Analgesia, Epidural
Analgesia, Obstetrical
Analgesia, Patient-Controlled
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).
Analgesics, Opioid
Morphine
Pain Measurement
Anesthetics, Local
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.
Acupuncture Analgesia
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.
Fentanyl
Meperidine
Labor Pain
Sufentanil
Pain
Nerve Block
Injections, Spinal
Labor, Obstetric
Anesthesia, Obstetrical
Amides
Double-Blind Method
Analgesics, Non-Narcotic
Naloxone
Interpleural Analgesia
Drug Tolerance
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
Anesthesia, General
Conscious Sedation
Ketorolac
Labor Stage, First
Hydromorphone
Lidocaine
Pain Management
Clonidine
Anesthesia and Analgesia
Ketamine
Femoral Nerve
Receptors, Opioid
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.
Pregnancy
Pirinitramide
Hypnotics and Sedatives
Butorphanol
Alfentanil
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.
Nalbuphine
Anesthetics, Combined
Anesthesia, Conduction
Opioid Peptides
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.
Electroacupuncture
Mepivacaine
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)
Pruritus
Ketoprofen
Adjuvants, Anesthesia
Placebo Effect
Hyperalgesia
Prospective Studies
Anesthesia, Local
Periaqueductal Gray
Nitrous Oxide
Pentazocine
Postoperative Care
Dexmedetomidine
Ambulatory Surgical Procedures
Dose-Response Relationship, Drug
Brachial Plexus
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.
Injections, Epidural
Acetaminophen
Anesthesia, Intravenous
Anesthetics, Dissociative
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)
Prilocaine
Nociceptors
Peripheral AFFERENT NEURONS which are sensitive to injuries or pain, usually caused by extreme thermal exposures, mechanical forces, or other noxious stimuli. Their cell bodies reside in the DORSAL ROOT GANGLIA. Their peripheral terminals (NERVE ENDINGS) innervate target tissues and transduce noxious stimuli via axons to the CENTRAL NERVOUS SYSTEM.
Delivery, Obstetric
Obstetric Labor Complications
Neostigmine
Nociceptive Pain
Dipyrone
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.
Spinal Cord
Drug Administration Schedule
Subarachnoid Space
Narcotics
Codeine
Nefopam
Patient Satisfaction
Infusions, Intravenous
Buprenorphine
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.
Heroin
Apgar Score
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.
Preanesthetic Medication
Administration, Rectal
Rats, Sprague-Dawley
Opium
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
Infusion Pumps
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.
beta-Endorphin
Enkephalin, Ala(2)-MePhe(4)-Gly(5)-
Treatment Outcome
Injections, Intramuscular
Nociception
Naltrexone
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.
Drug Combinations
Anesthesia
Enkephalins
Infusions, Parenteral
Endorphins
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.
Propofol
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.
Anesthetics, Intravenous
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)
Midazolam
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.
Morphinans
Neuralgia
Doulas
Labor Stage, Second
Tolmetin
Piroxicam
Acupuncture Points
Respiration
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).
Orthopedic Procedures
Acute Pain
Oxymorphone
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)
Hypnosis, Anesthetic
Droperidol
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)
Diclofenac
Heart Rate, Fetal
Drug Interactions
Postoperative Complications
Adrenergic alpha-2 Receptor Agonists
Nausea
Single-Blind Method
Hernia, Inguinal
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
Injections, Subcutaneous
Drug Therapy, Combination
Parity
Catheterization
Sciatic Nerve
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.
Epinephrine
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)-
Ketorolac Tromethamine
Intraoperative Care
Enkephalin, Leucine
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.
Catheterization, Peripheral
Analysis of Variance
Premedication
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)
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Midwifery Ramblings: Why Epidurals ARENT Gods Gift to Women
Analgesia, antipyretic, antiinflammatory and antigout APIs, Analgesia, antipyretic, antiinflammatory and antigout APIs Products...
Chapter 153. Regional Analgesia for Abdominal Surgery | The Anesthesia Guide | AccessAnesthesiology | McGraw-Hill Medical
Internet Scientific Publications
Local and Regional Analgesic Techniques - Management and Nutrition - Merck Veterinary Manual
Recurrent HSVL and the use of epidural morphine in obstetrics.
Medicinal Gas Mixtures
Browsing by Author Moreno-Cid García-Suelto, María
Epidural use at birth not linked to autism risk, study finds | News Center | Stanford Medicine
Study debunks notion that epidurals prolong labor - UPI.com
Pediatric Drug Labeling: Still an Unfinished Need : Anesthesia & Analgesia
Download Mitochondrial Dysfunction In Neurodegenerative Disorders
Effects of different types of anesthesia and analgesia on the cellular immunity of patients after radical resection for lung...
Caudal epidural block in children during catheter cerebral an...
Milestone Scientific Announces Publication of Study Validating Efficacy of CompuFlo(R) CathCheck(<sup>TM</sup>) System to...
PCEA labor analgesia
Epidural blood patch
Analgesia in 1970. Detractors such as Charles Bagley at Johns Hopkins University provided evidence against the treatment since ... An epidural needle is inserted into the epidural space like a traditional epidural procedure. The blood modulates the pressure ... An epidural is injected into the epidural space, inside the bony spinal canal but just outside the dura. In contact with the ... Insertion of an epidural needle involves threading a needle between the bones, through the ligaments and into the epidural ...
Postpartum psychosis
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 ...
Childbirth
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. ...
Andrew Doughty
Doughty, Andrew (1980). Epidural Analgesia in Obstetrics: A Second Symposium, University of Warwick, Coventry. London: Lloyd- ... Doughty, Andrew (1969). "Selective epidural analgesia and the forceps rate". British Journal of Anaesthesia. 41 (12): 1058-1062 ... He was an early promoter of the use of epidural anaesthesia during childbirth. In 1973, he set up an epidural course at ...
Electroanalgesia
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 ...
Combined spinal and epidural anaesthesia
In labouring women, the onset of analgesia is more rapid with CSE compared with epidural analgesia. CSE in labour was formerly ... Combined spinal-epidural versus epidural analgesia in labour. [Update of Cochrane Database of Systematic Reviews 2003; 4. ... The indwelling epidural catheter gives the ability to provide long lasting analgesia and to titrate the dose given to the ... Alternatively, smaller doses can provide analgesia, e.g. in the postoperative period. A standard epidural pack may be used with ...
Dogliotti's principle
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 ...
Remifentanil
As such, it has been used for analgesia in labor successfully; however, it is not as effective as epidural analgesia. In ... and respiratory effects of patient-controlled intravenous remifentanil analgesia and patient-controlled epidural analgesia in ... Comparing its analgesia-sedation effect in ventilated patients, remifentanil may be superior to morphine but not to fentanyl. ... Anesthesia & Analgesia, 110(2), 524-525. Feldman, P. L. (2006). Discovery and Development of the Ultrashort-acting Analgesic ...
Neosaxitoxin
... 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 ...
Obstetric anesthesiology
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 ...
Pubic symphysis
January 2004). "Epidural analgesia for acute symphysis pubis dysfunction in the second trimester". International Journal of ...
Tezampanel
... 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, ...
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 ...
Epidural administration
Use of epidural analgesia versus oral analgesia or no analgesia has no effect on the normal length of hospital stay after ... The use of epidural analgesia and anesthetic is considered safe and effective in most situations. Epidural analgesia is ... Epidural clonidine is rarely used but has been extensively studied for management of analgesia during labor. Epidural analgesia ... In a 2018 Cochrane review of studies which compared epidural analgesia with oral opiates, some advantages of epidural analgesia ...
