor Complications
Anti-Inflammatory Agents, Non-Steroidal
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.
Drug Administration Schedule
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.
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.
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.
Anesthesia Recovery Period
Receptors, Opioid, kappa
Receptors, Opioid, delta
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.
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.
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.
Labor Stage, Second
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).
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)
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)
Heart Rate, Fetal
Adrenergic alpha-2 Receptor Agonists
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.
Transcutaneous Electric Nerve Stimulation
Drug Therapy, Combination
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.
Enkephalin, D-Penicillamine (2,5)-
Receptors, Adrenergic, alpha-2
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.
Analysis of Variance
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...
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 | 40th Annual Regional Anesthesiology and...
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 ...
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.
The Westmead Anaesthesia Blog: Epidural analgesia in patients with traumatic rib fractures: a systematic review of randomised...
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 ...
Effect of thoracic epidural analgesia on clinical outcomes following transapical transcatheter aortic valve implantation | Heart
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 ...
Postoperative Thoracic Epidural Analgesia Versus Intravenous Patient-Controlled Analgesia For Liver and/or Pancreas - Full Text...
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 ...
Effect of thoracic epidural analgesia on clinical outcomes following transapical transcatheter aortic valve implantation | Heart
If patients could recognise themselves, or anyone else could recognise a patient from your description, please obtain the patients written consent to publication and send them to the editorial office before submitting your response [Patient consent forms] ...
Influence of oxytocin or epidural analgesia on personality profile in breastfeeding women : a comparative study
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 ...
For Pain Control during Early Labor, Combined Spinal-Epidural Analgesia Is Best | International Anesthesia Research Society
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 ...
For Pain Control during Early Labor, Combined Spinal-Epidural Analgesia Is Best | International Anesthesia Research Society
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 ...
Low Dose Epidural Analgesia During Labor: Comparison Between Patient Controlled Epidural Analgesia with Basal Continuous...
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 …
Labor Epidural Analgesia to Cesarean Section Anesthetic Conversion Failure: A National Survey
|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
VITAL CAPACITY AFTER THORACOTOMY:CONTINUOUS EPIDURAL ANALGESIA VS. INTRAVENOUS PATIENT CONTROLLED ANALGESIA | Anesthesiology |...
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Programmed intermittent epidural bolus as compared to continuous epidural infusion for the maintenance of labor analgesia: a...
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  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 ...
BestBets: In patients undergoing cardiac surgery, thoracic epidural analgesia combined with general anesthesia results in...
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 ...
Effect of Thoracic Epidural Analgesia for Thoracotomy on the Occurrence of AF - Full Text View - ClinicalTrials.gov
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:. ...
Reply:General Versus Regional Anesthesia for Peripheral Vascular Surgery | Anesthesiology | ASA Publications
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 ...
Epidural: The Principles and Benefits of Epidural Analgesia - Pain Community Centre
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 . The effects on the metabolic stress response (increase of ...
Effects of preemptive epidural analgesia on post-thoracotomy pain
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 ...
Parity, prolonged labor and epidural analgesia<...
TY - JOUR. T1 - Parity, prolonged labor and epidural analgesia. AU - Witter, F. R.. AU - Caulfield, L. E.. PY - 1996/6. Y1 - 1996/6. KW - Analgesia. KW - Epidural. KW - Labor. KW - Parity. UR - http://www.scopus.com/inward/record.url?scp=0029938227&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=0029938227&partnerID=8YFLogxK. U2 - 10.1016/0020-7292(96)02658-6. DO - 10.1016/0020-7292(96)02658-6. M3 - Letter. C2 - 8793631. AN - SCOPUS:0029938227. VL - 53. SP - 269. EP - 270. JO - International Journal of Gynecology and Obstetrics. JF - International Journal of Gynecology and Obstetrics. SN - 0020-7292. IS - 3. ER - ...
Occasionally painkillers may be given by infusion into the space just outside the membranes surrounding the spinal cord. This is known as epidural analgesia. Sometimes the painkiller is given into the fluid around the spinal cord -- this is known as intrathecal analgesia. These specialised techniques are usually used only to control severe pain and are managed by anaesthetists.. If you need to have your painkillers by injection or infusion, your doctor or nurse will discuss this with you.. Please see our leaflet on Strong Painkillers for more information.. ...
Epidural Analgesia May Reduce Short-Term Mortality in Acute Pancreatitis
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.
Epidurals for pain relief in labour | Cochrane
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, ...
Comparison of continuous paravertebral blockade (PVB) and continuous thoracic epidural analgesia (TEA) for analgesia following...
This trial was comparing the efficacy and tolerability of continuous paravertebral and epidural anesthesia blockage with levobupivacaine [Chirocaine] versus
2018 Abstract Details - SOAP
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  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 . 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 ...
2012 Abstract Details - SOAP
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 ...
Continuous caudal epidural analgesia for perioperative pain control after bilateral mastectomy in a mare | Veterinary Record...
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. ...
Wee Peek Prenatal Imaging | Epidurals in Labor
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 for Pain Relief
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 for Pain Relief
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.
Does epidural increase the risk of cesarean section?
epidural anaesthesia and caesarean, epidural analgesia on outcomes of labor, labour epidural, association of epidural and caesarean delivery in childbirth
PPT - The Effects of Regional Analgesia on the Progress and Outcome of Labor PowerPoint Presentation - ID:161159
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
Pregnancy Guidelines: 2008
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, ...
Remifentanil kan i særlige tilfælde anvendes som alternativ til epiduralanalgesi til fødende - Danish National Research...
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 ...
Prenatal Yoga Center | Epidurals: The Pros and The Cons
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 ...
Epidural pain relief. What is an epidural catheter? Why use an epidural catheter rather than other methods of giving pain...
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
Epidural analgesia during labor and maternal fever - Fingerprint - University of Texas Southwestern Medical Center
Epidural analgesia | Childrens Education Materials
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.. ...
Epidural Analgesia | GreenMedInfo | Anti-Therapeutic Action | Natural
By default, all articles on GreenMedInfo.com are sorted based on the content type which best reflects the data which most users are searching for. For instance, people viewing substances are generally most interested in viewing diseases that these substances have shown to have positive influences. This section is for allowing more advanced sorting methods. Currently, these advanced sorting methods are available for members only. If you are already a member, you can sign in by clicking here. If you do not currently have a user account, and would like to create one/become a member, click here to begin the singup process ...
Blog Archives - KIM WILDNER
The review identified 38 randomised controlled studies involving 9658 women. All but five studies compared epidural analgesia with opiates. Epidurals relieved labour pain better than other types of pain medication but led to more use of instruments to assist with the birth. Caesarean delivery rates did not differ overall and nor were there effects of the epidural on the baby soon after birth; fewer babies needed a drug (naloxone) to counter opiate use by the mother for pain relief. The risk of caesarean section for fetal distress was increased. Women who used epidurals were more likely to have a longer delivery (second stage of labour), needed their labour contractions stimulated with oxytocin, experienced very low blood pressure, were unable to move for a period of time after the birth (motor blockage), had problems passing urine (fluid retention) and suffered fever. Long-term backache was no different. Further research on reducing the adverse outcomes with epidurals would be helpful. ...
Epidural analgesia | definition of epidural analgesia by Medical dictionary
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-control | JPR
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
Effects of combined spinal-epidural analgesia on first stage of labor: a cohort study<...
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 ...
Post-Pancreaticoduodenectomy Outcomes and Epidural Analgesia: A 5-year Single-Institution Experience<...
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: ...
ISRCTN - ISRCTN20639281: Paravertebral block versus thoracic epidural analgesia for video-assisted thoracic surgery
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 ...
Indian Journal of Anaesthesia (IJA)
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) ...
Labor Pain and Analgesia
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 ...
Epidural analgesia vs systemic intravenous analgesia in the major gynecological surgery. - AdisInsight
This trial will compare the efficacy of epidural administered levobupivacaine [Chirocaine] + sufentanil [fentatienil] with intravenously administered morphine
A clinical study of labour using epidural analgesia with 0.125% bupivacaine and its outcome | INTERNATIONAL JOURNAL OF CURRENT...
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 ...
Einfluss der patientenkontrollierten epiduralen Analgesie versus der patientenkontrollierten intravenösen Analgesie auf...
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 ...
How do you control pain after surgery? | Reference.com
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...
Surgeon-administered regional analgesia to replace anaesthetist-administered regional analgesia - need for communication and collaboration ...
Im the Mom, its my job to make informed decisions
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 - Epidural Catheter Suppliers, Buyers, Wholesalers and Manufacturers - ecplaza.net
Epidural Catheter directory ☆ Epidural Catheter manufacturers, suppliers ☆ Epidural Catheter buyers, importers, wholesalers, distributors
A multicentre, randomised controlled trial of position during the late stages of labour in nulliparous women with an epidural:...
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
Epidurals Dont Slow Labor
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 ...
Epidural management, Epidural Analgesia, Epidural Anesthesia, Thoracic Epidural, Lumbar Epidural, Regional Anesthesia - ONA
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Fentanyl and methadone used as adjuncts to bupivacaine for lumbosacral epidural analgesia in sheep | Veterinary Record
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Centers RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.. ...
The Comparison of Cryoanalgesia and Epidural Analgesia in Thoracotomy
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Elsevier: Côté: Clinical Veterinary Advisor, 3rd Edition · Epidural Analgesia/Anesthesia
The effects of perioperative anesthesia and analgesia on immune function in patients undergoing breast cancer resection: A...
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
Pregnancy Epidurals | Spinal Epidural | Epidural Block | Epidural Anaesthesia
Learn about Pregnancy Epidurals, when to have a Spinal Epidural, the effect of an Epidural Block and proper use of Epidural Anaesthesia.
Childbirth and Labor Pain Management
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 ...
Epidurals and Spinal Anaesthesia for Childbirth | Intelli Learn
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. ...