Ban Tsui
"Usefulness of the Tsui Test in Combined Spinal-Epidural Analgesia in Labour". ClinicalTrials.gov. ClinicalTrials.gov. Retrieved ... "Catheter Set for Epidural or Peripheral Nerve Blockade". Justia Patents. Retrieved 6 October 2014. "StimuLong Sono-Tsui Set" ( ... The Tsui Test is a simple protocol using a low current electrical stimulation test to confirm catheter location in the epidural ... Examples include describing the Tsui Test and developing the StimuLong Sono-Tsui for ease of pediatric epidural placement. ...
Tuohy needle
... 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 ...
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 ...
Ornipressin
An Efficient Alternative to Counteract Hypotension During Combined General/Epidural Anesthesia". Anesthesia & Analgesia. 90 (6 ...
Water birth
A 2018 Cochrane Review found that immersion at this stage reduces the use of epidural analgesia; however, there is no clear ... and the use of epidural or spinal analgesia. It is also associated with a lower rate of cesarean delivery and stress urinary ... Although there is moderate to weak evidence that water births lessen pain without the need for an epidural, there are no ... A 2018 Cochrane Review of water immersion in the first stages of labor found evidence of fewer epidurals and few adverse ...
Anesthesia
... occurrence of prolonged postoperative mechanical ventilation and myocardial infarction is also reduced by epidural analgesia. ... "Patient controlled opioid analgesia versus non-patient controlled opioid analgesia for postoperative pain". The Cochrane ... Alternatively, epidural and spinal anesthesia can be performed in the region of the central nervous system itself, suppressing ... Klomp T, van Poppel M, Jones L, Lazet J, Di Nisio M, Lagro-Janssen AL (September 2012). "Inhaled analgesia for pain management ...
Levobupivacaine
... 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 ( ...
Andrea Hayes-Jordan
"Safety of epidural analgesia in the perioperative care of patients undergoing cytoreductive surgery with hyperthermic ...
Fentanyl
... is sometimes given intrathecally as part of spinal anesthesia or epidurally for epidural anaesthesia and analgesia. ... It is FDA approved to provide four days of analgesia after a single application before surgery. It is not approved for multiple ... Supraspinal analgesia (μ1) Respiratory depression (μ2) Physical dependence Muscle rigidity It produces sedation and spinal ... Sublingual fentanyl dissolves quickly and is absorbed through the sublingual mucosa to provide rapid analgesia. Fentanyl is a ...
Lofentanil
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 ...
Thoracotomy
Thoracic epidural analgesia or paravertebral blockade have shown to be the most effective methods for post-thoracotomy pain ... Comparing thoracic epidural analgesia and paravertebral blockade, paravertebral blockade reduced the risks of developing minor ... Treatment to aid pain relief for this condition includes intra-thoracic nerve blocks/opiates and epidurals, although results ... Ökmen K (April 2019). "Efficacy of rhomboid intercostal block for analgesia after thoracotomy". Korean J Pain. 32 (2): 129-132 ...
Nerve block
Local anesthetic is often combined with other drugs to potentiate or prolong the analgesia produced by the nerve block. These ... The concept of nerve block sometimes includes central nerve block, which includes epidural and spinal anaesthesia. ...
Childbirth in Nepal
Medical management of pain is rarely found in home births, but analgesia (i.e. epidural) is prevalent in the hospitals. Touch, ...
Nuss procedure
... and because the epidural can interfere with normal urination. The patient may also receive thoracic epidural analgesia in the ... thus requiring multi-modal pain management including epidural anesthetics. Nurses who attend these patients post operation ...
Hydromorphone
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 ...
Pain
Episodic analgesia may occur under special circumstances, such as in the excitement of sport or war: a soldier on the ... report less labor pain and are less likely to use epidural anesthesia during childbirth, or suffer from chest pain after ... Selbst SM, Fein JA (2006). "Sedation and analgesia". In Henretig FM, Fleisher GR, Ludwig S (eds.). Textbook of pediatric ... Stevens B, Yamada J, Ohlsson A, Haliburton S, Shorkey A (July 2016). "Sucrose for analgesia in newborn infants undergoing ...
Childbirth in Mexico
Women often laboring in these hospitals will have epidurals or other forms of analgesia, if deemed necessary. Family members ... with rates of pharmaceutical analgesia being higher in institutional births. This is further outlined in the section regarding ...
Pain in babies
June 2010). "(June 2010). "Efficacy of sweet solutions for analgesia in infants between 1 and 12 months of age: a systematic ... or into the epidural space surrounding the spinal cord. It is used for pain relief after surgery, but requires special ... There are three forms of analgesia suitable for the treatment of pain in babies: paracetamol (acetaminophen), the nonsteroidal ... From needle sticks to tonsillectomies to heart operations were done with no anaesthesia or analgesia, other than muscle ...
Local anesthetic nerve block
Since it is a unilateral block, it may be chosen over epidurals for patients who can't tolerate the hypotension that follows ... Studies in humans indicate improved onset time and increased duration of analgesia. The duration of the nerve block depends on ... The paravertebral block provides unilateral analgesia, but bilateral blocks can be performed for abdominal surgeries. ... with the end goal of increasing the duration of the analgesia or shortening time of onset. Adjuvants may include epinephrine, ...
Index of anatomy articles
... cortex ependyma epicanthus epicardium epicondyle epicranial aponeurosis epidermis epididymis epidural hematoma epidural space ... amaurosis Ammon's horn ampulla Ampulla of Vater amygdala amygdalofugal pathway amygdaloid amylacea anaesthesia analgesia ...
Unassisted childbirth
Analgesia. 93 (1): 134-141. doi:10.1097/00000539-200107000-00028. PMID 11429354. S2CID 30026609. Retrieved 14 Apr 2009. Hawkins ... where Fraser herself requested transfer to a hospital for epidural anaesthesia, and then subsequently requested a caesarean ...
Intracranial pressure
Analgesia and sedation are used to reduce agitation and metabolic needs of the brain, but these medications may cause low blood ... For example, an increase in lesion volume (e.g., epidural hematoma) will be compensated by the downward displacement of CSF and ... subdural or epidural hematoma, or abscesses all tend to deform the adjacent brain.[citation needed] Generalized brain swelling ...
Spinal anaesthesia
The onset of analgesia is approximately 25-30 minutes in an epidural, while it is approximately 5 minutes in a spinal. An ... Epidural anaesthesia is a technique whereby a local anaesthetic drug is injected through a catheter placed into the epidural ... The injected dose for an epidural is larger, being about 10-20 mL compared to 1.5-3.5 mL in a spinal. In an epidural, an ... Combined spinal and epidural anaesthesia Epidural Intrathecal administration Lumbar puncture Bronwen Jean Bryant; Kathleen Mary ...
Post-anesthesia care unit
More intensive care monitoring may include: Preparation and education for the use of patient-controlled analgesia (PCA) units ... for postoperative pain control Preparation and administration of intravenous, epidural, or perineural infusions Invasive ...
PCEA
... is an initialism for: Patient-controlled epidural analgesia the Presbyterian Church of Eastern Australia the Presbyterian ...
Post-dural-puncture headache
A small amount of the person's blood is injected into the epidural space near the site of the original puncture; the resulting ... Collis, R. E.; Harries, S. E. (July 2005). "A subdural abscess and infected blood patch complicating regional analgesia for ... PDPH is thought to result from a loss of cerebrospinal fluid into the epidural space. A decreased hydrostatic pressure in the ... Safa-Tisseront V, Thormann F, Malassiné P, Henry M, Riou B, Coriat P, Seebacher J (August 2001). "Effectiveness of epidural ...
Outcomes Research Consortium
For example, unlikely as it might seem, there is strong basic science and animal evidence suggesting the regional analgesia ( ... Matsukawa T, Sessler DI, Christensen R, Ozaki M, Schroeder M (1995). "Heat flow and distribution during epidural anesthesia". ... Sessler DI (2008). "Does regional analgesia reduce the risk of cancer recurrence? A hypothesis". Eur J Cancer Prev. 17 (3): 269 ... About a hundred Consortium studies evaluate aspects of acute pain including peripheral nerve blocks and multimodal analgesia; ...