Midwifery Ramblings: Why Epidurals ARENT Gods Gift to Women
9. Epidurals confine you to bed, which can lead to a malpositioned baby. God designed our pelvis to be mobile, and this helps *tremendously* during labor. Through remaining mobile, we are able to help the baby rotate into optimal position for birth. In the absense of mobility, the pelvis can become stiff, and not respond to labor/pushing as it should. Epidurals also often come with the doctor artificially breaking the amniotic sac, which in turn helps to create or cement a malpositioned baby ...
Analgesia, antipyretic, antiinflammatory and antigout APIs, Analgesia, antipyretic, antiinflammatory and antigout APIs Products...
Analgesia, antipyretic, antiinflammatory and antigout APIs, find quality Analgesia, antipyretic, antiinflammatory and antigout APIs products,Analgesia, antipyretic, antiinflammatory and antigout APIs Manufacturers, Analgesia, antipyretic, antiinflammatory and antigout APIs Suppliers and Exporters at Baoji GuoKang Bio-Technology Co., Ltd..
Chapter 153. Regional Analgesia for Abdominal Surgery | The Anesthesia Guide | AccessAnesthesiology | McGraw-Hill Medical
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 ...
Internet Scientific Publications
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 ...
Local and Regional Analgesic Techniques - Management and Nutrition - Merck Veterinary Manual
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.
Recurrent HSVL and the use of epidural morphine in obstetrics. Anesthesia & Analgesia Wolters Kluwer N.V. 0003-2999 10.1213/00000539-198903000-00052
Medicinal Gas Mixtures
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 ...
Browsing by Author Moreno-Cid García-Suelto, María
Background: Epidural analgesia (EA), at the present time, is one of the most effective methods to reduce labor pain. In recent years its use has increased, being used between 20-70% of all deliveries; (2) Methods ...
Epidural use at birth not linked to autism risk, study finds | News Center | Stanford Medicine
Refuting an earlier study, researchers found that epidural anesthesia, commonly administered for pain relief during labor, does not increase the risk for autism in children.
Study debunks notion that epidurals prolong labor - UPI.com
Epidurals are a popular form of pain control for women during labor, but theyve long been blamed for hindering progress in the delivery room.
Pediatric Drug Labeling: Still an Unfinished Need : Anesthesia & Analgesia
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 ...
Download Mitochondrial Dysfunction In Neurodegenerative Disorders
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 ...
Effects of different types of anesthesia and analgesia on the cellular immunity of patients after radical resection for lung...
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 an...
[Caudal epidural block in children during catheter cerebral angiography (authors transl)].: Nineteen panangiographies under caudal epidural block were performe
Milestone Scientific Announces Publication of Study Validating Efficacy of CompuFlo(R) CathCheck(<sup>TM</sup>) System to...
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 ...
PCEA labor analgesia
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. ...
A possible complication of epidural analgesia. British Medical Journal 285: 972 only. name="Cambridge 2017, p56-58." Shoib S, ... Psychosis is occasionally associated with other arterial or venous lesions: epidural anaesthesia can, if the dura is punctured ...
Medicine administered via epidural can cross the placenta and enter the bloodstream of the fetus. Epidural analgesia has no ... Anim-Somuah M, Smyth RM, Cyna AM, Cuthbert A (May 2018). "Epidural versus non-epidural or no analgesia for pain management in ... Epidural analgesia is a generally safe and effective method of relieving pain in labour, but has been associated with longer ... Thorp JA, Breedlove G (June 1996). "Epidural analgesia in labor: an evaluation of risks and benefits". Birth. 23 (2): 63-83. ...
Doughty, Andrew (1980). Epidural Analgesia in Obstetrics: A Second Symposium, University of Warwick, Coventry. London: Lloyd- ... 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 ...
Analgesic Audioanalgesia Pain management Patient-controlled analgesia Pain in babies Congenital analgesia (insensitivity to ... Chronic stimulation via percutaneously inserted epidural electrodes. Neurosurgery 1977;1: 215-8.]. [Han JS, Chen XH, Sun SL, et ... Electroanalgesia is a form of analgesia, or pain relief, that uses electricity to ease pain. Electrical devices can be internal ... This electroanalgesic modality was originally recommended as an alternative to TENS for dental analgesia. In a 1999 randomized ...
It is a method for the identification of the epidural space, a potential space. As a needle is advanced through the ligamentum ... Analgesia. 12 (2): 59-65. doi:10.1213/00000539-193301000-00014. Iklé A (July 1950). "Preliminary report of new technique for ... Wilson MJA (2007). "Epidural endeavour and the pressure principle". Anaesthesia. 62 (4): 319-324. doi:10.1111/j.1365-2044.2007. ... Epidural procedure History of neuraxial anesthesia Odom's indicator Dogliotti, AM (1933). "Research and clinical observations ...
As such, it has been used for analgesia in labor successfully; however, it is not as effective as epidural analgesia. In ... and respiratory effects of patient-controlled intravenous remifentanil analgesia and patient-controlled epidural analgesia in ... Anesthesia & Analgesia, 110(2), 524-525. Feldman, P. L. (2006). Discovery and Development of the Ultrashort-acting Analgesic ... Hence, it causes a reduction in sympathetic nervous system tone, respiratory depression and analgesia. The drug's effects ...
... ropivacaine versus bupivacaine for epidural labor analgesia". Anesthesia & Analgesia. 111 (2): 482-7. doi:10.1213/ANE. ... Analgesia. 108 (3): 997-1007. doi:10.1213/ane.0b013e31819385e1. PMID 19224816. S2CID 41982515. Nouette-Gaulain K, Dadure C, ... "Comparison of neosaxitoxin versus bupivacaine via port infiltration for postoperative analgesia following laparoscopic ...
Chest pain in children
"Epidural analgesia versus intravenous patient-controlled analgesia following minimally invasive pectus excavatum repair: a ... Keech, Brian M. (2015). "Thoracic epidural analgesia in a child with multiple traumatic rib fractures". Journal of Clinical ...
Neuraxial (regional) anesthetic and analgesia techniques: (e.g. epidural, spinal, combined spinal-epidural) are used most ... Charles B. Odom introduced lumbar epidural analgesia to obstetrics in 1935. The anesthesiologist relies on several patient ... the lumbar epidural approach in 1921. In 1921, the first vaginal delivery under spinal analgesia was reported by Kreiss in ... Labor analgesia was debated on the grounds of religion and morality, which John Simpson used as his own weapon against ...
January 2004). "Epidural analgesia for acute symphysis pubis dysfunction in the second trimester". International Journal of ...
Failed back syndrome
... "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 ...
... 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, ...
Morphine - Simple English Wikipedia, the free encyclopedia
In epidural anesthesia or intrathecal analgesia. *For palliative care (i.e. to lessen pain without curing the underlying reason ...
... (also known as audio-analgesia) is the relief of pain using white noise or music without using pharmacological ... This measure is similar to breathing exercises during cramps before administration of epidurals. It has also been suggested ... "Auditory analgesia in dental operations". J Am Dent Assoc. 59 (6): 1144-1149. doi:10.14219/jada.archive.1959.0251. PMID ... "Audio analgesia revisited". Anesthesia Progress. 16 (1): 8-14. PMC 2235527. PMID 5250548. "Nonpharmacologic Approaches to ...
... an epidural needle is simply a needle that is placed into the epidural space. To provide continuous epidural analgesia or ... Frölich, MA; Caton, D (July 2001). "Pioneers in epidural needle design". Anesthesia and Analgesia. 93 (1): 215-20. doi:10.1097/ ... Frölich, MA; Caton, D (July 2001). "Pioneers in epidural needle design". Anesthesia and Analgesia. 93 (1): 215-20. doi:10.1097/ ... a small hollow catheter may be threaded through the epidural needle into the epidural space, and left there while the needle is ...
An Efficient Alternative to Counteract Hypotension During Combined General/Epidural Anesthesia". Anesthesia & Analgesia. 90 (6 ...
Continuous wound infiltration
... some patients might prefer an alternative to epidural analgesia because of epidural-related side effects. Epidural analgesia ... "Major complications of epidural analgesia after surgery: results of a six-year survey: Epidural complications". Anaesthesia. 62 ... "Factors associated with the choice of delivery without epidural analgesia in women at low risk in France". Birth (Berkeley, ... "Preperitoneal or Subcutaneous Wound Catheters as Alternative for Epidural Analgesia in Abdominal Surgery: A Systematic Review ...
... occurrence of prolonged postoperative mechanical ventilation and myocardial infarction is also reduced by epidural analgesia.[ ... "Patient controlled opioid analgesia versus non-patient controlled opioid analgesia for postoperative pain". The Cochrane ... "Anesthesia and Analgesia. 126 (6): 2047-2055. doi:10.1213/ANE.0000000000002927. PMID 29734240. S2CID 13688396.. ... Spinal, epidural and caudal anesthesia. Further information: Neuraxial blockade and History of neuraxial anesthesia ...
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 ...
A 2018 Cochrane Review found that immersion at this stage reduces the use of epidural analgesia; however, there is no clear ... and the use of epidural or spinal analgesia. It is also associated with a lower rate of cesarean delivery and stress urinary ... Although water births have been proven to lessen pain without the need for an epidural there are no medical proven reasons why ... A 2018 Cochrane Review of water immersion in the first stages of labor found evidence of fewer epidurals and few adverse ...
... is indicated for local anaesthesia including infiltration, nerve block, ophthalmic, epidural and intrathecal ... anaesthesia in adults; and infiltration analgesia in children. Levobupivacaine is contraindicated for IV regional anaesthesia ( ...
"Safety of epidural analgesia in the perioperative care of patients undergoing cytoreductive surgery with hyperthermic ...
... is sometimes given intrathecally as part of spinal anesthesia or epidurally for epidural anaesthesia and analgesia. ... It is FDA approved to provide four days of analgesia after a single application prior to surgery. It is not approved for ... Transdermal fentanyl has also been used for many years in dogs and cats for post-operative analgesia. This is usually done with ... Supraspinal analgesia (μ1) Respiratory depression (μ2) Physical dependence Muscle rigidity It produces sedation and spinal ...