Shoulder replacement
... it is still a useful alternative when continuous interscalenic analgesia cannot be performed. Interscalenic analgesia is most ... Major complications such as seizures, cardiac arrests, Horner's syndrome, hoarseness, and inadvertent spinal/epidural ... Single shot Continuous infusion Patient controlled Single shot interscalenic analgesia is preferably used during minor ...
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 ...
Phulchand Prithvi Raj
... and pharmacokinetics of continuous infusions Experience with volumetric infusion pumps for continuous epidural analgesia ... Raj, Phulchand (1979). "Experience with volumetric infusion pumps for continuous epdural analgesia". Reg Anesth. 4: 3-5. (Pages ...
Epidural Analgesia Has No Effect on Maternal Temperature
... but not epidural analgesia, is associated with elevated maternal temperature. ... All but 3 of the women received epidural analgesia. The median duration of epidural analgesia was 7.9 hours (interquartile ... Cite this: Epidural Analgesia Has No Effect on Maternal Temperature - Medscape - Jul 27, 2012. ... Fever in laboring women was not associated with epidural analgesia. The authors did note, however, the absence of a temperature ...
Epidural Analgesia | Children's Hospital of Philadelphia
Epidural analgesia is a type of pain relief. It is a way of putting pain medication close to the body part that hurts and is ... Epidural analgesia is a type of pain relief. Epidural analgesia is an important part of the overall plan for your childs pain ... Epidural analgesia is a way of putting pain medication close to the body part that hurts. It is useful for moderate to severe ... The epidural tubing is attached to a pump that constantly delivers pain medicine. Your child will not feel the epidural ...
Long-term Complications of Unintentional Dural Puncture During Labor Epidural Analgesia: A Case-Control Study | medRxiv
Introduction Epidural analgesia is the preferred method to manage pain during labor and delivery. The insertion of the epidural ... epidural analgesia and sustained an unintentional dural puncture and controls were women who received epidural analgesia but ... Long-term Complications of Unintentional Dural Puncture During Labor Epidural Analgesia: A Case-Control Study. Alexandre ... Long-term Complications of Unintentional Dural Puncture During Labor Epidural Analgesia: A Case-Control Study ...
Alkalinization of Adrenalized Lidocaine in Extending Epidural Analgesia for Extremely Urgent Cesarean Section During Labor: a...
Alkalinization of Adrenalized Lidocaine in Extending Epidural Analgesia for Extremely Urgent Cesarean Section During Labor: a ... epidural analgesia allows emergency Caesarean sections to be performed by converting epidural analgesia to epidural anesthesia ... Not sure for Initial indication for general anaesthesia defined by the following situations: non-functional epidural analgesia ... Yes for Initial indication for general anaesthesia defined by the following situations: non-functional epidural analgesia, ...
FOR EPIDURAL ANALGESIA IN LABOR, IS 0.25% BUPIVACAINE BETTER THAN 0.5%? | Anesthesiology | American Society of Anesthesiologists
FOR EPIDURAL ANALGESIA IN LABOR, IS 0.25% BUPIVACAINE BETTER THAN 0.5%? E. Abouleish, M.D.; E. Abouleish, M.D. ... E. Abouleish, P. Pan, Y. G. Kang, R. de la Vega, J. Harger; FOR EPIDURAL ANALGESIA IN LABOR, IS 0.25% BUPIVACAINE BETTER THAN ... Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018: A Report by the American Society of Anesthesiologists ... The Dose-Response of Intrathecal Sufentanil Added to Bupivacaine for Labor Analgesia Anesthesiology (June 2000) ...
Thoracic Epidural Analgesia
... Epidurally administered local anesthetics may decrease both the ... Anesth Analg 93: 253, 2001; FREE Full-text at Anesthesia & Analgesia].. Obviously, thoracic epidural analgesia plays an ... Anesth Analg 93: 253, 2001; FREE Full-text at Anesthesia & Analgesia]. Possible mechanisms include changes in the myocardial ... s study of 50 patients randomized to morphine versus bupivacaine epidurals, the incidence of arrhythmias fell from 28% to 4.35 ...
Epidural gravity flow technique for labor analgesia | Regional Anesthesia & Pain Medicine
Epidural analgesia in labor: an evaluation of risks and benefits. Review. Birth. 1996 Jun;23(2):63-83.
CONCLUSIONS: Epidural analgesia is a safe and effective method of relieving pain in labor, but is associated with longer labor ... This article reviews the literature about the effects of epidural analgesia on the mother and infant. METHODS: We performed a ... Epidural analgesia may also increase intervention for fetal distress. Several studies show its association with maternal fever ... BACKGROUND: Intrapartum epidural analgesia has become increasingly popular because it is the most effective method of providing ...
IMSEAR at SEARO: Thoracic epidural analgesia in cardiac surgery.
Comparison of the duration and quality of epidural analgesia between plain bupivacaine alone and plain bupivacaine with...
Analgesia; Analgesia, Epidural; Bupivacaine; Comparative Study; Injections, Epidural; Nigeria; Orthopedics; Quality Control; ... The duration of analgesia was from the time of epidural block to the time of rescue analgesia. While, the quality of block was ... Analgesia, Epidural / Analgesia / Nigeria Type of study: Controlled clinical trial Country/Region as subject: Africa Language: ... Analgesia, Epidural / Analgesia / Nigeria Type of study: Controlled clinical trial Country/Region as subject: Africa Language: ...
February 1979 - Volume 23 - Issue 1 : Survey of Anesthesiology
The Use of Ephedrine in Epidural Analgesia. ENGBERG, G. ENGBERG, G. Less ... Epidural Anesthesia and the Lateral Position. GRUNDY, E. M.; RAO, L. M.; WINNIE, A. P. ... What is the treatment of choice for nausea occurring during spinal or epidural anesthesia, especially for Cesarean section?. ... Effect of the Anesthetic Method, Epidural and General Anesthesia, on Intervillous Blood Flow in Caesarean Sections. JOUPPILA, R ...
Intrapartum epidural analgesia and breastfeeding: a prospective cohort study - Szoptatás Portál
... to epidural analgesia for women during childbirth results in difficulty establishing breastfeeding. The aim of this paper is to ... Intrapartum epidural analgesia and breastfeeding: a prospective cohort study. 2006-12-25. /in Szoptatásportál.hu. Siranda ... The aim of this paper is to determine any association between epidural analgesia and 1) breastfeeding in the first week ... Anecdotal reports suggest that the addition of fentanyl (an opioid) to epidural analgesia for women during childbirth results ...
Best Doctors for Epidural Analgesia in Rawalpindi - Book Online Appointment | Instacare
from the List of Top Epidural Analgesia in Rawalpindi. ... and Consultation with Best Doctors for Epidural Analgesia in ... Epidural Analgesia Radiology Pathology Labs In Pakistan. Labs in Lahore Labs in Karachi Labs in Islamabad Labs in Rawalpindi ... Best Doctors For Epidural Analgesia in Rawalpindi. Last Updated On Wednesday, November 30, 2022. ... Click here to book an appointment with a Best Doctor of Epidural Analgesia in Rawalpindi. Or, you can also call at 03171777509 ...
Andrew W. Dick - Profile | RAND
Regional Anesthesia for Postoperative Pain Control in Orthopedic Surgery: Overview, Neuraxial Analgesia, Peripheral Nerve Blocks
... studies have demonstrated that both spinal and epidural anesthesia tend to hav... ... Epidural analgesia. Epidural analgesia refers to the delivery of anesthetics to the epidural space for purposes of pain control ... Adverse effects are the similar to those of IT opioids (see Intrathecal analgesia, above). Epidural local anesthetics, ... Neuraxial Analgesia. Intrathecal analgesia. Intrathecal (IT), often referred to as "spinal," anesthesia refers to the delivery ...
Pain Relief Clinic
Comparison of bupivacaine plus fentanyl and bupivacaine plus clonidine using patient-controlled epidural analgesia | AVESİS
Study confirms... Women who labour in water have lower rate of epidural analgesia - Active Birth Pools
Primary: epidural analgesia and operative delivery rates.. Secondary: augmentation rates with amniotomy and oxytocin, length of ... To evaluate the impact of labouring in water during first stage of labour on rates of epidural analgesia and operative delivery ... Women randomised to immersion in water had a lower rate of epidural analgesia than women allocated to augmentation (47% v 66%, ... Study confirms… Women who labour in water have lower rate of epidural analgesia. ...
Pain management with epidural catheter and epidural analgesia after spinal dorsal instrumentation of lumbar spine. | Medicine ...
Analgesia Epidural; Anestesia Epidural; Humanos; Analgesia Epidural/efeitos adversos; Manejo da Dor; Analgésicos Opioides; ... The aim of the current study was to compare the use of epidural analgesia (EA) with systemic analgesia (SA) as regards pain ... Analgesia Epidural / Anestesia Epidural Limite: Humanos Idioma: Inglês Revista: Medicine (Baltimore) Ano de publicação: 2023 ... Analgesia Epidural / Anestesia Epidural Limite: Humanos Idioma: Inglês Revista: Medicine (Baltimore) Ano de publicação: 2023 ...
Does epidural analgesia delay the vaginal delivery of nulliparous women compared with non-epidural analgesia?: Retrospective...
Does epidural analgesia delay the vaginal delivery of nulliparous women compared with non-epidural analgesia?: Retrospective ... 92 women received non-epidural analgesia (Group NE) and 57 women received epidural analgesia (Group E). There were no ... Epidural analgesia was initiated with a 10ml epidural bolus of 1% lidocaine and was maintained with a 0.1% mixture of ... study to compare the difference in duration of labor in nulliparous women received epidural analgesia or non-epidural analgesia ...
Chorioamnionitis Treatment & Management: Approach Considerations, Medical Care, Consultations
Anim-Somuah M, Smyth RM, Jones L. Epidural versus non-epidural or no analgesia in labour. Cochrane Database Syst Rev. 2011 Dec ... Epidural analgesia for labor pain and its relationship to fever. Clin Perinatol. 2005 Sep. 32(3):777-87. [QxMD MEDLINE Link]. ... Segal S. Labor epidural analgesia and maternal fever. Anesth Analg. 2010 Dec. 111(6):1467-75. [QxMD MEDLINE Link]. ... The effects of epidural analgesia on labor, maternal, and neonatal outcomes: a systematic review. Am J Obstet Gynecol. 2002. ...
Guidelines for Prevention of Nosocomial Pneumonia
Bali Journal of Anesthesiology - Dexmedetomidine versus clonidine as adjuvants in epidural analgesia in gynecological...
Epidural analgesia during labour: Friend or foe? A reflection on medicine, midwives and Miranda Kerr
Why women prefer epidural analgesia during childbirth: the role of beliefs about epidural analgesia and pain catastrophizing. ... 2] Anim-Somuah M, Smyth R, Jones L. Epidural versus non-epidural or no analgesia in labour (review). The Cochrane Database of ... Epidural analgesia during labour: Friend or foe? A reflection on medicine, midwives and Miranda Kerr. Casey de Rooy Wednesday, ... Meta-analysis of the success if block following combined spinal-epidural vs epidural analgesia during labour. Anaesthesia. 2014 ...
Single-dose intrathecal analgesia to control labour pain | The College of Family Physicians of Canada
... obstetrical analgesia, opioid analgesia, epidural analgesia, pain measurement, pregnancy, fentanyl, morphine. The references of ... Single-dose intrathecal analgesia to control labour pain. Is it a useful alternative to epidural analgesia?. R.G. Minty, Len ... Epidural versus non-epidural analgesia for pain relief in labour. Cochrane Database Syst Rev 2005;3:CD000331. ... Unintended effects of epidural analgesia during labor: a systematic review. Am J Obstet Gynecol 2002;186(5 Suppl Nature):S31-68 ...
Long-term patient perception of pain control experience after participating in a trial between patient-controlled analgesia and...
Can ultrasound-guided erector spinae plane block replace thoracic epidural analgesia for postoperative analgesia in pediatric...
As a part of multimodal analgesia, many regional blocks have been described.[3],[4] Epidural analgesia is considered the gold ... Major complications related to epidural analgesia in children: A 15-year audit of 3,152 epidurals. Can J Anesth 2013;60:355-63 ... We randomly assigned patients into two groups: The thoracic epidural analgesia (TEA) group received GA with an epidural ... Can ultrasound-guided erector spinae plane block replace thoracic epidural analgesia for postoperative analgesia in pediatric ...
Immune response in case of using early parenteral nutrition and epidural anesthesia/analgesia in the perioperative intensive...
immune response, epidural anesthesia, analgesia, cancer Abstract. The tendency to an increase in the incidence of cancer, which ... The results of the study showed that in patients with bladder cancer the use of epidural anesthesia and analgesia and early ... Immune response in case of using early parenteral nutrition and epidural anesthesia/analgesia in the perioperative intensive ... Patients of the first group also were administered epidural analgesia and parenteral nutrition in the early postoperative ...
Fulltext | Postoperative epidural analgesia in thoracic surgery: continuous administration by electric push-syringe diffusion...
... the locoregional techniques are the only ones that achieve effective effort analgesia. Classically, the epidural analgesia is ... Rigg JR, Jamrozik K, Myles PS, Silbert BS, Peyton PJ, Parsons RW and Collins KS. Epidural anaesthesia and analgesia and outcome ... The thoracic epidural analgesia (TEA) is currently considered as the "gold standard" analgesic. This technique requires ... Up to now, no study has evaluated the DE in postoperative epidural analgesia in thoracic surgery compared to the syringe pump. ...
Incidence of epidural haematoma and neurological injury in cardiovascular patients with epidural analgesia/anaesthesia:...
There were no cases of epidural haematoma, giving maximum risks following epidural anaesthesia in cardiac, thoracic, and ... We performed an extensive systematic review to find published cohorts of use of epidural catheters during vascular, cardiac, ... The principle concern is bleeding in the epidural space, leading to transient or persistent neurological problems. ... These estimates for cardiothoracic epidural anaesthesia should be the worst case. Limitations are inadequate denominators for ...