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 ...
The long duration and high lipophilicity of lofentanil has been suggested as an advantage for certain types of analgesia, but ... Meert TF, Lu HR, van Craenndonck H, Janssen PA (September 1988). "Comparison between epidural fentanyl, sufentanil, carfentanil ... lofentanil and alfentanil in the rat: analgesia and other in vivo effects". European Journal of Anaesthesiology. 5 (5): 313-21 ...
Thoracic epidural analgesia or paravertebral blockade have shown to be the most effective methods for post-thoracotomy pain ... Comparing thoracic epidural analgesia and paravertebral blockade, paravertebral blockade reduced the risks of developing minor ... Treatment to aid pain relief for this condition includes intra-thoracic nerve blocks/opiates and epidurals, although results ... Assessing the effects of transcutaneous electrical nerve stimulation (TENS) in post-thoracotomy analgesia. Rev Bras Anestesiol ...
Medical practitioners who administer anesthesia have questioned whether epidural analgesia should be provided to women with ... There is consensus that epidural catheters should not be placed through irritated or infected tattoos. However, harm has not ... Welliver, Dawn; Mark Welliver; Tammy Carroll; Peggy James (June 2010). "Lumbar Epidural Catheter Placement in the Presence of ... Concerns have emerged that epidural catheters may cause tattoo pigment to enter interspinous ligaments and other areas, ...
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 ...
... 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. Other muscles that can be involved in inhalation include: ...
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. In any case, the term herbal tea is very well established and much more common than tisane. 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). 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 ...
Three main kinds of oxygen masks are used by pilots and crews who fly at high altitudes: continuous flow, diluter demand, and pressure demand. 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. Diluter-demand and pressure-demand masks supply oxygen only when the user inhales. 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). In a pressure-demand system, oxygen in the mask is above ambient ...
Congenital analgesia (insensitivity to pain). Notes. *^ 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. 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. 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; 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. In 2009, Intelliject, a US startup developing a new epinephrine autoinjector, licensed their product to Sanofi. King was acquired by Pfizer in 2010 for $3.6 billion in cash. In 2010, Sciele/Shionogi faced a recall of Twinject devices and launched Adrenaclick, a modified version of the Twinject that could deliver only one dose. In 2010, European regulators approved Twinject, and also approved a new epinephrine autoinjector made by ALK and sold under the brand name Jext. Jext was launched in the European Union in September 2011. Also in 2010, Shionogi authorized Greenstone, the ...
Childbirth in Nepal
Medical management of pain is rarely found in home births, but analgesia (i.e. epidural) is prevalent in the hospitals. Touch, ...
Ketamin - Vikipedi
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. ...
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 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. 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. Horse liniment ingredients such as menthol, chloroxylenol, or iodine are also used in different formulas in products used by humans. Absorbine, a horse liniment product manufactured by W.F. Young, Inc., was reformulated for humans and marketed as Absorbine Jr. The company also acquired other liniment brands including Bigeloil and ...
"Nefopam analgesia and its role in multimodal analgesia: A review of preclinical and clinical studies". Clinical and ... 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.. ... An analgesic or painkiller is any member of the group of drugs used to achieve analgesia, relief from pain. They are distinct ...
Postoperative nausea and vomiting
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. 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 ...
Brachial plexus block
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. 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 ...
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. 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 ...
... (pKa 8.7) is the drug of choice for epidural analgesia and a decompensating fetus, because it does not ... Fetal acidosis, 2-chloroprocaine, and epidural anesthesia for cesarean section. Am J Obstet Gynecol. 1985 Feb 1;151(3):322-4. ... several cases were reported of neurological deficits after inadvertent intrathecal injections intended for epidural delivery.[4 ...
... 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, ...
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.. Paracetamol. Comes in free ...
Theories of general anaesthetic action
It has long been believed that general anaesthetics exert their effects (analgesia, amnesia, immobility) by modulating the ...
Epidural Anesthesia-Analgesia and Patient Outcomes: A Perspective
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 | Children's Education Materials
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 ...
Epidural Analgesia Safe and Effective During Early Labor | Medpage Today
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 ...
Removal of a Tenacious Epidural Catheter : Anesthesia & Analgesia
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.. ...
What is the role of epidural analgesia in the treatment of rib fractures?
... 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 - Full Text View - ClinicalTrials.gov
Epidural versus non-epidural or no analgesia in labour
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 ...
Epidural Analgesia | GreenMedInfo | Anti-Therapeutic Action | Natural
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. ...
Patient-controlled analgesia not as effective as epidural for labor pain | EurekAlert! Science News
... 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 ...
Labor Epidural Analgesia to Cesarean Section Anesthetic Conversion Failure: A National Survey
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-Punct... : Anesthesia & Analgesia
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]. - PubMed -...
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 ...
Myofascial Foot Pain Following Uneventful Epidural Analgesia for Labor and Delivery
... 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 ...
Epidural Analgesia for Labor Pain - Cochrane for Clinicians - American Family Physician
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 | HealthEngine Blog
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 ...
Doula Combined Latent Phrase Epidural Analgesia in Primiparous Women - Full Text View - ClinicalTrials.gov
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 ...
Single vs Double Epidural Catheter Analgesia for Scoliosis Surgery - Full Text View - ClinicalTrials.gov
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 ...
No Link Found for Exposure to Epidural Labor Analgesia and Autism - Drugs.com MedNews
Exposure to epidural labor analgesia (ELA) is not associated with offspring risk for autism spectrum disorder (ASD), according ... No Link Found for Exposure to Epidural Labor Analgesia and Autism. TUESDAY, April 20, 2021 -- Exposure to epidural labor ... analgesia (ELA) is not associated with offspring risk for autism spectrum disorder (ASD), according to a study published online ...
The effect of ultra low dose epidural analgesia on newborn breastfeeding behaviors
... 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 ...
Epidural Analgesia Summary Report | CureHunter
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? - PubMed - NCBI
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 ...
Comparison of bupivacaine and fentanyl as an adjuvant of epidural morphine for postoperative analgesia | SpringerLink
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 ...
In Reply: Effect of Epidural Analgesia for Labor on Cesarean Section Rate | RTI
Tramadol Injection versus Epidural Analgesia in Controlling Labor Pain | OMICS International
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 ...
Epidural Analgesia and Any Vaginal Laceration | American Board of Family Medicine
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: ...
The Association Between Decreasing Labor Analgesia Epidural Infusion and Forceps Delivery
... 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? by Kyoko Wada, Louis Charland, Geoff Bellingham :: SSRN
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
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. ...
Postoperative pain and patient-controlled epidural analgesia-related a | JPR
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 ...
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Patient controlled epidural19
- Patient-controlled epidural analgesia is superior to nitrous oxide inhalation in controlling childbirth pain. (ebscohost.com)
- In our study, patient controlled epidural analgesia (PCEA) and patient controlled intravenous remifentanil analgesia (PCIVA) were compared for VAS, and also their side effects on mother and newborn. (nih.gov)
- In this retrospective study, data of 2,435 patients who received fentanyl and ropivacaine-based patient-controlled epidural analgesia (PCEA) for pain relief after elective surgery under general or spinal anesthesia were reviewed. (dovepress.com)
- 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). (dovepress.com)
- All women received epidural analgesia for the first stage of labor using 0.08% ropivacaine with 0.4 micrograms/mL sufentanil with patient-controlled epidural analgesia. (ovid.com)
- i] Patient-controlled epidural analgesia versus continuous infusion for labour analgesia: a meta-analysis. (anaesthesiauk.com)
- The objective of this study is pain at rest and coughing in addition to determine the effect of intraoperative and postoperative thoracic patient-controlled epidural analgesia (PCEA) compared to postoperative intravenous patient-controlled analgesia (PCA) on postoperative recovery parameters, such as time to potential discharge and resumption of intestinal function after major open gynecologic surgery. (knowcancer.com)
- Subjects will be randomized to either general anesthesia with postoperative intravenous patient controlled analgesia (control group) or general anesthesia with intraoperative thoracic epidural anesthesia and postoperative thoracic patient-controlled epidural analgesia (treatment group). (knowcancer.com)
- Epidural analgesia can be administered by three methods: single-injection and intermittent boluses, continuous infusion via an indwelling catheter or patient-controlled epidural analgesia (PCEA). (oncologynurseadvisor.com)
- After initial epidural or intrathecal injection, both groups received patient-controlled epidural analgesia. (iars.org)
- Some of the included studies maintained post-operative analgesia with patient-controlled epidural analgesia. (york.ac.uk)
- To compare the efficacy and safety of patient controlled epidural analgesia with basal continuous infusion versus intermittent bolus for labor analgesia using fentanyl and bupivacaine. (springermedizin.de)