BupivacaineAnesthesia and analgesiaIntravenousLabourWomen received epidural analgesiaRate of epidural analgesiaFentanylAnaesthesiaLaborThoracic epidural catheterRegional AnesthesiaPreemptiveReduction in epiduralPatientNulliparousGiven using an epPerioperativeMorphine analgesiaInjectionsMaternalOpioid analgesiaAnestesia EpiduralObstetricCatheter insertionPainDurationVersusVaginalMethod of analgesiaOpioidsEffective analgesiaSedationGeneral anesthesiaPatientsFetalMultimodal analgesiaMethodsPlacementDural punctureLidocaineAnalgesicAnesthesiologyParavertebralNerveSufentanilClinicalCardiacPreoperative
Bupivacaine7
- s study of 50 patients randomized to morphine versus bupivacaine epidurals, the incidence of arrhythmias fell from 28% to 4.35% [Oka T et al. (openanesthesia.org)
- Group A (n=37) received 19mls of 0.5% epidural plain bupivacaine with 1 ml of water for injection , while group B received 19mls of 0.5% epidural plain bupivacaine with 1ml (50mg) of preservative freetramadol. (bvsalud.org)
- EA is widely used for pain relief in labour and involves injection of a local anaesthetic (such as bupivacaine) into the epidural space. (amsj.org)
- A combination of 2.5 mg of bupivacaine, 25 μg of fentanyl, and 250 μg of morphine intrathecally usually provides a 4-hour window of acceptable analgesia for patients without complications not anticipating protracted labour. (cfp.ca)
- Aims The aim of the study was to compare the time of onset of sensory block and duration of sensory and motor blockade of epidural anaesthesia produced by bupivacaine 0.5% and ropivacaine 0.75% for lower limb surgery. (ispub.com)
- Conclusion Epidural ropivacaine 0.75% can be safely used as a possible alternative to bupivacaine 0.5% in lower limb orthopedic procedures. (ispub.com)
- 1998. Determination of the analgesic dose-response relationship for epidural fentanyl and sufentanil with bupivacaine 0.125% in laboring patients. . (cornell.edu)
Anesthesia and analgesia2
- The results of the study showed that in patients with bladder cancer the use of epidural anesthesia and analgesia and early parenteral nutrition helps maintain the number of main effectors of the cell-mediated immune response, namely, NK-lymphocytes and CTL. (org.ua)
- A study published in Anesthesia and Analgesia compared patients with a paravertebral blockade with rib fractures who received only sedation and opioids to similar patients who also received regional anesthesia. (sonosite.com)
Intravenous5
- If you did not have an epidural, you may receive pain medicines directly into your veins through an intravenous line (IV) after surgery. (medlineplus.gov)
- Analgesia is provided through continuation of the intraoperative epidural, patient-controlled intravenous analgesia, or oral analgesia. (medscape.com)
- Low-dose intravenous (IV) ketamine infusion has been considered to be an effective postoperative analgesia and resurged again as a substitute of opioid analgesics. (riajournal.com)
- Ismail S, Afshan G, Monem A, Ahmed A. Postoperative analgesia following caesarean section: intravenous patient controlled analgesia versus conventional continuous infusion. (riajournal.com)
- Ijichi K, Nijima K, Iwagaki T, Irie J, Uratsuji Y. A randomized double-blind comparison of epidural versus intravenous tramadol infusion for postoperative analgesia. (riajournal.com)
Labour8
- Prospective randomized study comparing the use of lidocaine 2% with epinephrine buffered with sodium bicarbonate and lidocaine 2% with epinephrine as epidural top-up for extremely urgent cesarean section during labour. (centerwatch.com)
- To evaluate the impact of labouring in water during first stage of labour on rates of epidural analgesia and operative delivery in nulliparous women with dystocia. (activebirthpools.com)
- Epidural analgesia during labour: Friend or foe? (amsj.org)
- Evidence suggests that women who are more fearful of labour pain have a higher likelihood of choosing elective caesarean, and if they do choose labour, a higher chance of having an epidural. (amsj.org)
- OBJECTIVE To examine the safety and efficacy of single-dose spinal analgesia (intrathecal narcotics [ITN]) during labour. (cfp.ca)
- Providing high-quality analgesia for Canadian women in labour in small community hospitals is a challenge. (cfp.ca)
- By 1915, the Ottawa Maternity Hospital was using chloroform in 75% of deliveries, 4 but by the end of the century, epidurals were chosen for 45% of women in labour. (cfp.ca)
- Epidural analgesia is commonly used to help reduce labour pain. (kkh.com.sg)
Women received epidural analgesia3
- All but 3 of the women received epidural analgesia. (medscape.com)
- We conduct this study to compare the difference in duration of labor in nulliparous women received epidural analgesia or non-epidural analgesia for labor pain. (e-jmls.org)
- 92 women received non-epidural analgesia (Group NE) and 57 women received epidural analgesia (Group E). There were no significant differences between the two groups in maternal demographic characteristics. (e-jmls.org)
Rate of epidural analgesia2
- The rate of epidural analgesia during labor is about 85% in France. (centerwatch.com)
- Women randomised to immersion in water had a lower rate of epidural analgesia than women allocated to augmentation (47% v 66%, relative risk 0.71 (95% confidence interval 0.49 to 1.01), number needed to treat for benefit (NNT) 5). (activebirthpools.com)
Fentanyl3
- Anecdotal reports suggest that the addition of fentanyl (an opioid) to epidural analgesia for women during childbirth results in difficulty establishing breastfeeding. (szoptatasportal.hu)
- Epidural analgesia was initiated with a 10ml epidural bolus of 1% lidocaine and was maintained with a 0.1% mixture of ropivacaine with fentanyl. (e-jmls.org)
- 1999. Analgesia, pruritus, and ventilation exhibit a dose-response relationship in parturients receiving intrathecal fentanyl during labor. . (cornell.edu)
Anaesthesia6
- This is in contrast to spinal anaesthesia (injection of local anaesthetic into the subarachnoid space), which, while faster and safer, does not allow insertion of a catheter for continuing analgesia. (amsj.org)
- Regional anaesthesia and analgesia has the potential to provide excellent operating conditions and prolonged post operative pain relief. (ispub.com)
- It is more versatile than spinal anesthesia, giving the clinician the opportunity to provide anaesthesia and analgesia, as well as enabling chronic pain management. (ispub.com)
- A total of 60 patients between the age group 18-60 years of ASA I and II physical status, scheduled to undergo various surgical procedures on the lower limb under epidural anaesthesia were randomly allocated into two groups and a prospective double blind study was conducted. (ispub.com)
- Patients who had any contra-indications to epidural anaesthesia, any neurologic, cardiopulmonary, psychiatric disease, active liver or kidney disease, those receiving anti arrythmics/beta blockers/anticoagulants and pregnant women were excluded from the study. (ispub.com)
- Is Outcome Post-surgery Improved by Epidural Anaesthesia/Analgesia? (edu.au)
Labor40
- July 27, 2012 - Contrary to previous studies, there's no significant relationship between epidural anesthesia and an increase in maternal body temperature during labor, according to a new study published in the August issue of Anesthesiology . (medscape.com)
- Reports over recent years suggest that possible causes of noninfectious maternal temperature elevations during labor include epidural analgesia, endogenous heat production by uterine contractions, and overheated delivery rooms. (medscape.com)
- Previous studies have reported maternal temperature elevations in women who received epidural analgesia in association with placental inflammation, neonatal sepsis work-up, pregnancy-induced hypertension, labor progress, and mode of delivery. (medscape.com)
- Introduction Epidural analgesia is the preferred method to manage pain during labor and delivery. (medrxiv.org)
- Alkalinization of Adrenalized Lidocaine in Extending Epidural Analgesia for Extremely Urgent Cesarean Section During Labor: a Randomized Controlled Trial. (centerwatch.com)
- Epidural analgesia in labor: an evaluation of risks and benefits. (afar.info)
- BACKGROUND: Intrapartum epidural analgesia has become increasingly popular because it is the most effective method of providing pain relief during labor. (afar.info)
- Retrospective studies and randomized controlled trials both demonstrate that epidural analgesia is associated with increases in duration of labor, instrument vaginal delivery, and cesarean birth. (afar.info)
- Limiting epidural use in nulliparous labor and delaying its placement until after 5 cm of cervical dilation may reduce the risk of operative intervention for dystocia. (afar.info)
- CONCLUSIONS: Epidural analgesia is a safe and effective method of relieving pain in labor, but is associated with longer labor, more operative intervention, and increases in cost. (afar.info)
- Epidural analgesia delayed the first stage of labor in this study. (e-jmls.org)
- When compared with nonpharmacologic approaches based on Central Nervous System Control (education, attention deviation, support), usual care is associated with increased odds of epidural OR 1.13 (95% CI 1.05-1.23), cesarean delivery OR 1.60 (95% CI 1.18-2.18), instrumental delivery OR 1.21 (95% CI 1.03-1.44), use of oxytocin OR 1.20 (95% CI 1.01-1.43), labor duration (29.7 min, 95% CI 4.5-54.8), and a lesser satisfaction with childbirth. (nih.gov)
- Epidural analgesia for labor pain: whose choice? (arctichealth.org)
- To test the hypothesis that the decision to use epidural analgesia during labor is influenced not only by the woman and her background but also by the local cultural practice in the delivery unit. (arctichealth.org)
- Epidural analgesia during labor. (arctichealth.org)
- Maintaining an epidural for pregnant women through the second stage of labor had no impact on the length of the second stage compared with placebo, a randomized trial found. (medpagetoday.com)
- Not only duration of labor, but rates of spontaneous vaginal delivery were comparable among pregnant women given an epidural versus women given saline during the second stage of labor, reported XiaoFeng Shen, MD, of Nanjing Medical University in China, and colleagues. (medpagetoday.com)
- Also, many obstetricians "request termination of the epidural infusion for the second stage of labor," they stated. (medpagetoday.com)
- All received epidural analgesia for the first stage of labor. (medpagetoday.com)
- Patient satisfaction scores with labor analgesia were measured on the 11-point Likert scale. (medpagetoday.com)
- An intention-to-treat analysis found duration of second stage labor was around 51 to 52 minutes for the placebo and the epidural groups, respectively ( P =0.52). (medpagetoday.com)
- Shen's group argued that the potential effect on epidural analgesia during the second stage of labor "remains controversial," based on prior observational studies that did find the second stage of labor was longer, with higher rates of assisted vaginal delivery when women were given epidural analgesia. (medpagetoday.com)
- It was conducted at a single center, so labor and labor analgesia management may differ from other institutions. (medpagetoday.com)
- This study investigated the efficacy of compression stockings in preventing maternal hypotension and discomfort in women that received an epidural anesthesia during term labor. (sigvaris.com)
- Epidural analgesia (EA) is widely used as most effective analgesia for labor. (sigvaris.com)
- 10% to 20% of the 600 000 women given epidural analgesia during labor experience hypotension, which in 15% of cases is associated with fetal heart rate abnormalities. (sigvaris.com)
- We assessed the preventive effect of medical lower limbs venous compression on the incidence of maternal hypotension after epidural analgesia during spontaneous term labor. (sigvaris.com)
- This before/after, single-center study in a university hospital included 93 women in spontaneous labor at term who between 1 January and 31 March 2015 with epidural analgesia plus lower limbs compression and 202 women in spontaneous labor at term who delivered between 1 and 31 December 2014 with epidural analgesia without lower limbs compression (control group). (sigvaris.com)
- The results suggest that medical lower limbs compression (20 - 36 mmHg) in women in spontaneous labor at term, could significantly reduce the incidence of maternal hypotension following epidural analgesia. (sigvaris.com)
- Although the incidence of hypotension after EA for labor is significantly lower than after a spinal or an epidural anesthesia for cesarean section, there is still one women out of 4 with EA for labor who present a significant hypotension after EA, and the incidence of hypotension was significantly higher than without EA, even with low dose epidural analgesia, as could be shown in this study. (sigvaris.com)
- 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)
- Approximately 60% of laboring women (2.4 million each year) choose regional analgesia for pain relief during labor. (medscape.com)
- Besides providing analgesia in labor, regional analgesia may facilitate atraumatic vaginal delivery of twins, preterm neonates, and neonates with breech presentation. (medscape.com)
- Only opioids could be used for labor analgesia in these situations, as they do not decrease systemic vascular resistance. (medscape.com)
- Epidural pain relief is administered by the insertion of anesthetic drugs directly into the spinal column to provide pain relief to the parts of the body involved in labor while leaving the woman conscious throughout labor. (expectny.com)
- Epidurals are the most widely used form of labor pain medication but side effects such as fever, itching, bad headaches and a slowed fetal heart rate are possible. (expectny.com)
- Because epidurals slow labor, synthetic oxytocin (Pitocin) might be used to strengthen contractions. (expectny.com)
- Hospitals can help you avoid an epidural by making other labor pain relief options available and supporting their use. (expectny.com)
- A hospital with a lower epidural rate may be better at offering other help with comfort and pain relief during labor. (expectny.com)
Thoracic epidural catheter1
- The records of consecutive patients who received a thoracic epidural catheter were reviewed. (hindawi.com)
Regional Anesthesia3
- Regional anesthesia has been consistently associated with superior pain control, lower opioid use and related side effects, when compared to conventional opioid-based analgesia 1-3 . (researchsquare.com)
- 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)
- 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)
Preemptive6
- The objective of this prospective, double-blinded, randomized, controlled trial was to assess the effect of preemptive low-dose epidural ketamine in addition to preemptive thoracic epidural analgesia on the incidence of chronic post-thoracotomy pain. (clinicaltrials.gov)
- The researchers note that "scalp acupuncture can serve as a preemptive analgesia technique and increase effectiveness of epidural morphine analgesia. (healthcmi.com)
- Helmy N, Badawy AA, Hussein M, Reda H. Comparison of the preemptive analgesia of low dose ketamine versus magnesium sulfate on parturient undergoing cesarean section under general anesthesia. (riajournal.com)
- To evaluate the effect of preemptive analgesia of paracetamol and dipyrone in vital teeth professionally whitened in office. (bvsalud.org)
- Dipyrone 500 mg exhibited higher effectiveness than Paracetamol 500 mg in the study population, as a technique of preemptive analgesia in tooth whitening procedure. (bvsalud.org)
- An adjuvant therapy is the preemptive analgesia, which is a drug regimen prior to the nociceptive stimulus, aiming at preventing hyperalgesia and the subsequent pain amplification 1 . (bvsalud.org)
Reduction in epidural1
- Nonpharmacologic approaches, based on Gate Control (water immersion, massage, ambulation, positions) and Diffuse Noxious Inhibitory Control (acupressure, acupuncture, electrical stimulation, water injections), are associated with a reduction in epidural analgesia and a higher maternal satisfaction with childbirth. (nih.gov)
Patient16
- The advantages of IT opioids for analgesia, especially if spinal anesthesia is already planned, include its simplicity, lack of need for catheter care or pumps, low cost, and easy supplementation with low-dose patient-controlled analgesia (PCA) opioids as needed. (medscape.com)
- 4 No statistics on use of ITN, patient-controlled analgesia using narcotics, nitrous oxide, or pudendal blocks exist in Canada. (cfp.ca)
- Long-term patient perception of pain control experience after participating in a trial between patient-controlled analgesia and epidural after pectus excavatum repair with bar placement. (childrensmercy.org)
- Patient Controlled Analgesia (PCA) is delivered using a computerised pump. (kkh.com.sg)
- Through the proper application of multimodal analgesia, ICU clinicians can effectively manage patient pain while reducing the need for opioids and heavy sedation. (sonosite.com)
- We aim to use computed tomography scans, patient demographics, and vertebral level to estimate the depth of the loss of resistance for placement of thoracic epidural catheters. (hindawi.com)
- Patient demographics, epidural placement site, and technique were collected. (hindawi.com)
- The measured loss of resistance is positively correlated with the computed tomography epidural space depth measurement and patient demographics. (hindawi.com)
- A number of studies have measured the mean skin to epidural space depth (SES) in various patient populations and have proposed prediction models based on anthropometric measures and imaging. (hindawi.com)
- Perioperative management for nephrectomy using combined spinal-epidural anesthesia with sedation in a patient with cerebral palsy under maintenance hemodialysis. (scielo.br)