- 30 parturients were allocated to receive patient controlled epidural analgesia + basal continuous infusion (Group-A) and 30 received intermittent bolus on demand (Group-B). Efficacy of technique was assessed in terms of quality of analgesia on 0-10 cm verbal analogue scale. (springermedizin.de)
- In a busy obstetric unit with increased demand of epidural analgesia, patient controlled epidural analgesia with basal continuous infusion may be preferred. (springermedizin.de)
- Comparison of midwife top-ups, continuous infusion and patient controlled epidural analgesia for maintaining mobility after a low-dose combined spinal epidural. (springermedizin.de)
- 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)
- The authors studied the efficacy of sufentanil patient-controlled epidural analgesia (PCEA) for postoperative analgesia after cesarean delivery and compared these results to a morphine intravenous-patient-controlled-analgesia (IV-PCA) regimen. (elsevier.com)
- The purpose of this investigation is to determine whether analgesia provided by Patient Controlled Epidural Analgesia (PCEA) is more effective than Continuous Epidural Infusion Analgesia (CEIA) in patients undergoing major abdominal surgery. (isrctn.com)
- Patient-controlled epidural analgesia (PCEA) is a related term describing the patient-controlled administration of analgesic medicine in the epidural space , by way of intermittent boluses or infusion pumps. (wikipedia.org)
- This article provides an overview of the use of epidural infusion analgesia in the management of patients with post-operative pain. (ebscohost.com)
- However, all cases of peroneal nerve palsy with motor deficits and partial neurologic recovery occurred in patients receiving postoperative epidural analgesia and were diagnosed after discontinuation of the epidural infusion. (nih.gov)
- The objectives of this study will be to compare epidural infusion management, specifically looking at infusion rate changes, in patients who receive forceps deliveries versus normal spontaneous vaginal deliveries. (bioportfolio.com)
- Patients who require a decrease in their basal labor analgesia epidural infusion rate will have an increased incidence of forceps delivery. (bioportfolio.com)
- The primary endpoint is to evaluate if decreasing the epidural infusion rate was associated with a forceps delivery. (bioportfolio.com)
- To evaluate whether maintaining a motor-sparing epidural analgesia infusion affects the duration of the second stage of labor in nulliparous parturients compared with a placebo control. (ovid.com)
- Maintaining the infusion of epidural medication had no effect on the duration of the second stage of labor compared with a placebo infusion. (ovid.com)
- PCEA has become the standard method of epidural pain relief in some centres, or is offered as an alternative to continuous infusion. (anaesthesiauk.com)
- Influence of naloxone infusion on analgesia and respiratory depression following epidural morphine. (lu.se)
- The influence of two different concentrations of iv naloxone infusion on the analgesia and adverse effects of epidural morphine were compared in a double-blind, placebo-controlled study. (lu.se)
- However, naloxone infusion at the rate of 10 micrograms X kg-1 X h-1 reduced the duration of analgesia by about 25%, and more frequent injections of epidural morphine were required to give effective analgesia. (lu.se)
- Continuous epidural infusion offers the distinct advantage of providing steady-state analgesia when compared with single-injection administration or intermittent boluses, especially when short-acting opioids are used for infusion. (oncologynurseadvisor.com)
- Patients then begin an epidural infusion of ropivacaine hydrochloride and fentanyl immediately after surgery (postoperative day 0). (knowcancer.com)
- Arm I: Patients continue to receive the epidural infusion until they can be weaned to oral pain medication. (knowcancer.com)
- Arm II: Patients undergo daily weaning of the fentanyl concentration of the epidural infusion. (knowcancer.com)
- In both groups, the Gynecologic Oncology pain service may make adjustments to the epidural infusion or PCA for optimal pain management until the patient can be weaned to oral pain medication. (knowcancer.com)
- 420 patients undergoing elective CABG surgery Standard GA with 72hrs narcotic analgesia v standard GA with 96hrs TEA Elective CABG pts with normal preoperative coagulation status Epidurals inserted at T2/3 or T3/4 in OR immediately preoperatively operation postponed if "bloody tap" obtained Bilateral T1-T10 block instituted with Bupivacaine 0.5% and maintained with Bupivacaine / Clonidine infusion perioperatively +/- additional Bupivacaine top-ups postop. (bestbets.org)
- Efficacy of postoperative patient-controlled and continuous infusion epidural analgesia versus intravenous patient-controlled analgesia with opioids: a meta-analysis. (springermedizin.de)
- Continuous compared with intermittent epidural infusion on progress of labor and patient satisfaction. (springermedizin.de)
- Finegold H, Mandell G, Ramanathan S. Comparison of ropivacaine.1%-fentanyl and bupivacaine.125%-fentanyl infusion for epidural labor analgesia. (springermedizin.de)
- Sia AT, Lim Y, Ocampo C. A comparison of basal infusion with automated mandatory boluses in parturient-controlled epidural analgesia during labor. (springermedizin.de)
- Unpredictability of regression of analgesia during the continuous postoperative extradural infusion of bupivacaine. (semanticscholar.org)
- This knowledge would allow acute pain services to plan either to provide PCEA as a routine service, or to confine their services to continuous infusion epidural analgesia. (isrctn.com)
-  The Analgizer was widely utilized for analgesia and sedation until the early 1970s, in a manner that foreshadowed the patient-controlled analgesia infusion pumps of today. (wikipedia.org)
- Epidural anesthesia can be continued for longer duration during longer surgeries by either giving top ups of local anesthetics or by continuous infusion of local anesthetics by infusion pumps. (wikipedia.org)
- When a catheter is placed into the epidural space (see below) a continuous infusion can be maintained for several days, if needed. (wikipedia.org)
- An epidural injection or infusion for pain relief (e.g. in childbirth) is less likely to cause loss of muscle power, but has to be augmented to be sufficient for surgery. (wikipedia.org)
- In this study, 37 pregnant women with a single fetus, who had labor analgesia, were divided into groups of PCIVA (Group 2) and PCEA (Group 1). (nih.gov)
- PCEA is the gold standard in labor analgesia. (nih.gov)
- Satisfactory epidural blockade must be established before the PCEA regimen is instituted. (anaesthesiauk.com)
- PCEA is a useful and safe alternative for labour analgesia, provided that bolus doses of dilute local anaesthetic are small, that the lockout period and hourly maximum dose are appropriate and that the mother is regularly assessed by the labour ward anaesthetist. (anaesthesiauk.com)
- Fifty patients were randomized into two groups to receive sufentanil PCEA or morphine IV-PCA after cesarean delivery under epidural anesthesia. (elsevier.com)
- Although sufentanil PCEA provided satisfactory sustained postoperative analgesia, sufentanil PCEA appears to offer no clear advantage over morphine IV-PCA beyond the effects of the initial physician-administered loading dose. (elsevier.com)
Benefits of epidural analgesia3
- This study will address the potential benefits of epidural analgesia on multiple measurements of postoperative recovery. (knowcancer.com)
- Could benefits of epidural analgesia following oesophagectomy be measured by perceived perioperative patient workload? (diva-portal.org)
- Therefore, it is critical to quantify the real benefits of epidural analgesia over other modes of pain treatment. (northwestern.edu)
- A meta-analysis that included 8 studies (232 patients) did not demonstrate significant benefit of epidural analgesia on mortality, ICU, and hospital length of stay compared with other analgesic modalities in adult patients with traumatic rib fractures. (medscape.com)
- The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. (curehunter.com)
- Both commonly used pharmacological options for pain relief during labour - epidural and opioid analgesic options - have advantages and disadvantages. (who.int)
- A controversy exists whether beneficial analgesic effects of epidural analgesia over intravenous analgesia influence the rate of post-operative complications and the length of hospital stay. (diva-portal.org)
- Higher costs and better analgesic effects of epidural analgesia compared with intravenous analgesia do not reduce total costs for post-operative care following major surgery. (diva-portal.org)
- For the patient selected for epidural analgesia administration, an appropriately placed and functioning epidural catheter can produce pain relief that is superior to other routes of analgesic administration. (oncologynurseadvisor.com)
- In this prospective, double-blind, randomized experimental study the analgesic, physiologic, and behavioral effects of the epidural administration of tiletamine/zolazepam in horses are evaluated. (vetcontact.com)
- A variety of neuraxial (primarily epidural) and peripheral regional analgesic techniques may be employed for the effective treatment of postoperative pain. (omicsonline.org)
- This blinded, randomised experimental study was designed to compare the analgesic effects of lumbosacral epidural administration of lidocaine-epinephrine or lidocaine-xylazine combinations in fat-tailed sheep. (scielo.org.za)
- Therefore, the objective of the study reported here was to evaluate the analgesic efficacy of lidocaine-epinephrine or lidocaine-xylazine combinations following lumbosacral epidural administration in fat-tailed sheep. (scielo.org.za)
- They write, 'The findings…highlight that fact that both CSE and epidural analgesia are an excellent analgesic option during labor. (iars.org)
- Early initiation of epidural analgesic infusions (before HIPEC) was associated with significantly less surgical blood loss and fluid requirements ( P = 0.005 and 0.02, respectively). (springermedizin.de)
- Epidural local anaesthetics versus opioid-based analgesic regimens on postoperative gastrointestinal paralysis, PONV and pain after abdominal surgery. (springermedizin.de)
- epidural analgesia analgesia induced by introduction of the analgesic agent into the epidural space of the vertebral canal. (thefreedictionary.com)
- Neuraxial analgesia in the form of a labour epidural has been shown to be the most effective analgesic strategy for the labouring mother. (sun.ac.za)
- Conclusion Epidural analgesia, regardless of analgesic agent, location of catheter placement, and type and time of pain assessment, provided better postoperative analgesia compared with parenteral opioids. (jamanetwork.com)
- The epidural route is frequently employed by certain physicians and nurse anaesthetists to administer diagnostic (e.g. radiocontrast agents ) and therapeutic (e.g., glucocorticoids ) chemical substances, as well as certain analgesic and local anaesthetic agents. (wikipedia.org)
Anesthesia and Analgesia2
- These statements present the safety, efficacy, and risks of neuraxial anesthesia and analgesia based on the timing of needle insertion and catheter removal in relation to the time anticoagulants are administered. (oncologynurseadvisor.com)
- A prospective randomized study of the potential benefits of thoracic epidural anesthesia and analgesia in patients undergoing coronary artery bypass grafting. (springermedizin.de)