- For the control group patients, combined general/epidural anesthesia was administered during the operation, while morphine was administered for patient-controlled epidural analgesia after the operation. (healthcmi.com)
- Regional analgesia is also contraindicated in cases of patient refusal or inadequate practitioner training and experience. (medscape.com)
- This is called patient controlled analgesia (PCA). (medlineplus.gov)
- Conclusion: We concluded that low-dose IV ketamine infusion was associated with significantly lower pain scores, reduced rescue analgesic requirement along with better patient satisfaction so that it could be used as a useful adjunct to multimodal postoperative analgesia. (riajournal.com)
- Patient-controlled analgesia versus continuous infusion. (riajournal.com)
- 19 demonstrated that dipyrone use prior to surgical incision reduces the consumption of morphine per hour, evaluated through the method of analgesia controlled by the patient. (bvsalud.org)
Nulliparous2
- Does epidural analgesia delay the vaginal delivery of nulliparous women compared with non-epidural analgesia? (e-jmls.org)
- Researchers conducted a double-blind, randomized controlled trial of nulliparous women with term singleton pregnancies, who requested epidural analgesia. (medpagetoday.com)
Given using an ep1
- Local anaesthetic and other pain medicines are given using an epidural catheter (a small tube or line) that is inserted into your back to block pain during surgery and/or after your operation. (kkh.com.sg)
Perioperative2
- Clinically, combined PICBs at the same levels resulted in consistent segmental chest wall analgesia and reduction in perioperative opioid consumption after breast surgery. (researchsquare.com)
- Patients who have epidural anesthesia have been shown to develop fewer perioperative deep vein thromboses (DVTs). (medscape.com)
Morphine analgesia6
- Researchers conclude that acupuncture increases the effectiveness of epidural morphine analgesia for the relief of pain after intestinal cancer surgery. (healthcmi.com)
- Guangdong Provincial Hospital of Traditional Chinese Medicine researchers combined scalp acupuncture with epidural morphine analgesia in a controlled clinical trial. (healthcmi.com)
- Patients receiving both epidural morphine analgesia and scalp acupuncture in a combined pain management protocol after completion of intestinal cancer surgery showed significant improvements in visual analog scale (VAS) scores and Bruggman comfort scale (BCS) scores. (healthcmi.com)
- 4] In the Guangdong Provincial Hospital of Traditional Chinese Medicine study, acupuncture increases the effectiveness of epidural morphine analgesia by improving VAS and BCS scores and facilitates the postoperative recovery of gastrointestinal function. (healthcmi.com)
- note, "The addition of acupuncture therapy to epidural morphine analgesia in a clinical setting can reduce the total dosage of morphine and correspondingly eliminate the medication-induced side effect rate. (healthcmi.com)
- Therefore, the current study was performed to evaluate the effect of the FICB method compared with standardized systemic morphine analgesia in acute hip fracture patients after arrival in the ED in a double-blind controlled setup with placebo blockade. (silverchair.com)
Injections2
- The goal of this study was to examine the anatomical spread of large-volume PICB injections and its relevance to breast surgery analgesia. (researchsquare.com)
- A larger-volume injection may cause further spread to the paravertebral and/or epidural space, providing multilevel analgesia with 1-2 level injections. (researchsquare.com)
Maternal5
- Cite this: Epidural Analgesia Has No Effect on Maternal Temperature - Medscape - Jul 27, 2012. (medscape.com)
- Nonetheless, they concluded that stopping the second epidural infusion does not affect duration or any other outcome "with the exception of possibly resulting in lower maternal satisfaction. (medpagetoday.com)
- Analgesia is indicated for patients with certain risk factors even in the absence of maternal request. (medscape.com)
- Other maternal conditions such as aortic stenosis , pulmonary hypertension , or right-to-left shunts are also relative contraindications to the use of regional analgesia. (medscape.com)
- [ 152 ] In turn, their fetus may have an increased heart rate associated with epidural anesthesia and maternal fever. (medscape.com)
Opioid analgesia1
- Effects of the OPRM1 A118G Polymorphism (rs1799971) on Opioid Analgesia in Cancer Pain: A Systematic Review and Meta-Analysis. (cdc.gov)
Anestesia Epidural1
- Se diferencia de la ANESTESIA EPIDURAL que se refiere al estado de insensibilidad a la sensación. (bvsalud.org)
Obstetric2
- QUALITY OF EVIDENCE MEDLINE was searched and the references of 2 systematic reviews and a meta-analysis were reviewed to find articles on obstetric analgesia and pain measurement. (cfp.ca)
- In obstetric patients, regional analgesia refers to partial or complete loss of pain sensation below the T8 to T10 spinal level. (medscape.com)
Catheter insertion2
- Women who sustained a dural puncture during their epidural catheter insertion had a higher risk of developing chronic headache [14.3%, versus 4.8%, p=0.049, AOR: 3.36 (1.05, 12.82)] and chronic back pain [39.7% versus 19.1%, p=0.009, AOR: 2.67 (1.25, 5.72)] than women who did not sustain a dural puncture. (medrxiv.org)
- Conclusions An unintentional dural puncture during epidural catheter insertion in parturients is associated with increased risk of chronic headache, back pain and auditory impairment. (medrxiv.org)
Pain35
- Epidural analgesia is a type of pain relief. (chop.edu)
- Epidural analgesia is an important part of the overall plan for your child's pain control. (chop.edu)
- Epidural analgesia is a way of putting pain medication close to the body part that hurts. (chop.edu)
- The end of the epidural catheter is near the nerves that help the body feel and control pain. (chop.edu)
- Pain medication is given through the epidural catheter. (chop.edu)
- The epidural tubing is attached to a pump that constantly delivers pain medicine. (chop.edu)
- The epidural will not make all of your child's pain go away, but your child should feel comfortable enough to move around in bed. (chop.edu)
- If you have any questions about epidural pain relief, please speak with your child's doctor or nurse. (chop.edu)
- 0.0001), with women who had epidurals being more likely to stop breastfeeding than women who used non-pharmacological methods of pain relief (adjusted hazard ratio 2.02, 95% CI 1.53, 2.67). (szoptatasportal.hu)
- Various regional analgesia techniques exist that can be used to promote postoperative pain relief. (medscape.com)
- Pain management with epidural catheter and epidural analgesia after spinal dorsal instrumentation of lumbar spine. (bvsalud.org)
- The aim of the current study was to compare the use of epidural analgesia (EA) with systemic analgesia (SA) as regards pain reduction and early postoperative complications after SDI . (bvsalud.org)
- Pain management with epidural or systemic analgesia in patients undergoing SDI by posterior approach between January 2019 and July 2020 was evaluated by clinical functional testing, measuring total opioid amounts used, and evaluating numerical rating scale values 24 and 96 hours postoperatively. (bvsalud.org)
- Our data demonstrate that epidural anesthesia was inferior to an opioid -based SA regime in reducing postoperative pain in patients undergoing spinal surgery . (bvsalud.org)
- 2, 10] In many centres, a combined spinal and epidural anaesthetic (CSE) is given, where a single injection of local anaesthetic is inserted into the subarachnoid space (for fast onset of pain relief) in addition to insertion of an epidural catheter for ongoing pain management. (amsj.org)
- [3] , [4] Epidural analgesia is considered the gold standard for post-thoracotomy pain relief but may have side effects. (annals.in)
- Epidurals can be used during and/or after surgery for pain relief. (cgh.com.sg)
- Pain scores decreased in the epidural group until the 90-minute mark and increased in the saline group throughout, the authors said, though there were no significant differences in visual analog pain scores between groups. (medpagetoday.com)
- Urban BJ , Nashold BS Jr . Combined epidural and peripheral nerve stimulation for relief of pain. (avma.org)
- While thoracic epidural analgesia has become the mainstay for managing acute post-thoracotomy pain, its effect on the chronic post-thoracotomy pain seems questionable. (clinicaltrials.gov)
- As a result, multimodal analgesia can reduce postoperative pain (Jin and Chung 2001). (sonosite.com)
- Dr. Capdevila concludes multimodal analgesia optimizes pain management and decreases organ dysfunction while demonstrating a positive impact on the long-term mortality in patients after major surgeries. (sonosite.com)
- Epidural analgesia is widely used for postoperative pain management because of the advantages that epidural analgesia offers in reducing postoperative pain and the surgical stress response [ 1 - 3 ]. (hindawi.com)