- An additional finding was that Apgar scores at one minute were lower in the neonates whose mothers had been given systemic opioid analgesia. (medpagetoday.com)
- To compare efficacy of tramadol injection as an opioid analgesia versus epidural analgesia on governing labor pain, progress and outcomes (maternal and fetal). (omicsonline.org)
- Epidural analgesia appears to be the more effective pain relief option but compared with opioid analgesia it also requires more resources to implement and to manage its adverse effects, which are more common with epidural analgesia. (who.int)
- Forceps delivery and the use of synthetic opioid analgesia during epidural anaesthesia. (afar.info)
- However, our analyses of Medicare patients undergoing lower-risk procedures (e.g., total hip and total knee replacement) showed that the use of postoperative epidural analgesia was not associated with a lower incidence of mortality and major morbidity [ 9 , 10 ]. (hindawi.com)
- Nevertheless, concern persists that the initiation of regional analgesia in early labor will result in a higher incidence of cesarean delivery than does its initiation during a later stage. (medpagetoday.com)
- Labor epidural top up for cesarean section can fail, the incidence of which has been reported to range from 0% to 21% [ 4 ]. (hindawi.com)
- Studies have shown increased incidence of severe vaginal lacerations (third and fourth degree) in women under the influence of epidural analgesia. (jabfm.org)
- Differences in postoperative pain, incidence of patient-controlled analgesia (PCA)-related adverse effects, and risk factors for the need for rescue analgesics for 48 hours postsurgery in young (age 20-39 years) and elderly (age ≥70 years) patients were evaluated. (dovepress.com)
- While younger patients exhibited greater incidence of numbness, motor weakness, and discontinuation of PCA postsurgery, elderly patients exhibited greater incidence of hypotension, nausea/vomiting, rescue analgesia, and antiemetic administration. (dovepress.com)
- A recent meta-analysis of 4 studies post-1990 which involved more than 1 million obstetric patients found an incidence of 1 in 168,000, but with only 6 epidural hematomas the accuracy of this estimate cannot be relied upon. (oncologynurseadvisor.com)
- Theoretically epidural ropivacain combined with oral oxycodone could decrease the incidence of these side effects. (diva-portal.org)
- Incidence of epidural catheter-associated infections after continuous epidural analgesia in children. (harvard.edu)
- Despite controversies and concerns, more rapid onset of analgesia, early bilateral sacral analgesia, lower incidence of asymmetric block and fewer maternal and fetal side effects are provided with DPE when compared to epidural. (springer.com)
- The authors concluded that preemptive thoracic epidural analgesia (TEA) appeared to reduce the severity of acute post-operative pain compared with TEA initiated after completion of surgery for patients undergoing unilateral thoracotomy, but did not affect the incidence of chronic post-thoracotomy pain. (york.ac.uk)
- To determine whether preemptive thoracic epidural analgesia (TEA) initiated before surgical incision reduces the severity of acute post-thoracotomy pain and incidence of chronic post-thoracotomy pain compared with TEA initiated after completion of surgery. (york.ac.uk)
- Epidural analgesia on top of general anesthesia in cardiac surgery might improve relevant clinical outcomes but the incidence of epidural hematoma is under-reported. (biomedcentral.com)
- Out of the 66 randomized and case-matched studies, 57 trials reported the incidence of all-cause mortality at the longest available follow-up with a significant reduction in the epidural group (59/3,137 (1.9%) in the epidural group vs. 108/3,246 (3.3%) in the control arm, RR 0.64 (95% CI 0.48 to 0.85), P = 0.002, NNT = 69). (biomedcentral.com)
- Epidural analgesia on top of general anesthesia in cardiac surgery might reduce the incidence of all-cause mortality (NNT 69). (biomedcentral.com)
- The incidence of epidural hematoma in this setting is 1:3,436 (95% CI = 1:2,325 to 1:5,076) including both published and unpublished data. (biomedcentral.com)
- This audit revealed a low incidence of labour epidural analgesia at RMMCH during the study period. (sun.ac.za)
- The incidence of subdural injection ranges between 0.024% reported by Jenkins in 145550 epidurals [ 1 ] to 0.82% reported by Lubenow, et al. (clinmedjournals.org)
- Introduction: Remifentanil has an attractive pharmacological profile for use in obstetric analgesia as a technique for mass application, with similar benefits and satisfaction as epidural analgesia. (ebscohost.com)
- Other surveys have found no cases in more than 700,000 obstetric epidural procedures. (oncologynurseadvisor.com)
- A novel approach called dural puncture epidural (DPE) which is a modification of CSE in terms of practice has gained popularity after its description and use in the obstetric population. (springer.com)
- 369 women (mean age 24 y) at first pregnancy who were in spontaneous full-term labor had a normal obstetric and medical history, had no contraindication to either form of analgesia, were willing to participate, and had continued eligibility at time of labor. (acpjc.org)
- OBJECTIVE: To verify whether the use of sufentanil during obstetric epidural anaesthesia (EA) was accompanied by an increase in the rate of instrumental extraction. (afar.info)
- To report a rare case of Pourfour du Petit Syndrome (PDPS), presenting clinically as Subdural Block (SDB), as a complication of Obstetric Epidural Analgesia (OEA). (clinmedjournals.org)
- Obstetric Epidural Analgesia (OEA) is presently considered to be one of the most effective and commonly utilized techniques for providing pain relief during labor and delivery. (clinmedjournals.org)
- In obstetric patients, regional analgesia refers to partial or complete loss of pain sensation below the T8 to T10 spinal level. (medscape.com)
- If the sensory block level was higher or unilateral, then a lower dose of intrathecal local anesthetic was selected and alternative options such as combined-spinal epidural and general anesthesia were increasingly favored. (hindawi.com)
- If a cesarean delivery is needed in a parturient with an existing labor epidural, it is common practice to convert or "top up" the epidural catheter [ 2 ], with the aim of initiating surgical anesthesia by injecting more concentrated local anesthetic, usually combined with a lipid soluble opioid. (hindawi.com)
- The loosely packed epidural fat may facilitate the spread of local anesthetic and help achieve a quicker block onset. (nysora.com)
- Since most pediatric patients receive epidural analgesia in conjunction with a general anesthetic, the main purpose of the epidural catheter is to deliver enough local anesthetic solution for effective intraoperative and postoperative analgesia. (nysora.com)
- As with epidural anesthesia in adults, local anesthetic concentration and volume are important factors in determining the density and level of blockade. (nysora.com)
- 4. The use of a dilute concentration of local anesthetic for continuous epidural analgesia should not result in a dense motor block, aiding diagnosis in patients who develop symptoms of an epidural hematoma. (oncologynurseadvisor.com)
- A low concentration of epidural local anesthetic does not affect the duration of the second stage of labor. (ovid.com)
- In this technique, local anesthetic and pain medications are injected into the epidural space-inside the membranes (dura) covering the spinal cord. (iars.org)
- We will review our group's work on perioperative epidural anesthesia-analgesia on patient outcomes which includes mortality, major morbidity, and patient centered outcomes but not technical failures or complications. (hindawi.com)
- To avoid complications and preserve as much motor function as possible, the lowest possible effective concentration of local anaesthetic should be used when administering epidural analgesia (1). (who.int)
- Conclusions TEA provided superior analgesia following TA-TAVI, and was associated with a dramatic reduction in periprocedural respiratory complications, and both, short- and long-term mortality. (bmj.com)
- No significant thoracic epidural related complications occurred. (koreamed.org)
- Epidural blockade can reduce such complications ( 2 ). (acpjc.org)
- The perioperative coagulopathy, hemodynamic instability, and infectious complications that may occur during cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has raised concerns about the safety of epidural analgesia in patients undergoing such procedures. (springermedizin.de)
- We reviewed epidural-related complications and analyzed the effect of early initiation of continuous epidural analgesia on estimated blood loss, intraoperative fluid administration, blood transfusion and vasopressor requirements, time to extubation, and length of stay. (springermedizin.de)
- Even if from the public health point of view the benefits seem to encourage the use of epidural analgesia in cardiac surgery with a possible reduction in perioperative mortality, this topic merits further investigation and the decision to insert the epidural catheter should be discussed with the patient considering both local experience and legal dispute in case of medical complications. (biomedcentral.com)
- Thoracic epidural analgesia (TEA) is associated with greater pain control, lower need for narcotics, and fewer complications after hepatopancreatobiliary (HPB) surgery compared with intravenous patient-controlled analgesia (IV-PCA), according to results of a randomized controlled trial published in the Annals of Surgery . (clinicalpainadvisor.com)
- However, epidural analgesia has sometimes been associated with rare but serious complications. (northwestern.edu)
- During epidural administration, there are four possible sites into which an epidural catheter or needle may be unintentionally placed, causing complications: The subdural [ 1 , 2 ], intradural [ 3 , 4 ], subarachnoid and intravascular spaces. (clinmedjournals.org)
- Continuous thoracic epidural analgesia (C-TEA) allows earlier postoperative mobilisation of patients and decreases the rate of complications. (viamedica.pl)
- Women in the other group received systemic hydromorphone at the first request for pain relief and epidural analgesia at either a cervical dilation of 4 cm or at the third request for analgesia. (medpagetoday.com)
- The median time from the initiation of analgesia to complete dilation (and also to vaginal delivery) was significantly shorter after intrathecal analgesia was administered than it was after systemic analgesia was administered. (medpagetoday.com)
- Pain scores after the first intervention were significantly lower following intrathecal analgesia than they were following systemic analgesia. (medpagetoday.com)
- Moreover, they noted, epidural analgesia provides better pain relief than systemic analgesia and is also more effective than systemic analgesia in shortening the duration of labor. (medpagetoday.com)
- Epidural analgesia provides a reliable and excellent analgesia during childbirth without resulting in concomitant maternal or foetal central depression seen with systemic opioids. (healthengine.com.au)
- 1984) Postthoracotomy pain and pulmonary function following epidural and systemic morphine. (springer.com)
- This protocol avoids epidural analgesia, systemic opioids and nerve blockade. (hss.edu)
- In general, these techniques can provide superior analgesia (especially when local anesthetics are used) compared with systemic opioids and use of these techniques can even reduce morbidity and mortality. (omicsonline.org)
- 2 The alpha 2 -agonists can be absorbed from the epidural space and have systemic effects (sedation and cardiopulmonary depression) that are most obvious in the ruminants because of their increased sensitivity to this group of drugs. (scielo.org.za)
- 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. (isrctn.com)
- Epidural anesthesia is contraindicated in patients receiving systemic anticoagulation and antiplatelet therapy, e.g., aspirin products or NSAIDs, patients with abnormal or reduced concentrations of clotting factors, patients in hypovolemic shock, with abruptio placentae, and whenever there is evidence of active infection near the site of the insertion of the epidural catheter. (thefreedictionary.com)
- Compared with systemic analgesia alone, epidural analgesia may offer better pain control. (northwestern.edu)
- Objectives To assess the effectiveness and safety of epidural analgesia compared with systemic analgesia for acute postoperative pain control after thoraco-lumbar spine surgery in children. (northwestern.edu)
- Selection criteria We included all randomized controlled trials performed in children undergoing any type of thoraco-lumbar spine surgery comparing epidural analgesia with systemic analgesia for postoperative pain. (northwestern.edu)
- Main results We included 11 trials (559 participants) in the review, and seven trials (249 participants) in the analysis: 140 participants received epidural analgesia and 109 received systemic analgesia. (northwestern.edu)
- Compared with systemic analgesia, epidural analgesia reduced pain at rest at all time points. (northwestern.edu)
- Only opioids could be used for labor analgesia in these situations, as they do not decrease systemic vascular resistance. (medscape.com)
- Labor analgesia: Comparison of epidural patient-controlled analgesia and intravenous patient-controlled analgesia]. (nih.gov)
- It has been demonstrated that paravertebral block, which resulted in lower cumulative dezocine doses and produced fewer side effects than intravenous patient-controlled analgesia, can provide effective pain relief for patients undergoing video-assisted thoracic surgery. (isrctn.com)
- The use of perioperative epidural anesthesia-analgesia may confer many benefits including superior postoperative analgesia, decreased morbidity, and improvement in patient-centered outcomes. (hindawi.com)
- Further research may be helpful to evaluate rare but potentially severe adverse effects of epidural analgesia on women in labour and long-term neonatal outcomes. (nih.gov)
- For management of labor pain, how does epidural analgesia compare with nonepidural pain control or no analgesia in terms of maternal and newborn outcomes? (aafp.org)
- Objective To determine the impact of perioperative thoracic epidural analgesia (TEA) on acute and late outcomes following transapical transcatheter aortic valve implantation (TA-TAVI). (bmj.com)
- Wong CA. Epidural and spinal analgesia for labor and vaginal delivery. (springer.com)
- To achieve epidural analgesia or anaesthesia, a larger dose of drug is typically necessary than with spinal analgesia or anaesthesia. (wikipedia.org)
- The onset of analgesia is slower with epidural analgesia or anaesthesia than with spinal analgesia or anaesthesia. (wikipedia.org)
- An indwelling catheter is more commonly placed in the setting of epidural analgesia or anaesthesia than with spinal analgesia or anaesthesia. (wikipedia.org)
- Possible regional anesthesia techniques include epidural analgesia, spinal analgesia (sometimes referred to as the intrathecal or subarachnoid space), or a combination of epidural and spinal analgesia. (medscape.com)
- This is a study comparing pain control utlilizing one or two epidural catheters, along with a hydromorphone PCA, for analgesia following surgery for correction of scoliosis. (clinicaltrials.gov)
- Precise placement of epidural needles for single-injection techniques and catheters for continuous epidural anesthesia ensures that the dermatomes involved in the surgical procedure are selectively blocked, allowing for lower doses of local anesthetics to be used and sparing unnecessary blockade in nondesired regions. (nysora.com)
- It may also allow the unimpeded advancement of epidural catheters from the caudal epidural space to the lumbar and thoracic levels. (nysora.com)
- Through an anonymous, web-based, viral, international survey, we identified at least 16 further nonpublished epidural hematomas together with at least 72,400 epidural analgesia catheters positioned in cardiac surgery in the last 20 years. (biomedcentral.com)
- There are different types of analgesia used in epidural analgesia, for instant the local anaesthetics and or opioids. (healthengine.com.au)
- Lipophilic (fat soluble) opioids, such as fentanyl, are able to penetrate the dura or the arachnoid membranes and spinal tissues resulting in a rapid onset of analgesia, but a limited duration. (healthengine.com.au)
- Cousins MJ, Mather LE (1984) Intrathecal and epidural administration of opioids. (springer.com)
- Single-injection or intermittent epidural bolus requires the use of longer-acting opioids (e.g. preservative-free morphine) to achieve a realistic duration of analgesia. (oncologynurseadvisor.com)
- Context Whether epidural analgesia is a better method than parenteral opioids for postoperative pain control remains controversial. (jamanetwork.com)
- Objective To systematically review the efficacy of postoperative epidural analgesia vs parenteral opioids, the primary alternative technique. (jamanetwork.com)
- Study Selection Inclusion criteria were a comparison of epidural therapy vs parenteral opioids for postoperative analgesia, measurement of pain using a visual analog scale (VAS) or numeric rating scale, randomization of patients to either therapy, and adult patients (≥18 years). (jamanetwork.com)
- However, reassure them that several other randomized, controlled trials have convincingly demonstrated that regional analgesia during labor as compared with other methods of pharmacologic pain relief, does not necessarily increase the risk of cesarean delivery. (medpagetoday.com)
- Over the past decade, however, several studies, involving many thousands of patients, have convincingly demonstrated that regional analgesia during labor, as compared with other methods of pharmacologic pain relief, does not necessarily increase the risk of cesarean delivery. (medpagetoday.com)
- We investigated the effect of epidural analgesia after median sternotomy METHODS: Fifty-six patients were randomized to epidural patient controlled analgesia (PCA) or conventional analgesia (control). (koreamed.org)
- Studies comparing TEA only to nonepidural methods of analgesia were excluded from the review, as were studies that examined the effects of lumbar epidural analgesia for upper abdominal surgery. (york.ac.uk)
- Methods: The study was a randomized, double-blind, controlled trial of parous women at greater than 38 weeks gestation who planned to breastfeed, had successfully breastfed a prior infant, and who received neuraxial labor analgesia. (northwestern.edu)
- Laboring patients must be educated about the different available methods of labor analgesia. (medscape.com)
- Many pharmacological and nonpharmacological methods of labor analgesia have been adopted over the years. (medscape.com)
- The onset of analgesia was relatively rapid in Group 2 followed by Group 3 then Group 1. (curehunter.com)
- The lockout time ensures that the drug has had enough time to work before the next dose is given, because there is usually a lag of 5-10 minutes between delivery of drug into the epidural catheter and onset of effect. (anaesthesiauk.com)
- 1. Time of onset of analgesia in minutes: It was recorded a interval between the time of injection into the epidural space and development of loss of sensation to pin prick. (thefreelibrary.com)
- 4. Duration of analgesia: This was measured as the interval between onset of analgesia and regression of analgesia by 2 segments or when the patient complained of pain, whichever occurred first. (thefreelibrary.com)
- Wilson SH, Wolf BJ, Bingham K, Scotland QS, Fox JM, Woltz EM, Hebbar L. Labor analgesia onset with dural puncture epidural versus traditional epidural using a 26-Gauge Whitacre needle and 0.125% bupivacaine bolus: a randomized clinical trial. (springer.com)
- A CSE technique provides more rapid onset of analgesia and more first-stage analgesia compared with a traditional epidural technique,' concludes the new study, led by Dr David Gambling of Sharp Mary Birch Hospital for Women and Newborns, San Diego, Calif. (iars.org)
- For post-operative analgesia, after an operation where the epidural technique is employed as the sole anaesthetic, or in conjunction with general anaesthesia. (wikipedia.org)
Thoracic epidural anesthesia3
- A letter to the editor is presented about a study on the efficacy and safety of thoracic epidural anesthesia after abdominal surgery for acute post-operative pain. (ebscohost.com)
- Combination of Thoracic Epidural Anesthesia Does Not Always Induce Hypothermia during General Anesthesia. (ebscohost.com)
- The article presents a study about the effect of the combination of general anesthesia and thoracic epidural anesthesia, which has been considered to induce hypothermia. (ebscohost.com)
- A quiz concerning the use of epidural analgesia for pain management is presented. (ebscohost.com)
- A Study of Pain Management during Labour by Epidural V/S Pentazocine & Tramadol. (ebscohost.com)
- Early Post operative Pain Management and Early Extubation after Off-pump Coronary Artery Bypass Graft Surgery is better managed with Thoracic Epidural Analgesia. (ebscohost.com)
- Preperitoneal catheter analgesia is an effective method for pain management after colorectal surgery: the results of 100 consecutive patients. (ebscohost.com)
- Remifentanil vs. epidural analgesia for the management of acute pain associated with labour. (ebscohost.com)
- Comparison of transversus abdominis plane block and epidural analgesia for pain relief after surgery. (ebscohost.com)
- Objectives: To compare the effects of different labor analgesia in controlling childbirth pain and seek more effective and reliable pain management strategy during natural childbirth in order to reduce maternal pain and promote natural childbirth. (ebscohost.com)
- Use of epidural analgesia in post-operative pain management. (ebscohost.com)
- Epidural analgesia is an effective method for relieving pain and has minimal side effects. (ebscohost.com)
- In one group, the subjects received intrathecal (neuraxial) fentanyl at the first request for pain relief and epidural analgesia at the second request. (medpagetoday.com)
- Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain and is widely used as a form of pain relief in labour. (nih.gov)
- To assess the effects of all modalities of epidural analgesia (including combined-spinal-epidural) on the mother and the baby, when compared with non-epidural or no pain relief during labour. (nih.gov)
- Randomised controlled trials comparing all modalities of epidural with any form of pain relief not involving regional blockade, or no pain relief in labour. (nih.gov)
- Epidural analgesia appears to be effective in reducing pain during labour. (nih.gov)
- Epidural analgesia had no statistically significant impact on the risk of caesarean section, maternal satisfaction with pain relief and long-term backache and did not appear to have an immediate effect on neonatal status as determined by Apgar scores. (nih.gov)
- Why women prefer epidural analgesia during childbirth: the role of beliefs about epidural analgesia and pain catastrophizing. (greenmedinfo.com)
- CST, at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting™, in New Orleans, researchers will report findings which suggest remifentanil patient controlled analgesia is not equivalent to epidural analgesia for pain, pain appreciation scores, and overall satisfaction in women who request for pain relief during labor. (eurekalert.org)
- Remifentanil patient controlled analgesia (RPCA) is a short-acting pain reliever, an opiate, similar to pethidine. (eurekalert.org)
- It relieves pain rapidly, but also wears off very quickly, which makes it very suitable for administration through patient controlled analgesia. (eurekalert.org)
- Recent studies suggest that remifentanil patient controlled analgesia (RPCA) is equivalent to epidural analgesia (EA) with respect to pain appreciation (satisfaction with pain relief). (eurekalert.org)
- Following an uneventful delivery under epidural analgesia, a 17 year old female patient was referred to the Pain Clinic because of numbness and pain of the left big toe for 2 and a half Months. (scirp.org)
- An Orthopedic consultation had ruled out foot injury and concluded that the pain was radicular and secondary to nerve damage from the epidural analgesia. (scirp.org)
- B. Mansour, G. Wienecke, J. Cure, J. Almon and A. Armendi, "Myofascial Foot Pain Following Uneventful Epidural Analgesia for Labor and Delivery," Open Journal of Anesthesiology , Vol. 2 No. 1, 2012, pp. 11-13. (scirp.org)
- L. C. Tsen and W. R. Camann, "Trigger Point Injections for Myofascial Pain During Epidural Analgesia for Labor," Regional Anesthesia, Vol. 22, No. 5, 1997, pp. 466-468. (scirp.org)
- Compared with other types of analgesia or no analgesia, epidurals offered better pain relief, but were associated with a longer second stage of labor and increased risk of instrumental vaginal delivery, maternal fever, and oxytocin (Pitocin) administration. (aafp.org)
- Epidural analgesia had no statistically significant impact on the risk of cesarean delivery, maternal satisfaction with pain relief, or long-term backache, and did not appear to have an immediate effect on neonatal status as determined by Apgar scores. (aafp.org)
- Epidural analgesia is an injection of local anaesthetic alone, or more commonly in combination with pain . (healthengine.com.au)
- Epidural analgesia provides complete motor (causing paralysis ) and sensory blockade (causing loss of sensation), around or near the site of pain. (healthengine.com.au)
- Investigators hypothesized that doula combined neuraxial (epidural) analgesia in the latent phrase would be a superior means for effective pain relief, decreased rate of cesarean section, and shortened duration of labor. (clinicaltrials.gov)
- To determine whether a difference in breastfeeding behaviors could be observed between newborns whose mothers received epidural analgesia for labor pain relief and those newborns whose mothers received no pain medication in labor. (nih.gov)
- One group was born to mothers who received epidural analgesia, and one group was born to mothers who received no pain medication for labor. (nih.gov)
- thoracic epidural analgesia represented the "gold standard" for post-thoracotomy pain relief in combination with intravenous analgesia. (curehunter.com)
- 1983) Epidural morphine for the relief of postoperative pain after Cesarean delivery. (springer.com)
- Saleh HS, Abdelsalam WA, Helal KF, Abdelhamid Attiya AM (2015) Tramadol Injection versus Epidural Analgesia in Controlling Labor Pain. (omicsonline.org)
- There were no significant differences.In the tramadol group, pain relief was excellent in 13.3%, good in 30.6% and average in 54.6% versus 29.3%, 48% and 22.6% in epidural group. (omicsonline.org)
- Epidural anesthesia and tramadol provided excellent pain relief in majority of the patients. (omicsonline.org)
- Epidural analgesia is becoming more commonly available 2 and provides superior pain relief compared with noninvasive musculoskeletal techniques or intravenous analgesics. (jabfm.org)
- 11 Analysis of results have concluded that epidural analgesia increases the likelihood of severe vaginal laceration by increasing the likelihood of OVD, 8 or that it reduces the likelihood of vaginal laceration as reduced pain results in a more controlled delivery. (jabfm.org)
- A systematic literature search identified a total of 20 empirical studies focused on women's decision‐making about epidural analgesia for labor pain. (ssrn.com)
- These data show that epidural fentanyl provides good to excellent pain relief with minimal side effects. (jaoa.org)
- Epidural analgesia is commonly used in addition to general anesthesia and to manage postoperative pain. (nysora.com)
- Effective postoperative pain relief from epidural analgesia has numerous benefits including earlier ambulation, facilitating weaning from ventilators, reducing time spent in a catabolic state, and lowering circulating stress hormone levels. (nysora.com)
- Epidural analgesia is recommended for healthy pregnant women requesting pain relief during labour, depending on a woman's preferences. (who.int)
- The GDG agreed that while there is limited evidence on the impact of epidural analgesia compared with no epidural analgesia for pain relief during labour, epidural analgesia is a proven method for relieving pain related to surgery, including abdominal surgery, and chose to recommend it as a pain relief option. (who.int)
- Health care professionals should be aware that women's desire for epidural analgesia might be moderated by the clinical context in which they receive antenatal and intrapartum care, whether labour is spontaneous or not, and their access to and knowledge of a range of other forms of pain relief measures. (who.int)
- All patients received catheter-based pain control, either via TEA (TEA group, n=74) or intercostal local analgesia with a catheter placed at the surgical incision site (non-TEA group, n=61), depending on the preference of the anaesthesiologist responsible for the case. (bmj.com)
- To relieve this pain, epidural analgesia is both the most effective and the safest technique. (centerwatch.com)
- These include patient autonomy in determining level of pain relief, more easily titrated sensory level with minimisation of drug dose, optimal analgesia with minimal side-effects, high patient satisfaction and a reduced demand on professional time. (anaesthesiauk.com)
- When the pain of contractions begins to be felt, she presses the button and a small amount of pain relieving medication is delivered via the epidural catheter. (anaesthesiauk.com)
- For total knee arthroplasty at HSS, femoral nerve blockade is commonly added to epidural analgesia, as this reduces pain with physical therapy. (hss.edu)
- HealthDay)-In the first stage of labor, a combined spinal-epidural technique provides faster and better pain relief compared to traditional epidural pain relief, a new study suggests. (medicalxpress.com)
- HealthDay)-Dual continuous epidural analgesia (CEA) is the most effective pain control method following surgery for adolescent idiopathic scoliosis, according to a study published in the Sept. 1 issue of Spine. (medicalxpress.com)
- Higher calculated costs of epidural vs. intravenous pain treatment, 1,037 vs. 410 Euros/patient, were outweighed by lower post-operative costs of intensive care 5,571 vs. 7,921 Euros/patient (NS). (diva-portal.org)
- Epidural analgesia with bupivacain, epinephrine and fentanyl provides excellent pain control after lumbar fusion surgery, but pruritus and motor block are frequent side effects. (diva-portal.org)
- Pruritus could be reduced with a combination of epidural ropivacain and oral oxycodone, at the price of a slightly higher pain level. (diva-portal.org)
- High thoracic epidural analgesia may reduce postoperative pain and improve the pulmonary function. (koreamed.org)
- This allows maximum analgesia using relatively small doses at the site where pain fibers enter the spinal cord. (oncologynurseadvisor.com)
- Epidural analgesia is a pharmacologic approach to pain management that should be considered following an appropriate assessment of a patient's pain. (oncologynurseadvisor.com)
- Anticoagulation, once considered a relative contraindication to the use of epidural analgesia, has been a focus for the American Society of Regional Anesthesia and Pain Medicine (ASRA), which has published consensus statements concerning regional anesthesia and anticoagulation. (oncologynurseadvisor.com)
- Determine whether the gradual weaning of an epidural opioid can shorten the duration of postoperative ileus, without worsening pain control, in patients who have undergone surgery for gynecologic cancer. (knowcancer.com)
- Compare postoperative pain management in patients treated with perioperative epidural analgesia vs patient controlled analgesia. (knowcancer.com)
- Patients choose between epidural analgesia or patient controlled analgesia (PCA) for perioperative pain management. (knowcancer.com)
- The day after surgery (postoperative day 1), patients are randomized (as long as there is adequate pain control) to 1 of 2 epidural management arms. (knowcancer.com)
- Comparison of continuous thoracic epidural analgesia with bilateral erector spinae plane block for perioperative pain management in cardiac surgery. (medworm.com)
- Efficacy and safety of thoracic epidural analgesia after major abdominal surgery for acute post-operative pain. (ebscohost.com)
- Epidural analgesia during labor is an effective method of relieving pain and has been used extensively since the mid-1970s, even in developing countries. (acpjc.org)
- Women in labor who request pain relief should be fully informed about the benefits and possible risks of their choice of analgesia ( 1 ). (acpjc.org)
- Postoperative epidural analgesia was associated with lower pain scores during the first 3 days after surgery. (acpjc.org)
- The epidural group in the study by Riggs and colleagues also had less postoperative pain, an important goal in itself. (acpjc.org)
- Newswise - San Francisco, CA. (February 27, 2013) - During the first stage of labor, a combined spinal-epidural (CSE) technique offers faster and better-quality analgesia (pain relief) compared to traditional epidural analgesia, according to a report in the March issue of Anesthesia & Analgesia , official journal of the International Anesthesia Research Society (IARS). (iars.org)
- The researchers compared CSE with epidural analgesia in 800 healthy women requiring pain control during labor. (iars.org)
- During the first stage of labor, the typical pain score was 1.4 for women receiving CSE versus 1.9 for those receiving standard epidural analgesia. (iars.org)
- Women in the CSE group also had a shorter time to complete pain control-an average of 11 minutes faster than the epidural group. (iars.org)
- Women in the CSE group were less likely to need additional epidural 'top-up' doses to maintain good pain control. (iars.org)
- 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. (iars.org)
- 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. (iars.org)
- The results suggest that CSE provides significantly faster and better pain relief during the first stage of labor, compared to the traditional epidural technique. (iars.org)
- Participants in the second group receive thoracic epidural analgesia for pain relief and then undergo single intercostal VATS. (isrctn.com)
- However, epidural analgesia has been regarded as the gold standard for managing acute pain after thoracic surgery. (isrctn.com)
- This randomized study was designed to test whether paravertebral block has similar pain control when compared with epidural analgesia. (isrctn.com)
- 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)
- patient controlled analgesia (PCA) an apparatus used to relieve acute pain. (thefreedictionary.com)
- Patient-controlled extradural analgesia to compare bupivacaine, fentanyl and bupivacaine with fentanyl in the treatment of postoperative pain. (semanticscholar.org)
- Use of epidural analgesia in patients with critically acute pancreatitis may reduce 30-day mortality rates compared with the absence of a pain management strategy, according to a multicenter retrospective observational study published in Critical Care Medicine . (clinicalpainadvisor.com)
- Patient-controlled analgesia ( PCA  ) is any method of allowing a person in pain to administer their own pain relief . (wikipedia.org)
- For analgesia , 25% of animals in G4 had a pain score considered insufficient. (oatd.org)
- An epidural is a type of pain relief for women in labour or who are having a caesarean section. (gyno-talk.com)
- It usually takes between 5 and 30 minutes for your pain to be relieved by the epidural. (gyno-talk.com)
- Approximately 60% of laboring women (2.4 million each year) choose regional analgesia for pain relief during labor. (medscape.com)
- This study was therefore designed to assess the impact of epidural analgesia on mortality in ICU patients with acute pancreatitis. (ovid.com)
- Among critically ill patients with acute pancreatitis, mortality at 30 days was lower in patients who received epidural analgesia than in comparable patients who did not. (ovid.com)
- These findings support ongoing research on the use of epidural analgesia as a therapeutic intervention in acute pancreatitis. (ovid.com)
- Indications for epidural anesthesia (EA) in the ICU include blunt trauma with or without rib fractures, thoracic, abdominal, orthopedic and vascular surgery, as well as nonsurgical problems such as intractable angina pectoris and acute pancreatitis. (oncologynurseadvisor.com)
- The success of an epidural analgesia catheter placement depends on the parturient position. (centerwatch.com)
- Identified factors for difficult epidural analgesia catheter placement were: non-palpable spinous processes, obesity, spine deformity, inability for the patient to maintain an adequate position and poor experience of the operator. (centerwatch.com)
- Contraindication to epidural catheter placement. (knowcancer.com)
- Regional anesthesia is contraindicated in the presence of actual or anticipated serious maternal hemorrhage , refractory maternal hypotension, coagulopathy, untreated bacteremia , raised intracranial pressure, skin or soft tissue infection at the site of the epidural or spinal placement, and anticoagulant therapy. (medscape.com)
Standard care without epidural analgesia2
- Erel S, Gunaydin B. Neuraxial analgesia for labor: standard techniques versus novel approach (in Turkish with English abstract). (springer.com)
- The included studies evaluated epidural analgesics inserted at the upper thoracic level. (york.ac.uk)
- Drugs for epidural anesthesia include anesthetics such as lidocaine, analgesics such as morphine, or steroids such as methylprednisolone acetate. (thefreedictionary.com)
- Analgesics are administered into the epidural space typically for a few days after surgery, provided a catheter has been inserted. (wikipedia.org)
- If analgesia is inadequate, the bolus dose and lockout interval can be adjusted, and/or extra local anaesthetic can be given. (anaesthesiauk.com)
Fentanyl for postoperative analgesia2
- Objective: To assess the efficacy, equivalence and safety of remifentanil vs. epidural analgesia. (ebscohost.com)
- A twenty-year retrospective analysis of the efficacy of epidural analgesia-anesthesia when administered and/or managed by obstetricians. (afar.info)
- OBJECTIVE: The purpose of this study was to retrospectively determine the safety and efficacy of epidural anesthesia when administered by obstetricians in a community hospital. (afar.info)
Adverse effects of epidural1
- No studies reported on rare but potentially serious adverse effects of epidural analgesia. (nih.gov)
Influence of epidural analgesia1
- however, the influence of epidural analgesia on mortality remains under investigated in this setting. (ovid.com)
Association between epidural analgesia2
- Combination of Bupivacaine-Clonidine was found to be a better option than Bupivacaine-Fentanyl for postoperative epidural analgesia in hip surgery patients. (omicsonline.org)
- The spontaneous vaginal delivery rate was also similar (epidural 193 [96.5%] compared with saline 198 [99%], P =.17). (ovid.com)
- Odds ratios were calculated to determine the associations of epidural anesthesia with oxytocin stimulation, episiotomy, assisted vaginal delivery (forceps or vacuum extraction), and cesarean section. (afar.info)
- Besides providing analgesia in labor, regional analgesia may facilitate atraumatic vaginal delivery of twins, preterm neonates, and neonates with breech presentation. (medscape.com)
Produced by epidural fentanyl1
- 1989) Effect of diluent on analgesia produced by epidural fentanyl. (springer.com)
General anesthesia combined with epidural5
- We investigated 64 consecutive patients undergoing gynecological laparotomy under general anesthesia combined with epidural. (ebscohost.com)
- The effect of general anesthesia combined with epidural analgesia on post-operative recovery was investigated to improve the therapeutic effectiveness of laparoscopic radical resection of rectal carcinoma. (alliedacademies.org)
- Patients accepting general anesthesia comprised the control group, and those accepting general anesthesia combined with epidural analgesia comprised the test group. (alliedacademies.org)
- The application of general anesthesia combined with epidural analgesia to patients who will undergo laparoscopic radical resection of rectal carcinoma leads to improved therapeutic effect and facilitates their recovery. (alliedacademies.org)
- Hence, administering general anesthesia combined with epidural analgesia is worthy of promotion and application. (alliedacademies.org)
- However, the benefits of perioperative epidural anesthesia-analgesia are not definitive in part due to some of the methodological issues present in available studies. (hindawi.com)
- The overall effect of epidural anesthesia-analgesia on perioperative mortality is controversial. (hindawi.com)
- We have used a 5% nationally random sample of Medicare beneficiaries (1997-2001) to examine the association between the presence or absence of postoperative epidural analgesia and perioperative (7- and 30-day) mortality [ 6 - 10 ]. (hindawi.com)
- Subsequent analyses of the Medicare claims data also revealed that the presence of postoperative epidural analgesia may be associated with lower perioperative mortality in patients undergoing higher-risk surgical procedures (e.g., lung lobectomy, colectomy) [ 7 , 8 ]. (hindawi.com)
- The use of combined general and epidural anesthesia has developed concurrently with improvements in preoperative assessment and perioperative management. (acpjc.org)
- We conducted a retrospective review of the perioperative anesthetic management of 215 adult patients who had undergone CRS with HIPEC with epidural analgesia. (springermedizin.de)
- In the setting of a failed epidural top up, the most influential factors determining further anesthetic management were the category of cesarean section (92%), dermatomal level of blockade (78%), and the assessment of maternal airway. (hindawi.com)
- Bupivacaine is suitable for continuous epidural blockade. (healthengine.com.au)
- We propose to compare peri-articular injection to femoral nerve blockade and epidural PCA. (hss.edu)
- INTRODUCTION: Although the techniques of epidural analgesia do not offer the economy of the drug dosage of motor blockade of spinal anaesthesia, they are currently more versatile and better studied. (thefreelibrary.com)
- Other measures (e.g., β-blockade) may have more effect on outcome than epidural blockade. (acpjc.org)
- Accumulating evidence indicated that neuraxial analgesia in the latent phase of the first stage of labor would be an effective and safe health care procedure for nulliparas. (clinicaltrials.gov)
- Neuraxial analgesia techniques are not limited to just standard epidural and CSE blocks. (springer.com)
- DPE offers a favorable risk-benefit ratio for management of neuraxial analgesia as a novel option. (springer.com)
- Some studies have consistently demonstrated a strong association between the use of epidural analgesia and an elevated risk of cesarean delivery. (medpagetoday.com)
- Based on their study, the researchers concluded that neuraxial administration of analgesia in early labor does not increase the rate of cesarean delivery when compared to later administration. (medpagetoday.com)
- Epidural analgesia is associated with an increased risk of cesarean delivery. (greenmedinfo.com)
- If conversion of labor epidural analgesia to cesarean delivery anesthesia fails, the anesthesiologist can be confronted with a challenging clinical dilemma. (hindawi.com)
- 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. (hindawi.com)
- Most respondents (89%) would consider topping up an existing labor epidural for a category-one cesarean section. (hindawi.com)
- Our survey revealed variations in the clinical management of a failed epidural top up for cesarean delivery, suggesting guidelines to aid decision-making are needed. (hindawi.com)
- Between 2017 and 2018, over 100 000 emergency cesarean deliveries were carried out in England, 21% of which were undertaken with epidural anesthesia alone [ 1 ]. (hindawi.com)
- In view of the lack of consensus and guidance for what constitutes the most frequently or optimal considered practice in the setting of a failed labor epidural top up for cesarean delivery, we conducted a survey to assess current practice. (hindawi.com)
- 1990) Epidural sufentanil and morphine for post-cesarean delivery analgesia. (springer.com)
- Epidural analgesia is a routine procedure in cattle, used in various surgical procedures e.g. cesarean section, foreign body removement etc. (vetcontact.com)
- Purpose: Failed conversion of epidural labor analgesia (ELA) to epidural surgical anesthesia (ESA) for intrapartum Cesarean delivery (CD) has been observed in clinical practice. (eur.nl)
Morphine for postoperative analgesia1
- We conducted a retrospective study to determine whether bupivacaine or fentanyl is a better adjuvant to epidural morphine for postoperative analgesia using 108 patients. (springer.com)
- In this study, we aimed at comparing the post-operative costs of intensive care in patients receiving epidural or intravenous analgesia. (diva-portal.org)
Labor epidural analgesia2
- Successful neuraxial anesthesia conversion is a useful measure of quality and safety, indicating the prior presence of functional labor epidural analgesia and limiting the use of general anesthesia in obstetrics [ 3 ]. (hindawi.com)
- Gupta D, Srirajakalisindi A, Soskin V. Dural puncture epidural analgesia is not superior to continuous labor epidural analgesia. (springer.com)
Lumbar Epidural Analgesia1
- Corticosteroid Lumbar Epidural Analgesia for Radiculopathy (C.L.E.A.R. (clinicaltrials.gov)