- Your epidural, or spinal, catheter can also be used for pain relief after surgery . (medlineplus.gov)
- The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. (bvsalud.org)
- What is the Epidural Pain Relief Measure? (expectny.com)
- The epidural pain relief measure is the percentage of woman who received epidural pain relief while having a vaginal birth. (expectny.com)
- What does epidural pain relief mean for me and my baby? (expectny.com)
- Epidural pain relief can also make pushing more difficult and make interventions such as forceps or C-section more likely. (expectny.com)
- As a result, many women prefer to have access to drug-free measures (such as tubs, showers and birth balls) or other types of pain medicine (such as nitrous oxide) and give birth without using epidural pain relief. (expectny.com)
- Why do hospital epidural pain relief rates matter? (expectny.com)
- Your likelihood of receiving epidural pain relief can be influenced by the hospital where you give birth. (expectny.com)
- If giving birth without epidural pain relief is a high priority or you're interested in exploring other pain relief options, looking for a hospital with a lower epidural rate may help you find an environment that will support your wishes. (expectny.com)
- Make sure that your doctor or midwife knows whether or under what conditions you want to receive epidural pain relief. (expectny.com)
- An epidural block is one of the most common forms of pain relief used in hospitals today for the laboring mom. (dianathedoula.com)
Duration4
- The median duration of epidural analgesia was 7.9 hours (interquartile range, 4.3 - 12.1 hours). (medscape.com)
- The duration of analgesia was from the time of epidural block to the time of rescue analgesia . (bvsalud.org)
- For IT morphine, the onset of analgesia is 30-60 minutes, and the duration of analgesia is 18-24 hours, depending on the dose. (medscape.com)
- The use of the epidural block in combination with general anesthesia for radical cystectomy and early onset of parenteral nutrition contribute to a lesser load on the patient's immune state, a reduction in complications in the postoperative period, an early preservation of nutritional status, and a reduction in the duration of treatment of patients with advanced bladder cancer. (org.ua)
Versus5
- To date only three trials randomized patients to narcotic versus epidural groups, and all showed a twofold to threefold increase in cesarean section for dystocia. (afar.info)
- Cherkab R, Lazraq M, Elhafid Z, Haddad W, Elkettani C and Barrou L. Postoperative epidural analgesia in thoracic surgery: continuous administration by electric push-syringe diffusion versus elastomeric diffuser . (hoajonline.com)
- There was also no significant difference among the portion of women with spontaneous vaginal delivery (96.5% for epidural versus 99% for placebo, P =0.17), nor were there differences between groups among rates of incidence of episiotomy, position of the fetus at delivery or what the authors characterized as "any measure of neonatal well-being. (medpagetoday.com)
- However, a significantly higher portion of women in the placebo group reported satisfaction scores of 8 or less compared with the epidural group (30.5% versus 16%, respectively, P =0.001). (medpagetoday.com)
- [5] However, in pediatric populations, the use of opioid medications for analgesia is considered off-label due to scant clinical data to elaborate on the harms versus benefits in this population. (statpearls.com)
Vaginal1
- and 2,045 with transmission from a mother to her newborn twins g, Apgar scores 8/9/9) under epidural analgesia with place- during vaginal delivery. (cdc.gov)
Method of analgesia1
- An alternative, effective, and safer method of analgesia would be preferable. (annals.in)
Opioids5
- Opioids administered to the IT space can offer effective postoperative analgesia. (medscape.com)
- In an article published in ICU Management and Practice , Dr. Xavier Capdevila, Head of the Department of Anesthesia and Critical Care Medicine at Lapeyronie University Hospital, France, outlines the concept of multimodal analgesia as an alternative to administering solely opioids to patients. (sonosite.com)
- A French study showed that the use of multimodal analgesia in mechanically ventilated critically ill patients decreases sedation and delirium while avoiding the need for opioids. (sonosite.com)
- Patients given multimodal analgesia were also more likely to have fewer organ failures compared to patients who received opioids alone (Payen et al. (sonosite.com)
- The patients who received regional analgesia experienced an optimized rehabilitation with a decreased use of opioids. (sonosite.com)
Effective analgesia1
- Failure to correctly identify the epidural space may result in a variety of undesirable outcomes, such as failure to provide effective analgesia, dural puncture, or spinal cord injury. (hindawi.com)
Sedation3
- Multimodal analgesia also reduces the need for total sedation. (sonosite.com)
- The practice of analgosedation in the ICU (using analgesia before sedation) is becoming increasingly common. (sonosite.com)
- The μ-opioid receptors, located in the CNS (e.g., brainstem, locus coeruleus, periaqueductal gray matter) and parts of the gastrointestinal tract, act to modulate various neurochemical activities involved in analgesia, euphoria, and sedation. (statpearls.com)
General anesthesia3
- In the former, a retrospective study of 51 cases from January 2019 to July 2019 showed a decrease of more than 80% in the rate of recourse to general anesthesia in extremely urgent caesarean sections (4/4 vs 0/7) and a 50% decrease in the time required to obtain adequate epidural anesthesia (5 min vs 10 min). (centerwatch.com)
- The addition of epidural analgesia to general anesthesia was also associated with long-term survival. (sonosite.com)
- The clinical part consisted of a retrospective medical records review of patients who had undergone breast surgery under general anesthesia (GA) with and without PICB, examining the dermatomal analgesia/hypoesthesia distribution and the analgesic effect of the PICB. (researchsquare.com)
Patients13
- CONCLUSION Physicians practising modern obstetrics in rural and small urban centres might find single-dose ITN a useful alternative to parenteral or epidural analgesia for appropriately selected patients. (cfp.ca)
- Can ultrasound-guided erector spinae plane block replace thoracic epidural analgesia for postoperative analgesia in pediatric patients undergoing thoracotomy? (annals.in)
- We studied the analgesic efficacy of unilateral continuous ultrasound-guided erector spinae plane block (ESPB) compared to a thoracic epidural in pediatric patients undergoing thoracotomy. (annals.in)
- We randomly assigned patients into two groups: The thoracic epidural analgesia (TEA) group received GA with an epidural catheter. (annals.in)
- This study shows that the ESPB provides similar postoperative analgesia to the TEA in pediatric patients undergoing thoracotomy. (annals.in)
- Patients of the first group also were administered epidural analgesia and parenteral nutrition in the early postoperative period (from the first day) was prescribed. (org.ua)
- Taking into account the fact that it is the cellular link of the immune system that plays the main role in the implementation of the antitumor immune response, providing the overall antitumor resistance of the organism, it seems promising to use the epidural block and early parenteral nutrition in patients operated on advanced bladder cancer. (org.ua)
- Notably, obstetricians requested that epidural infusion be stopped in 49 patients -- 22 from the placebo group and 27 from the epidural group. (medpagetoday.com)
- Patients who received epidural analgesia exhibited fewer complications than patients who received only analgosedation (Bardia et al. (sonosite.com)
- The records of twelve matched patients who had the same operations without PICB were reviewed to compare analgesia and opioid consumption. (researchsquare.com)
- However, changes in the epidural space that occur during pregnancy, as well as differences between the morphology of the thoracic and lumbar regions of the spine, make these studies inapplicable to nonobstetric patients receiving an epidural at the thoracic intervertebral levels. (hindawi.com)
- Following approval from The University of Texas MD Anderson Cancer Center Institutional Review Board, we retrospectively reviewed the records of patients who had epidurals placed between the T3 and T12 intervertebral levels by 1 of 2 providers at MD Anderson between July 1, 2007, and June 30, 2011. (hindawi.com)
- A total of 60 patients that received intestinal cancer surgery under combined general/epidural anesthesia were treated and evaluated in this study. (healthcmi.com)
Fetal1
- Epidural analgesia may also increase intervention for fetal distress. (afar.info)
Multimodal analgesia2
- As a part of multimodal analgesia, many regional blocks have been described. (annals.in)
- 2013). Dexmedetomidine, an alpha 2 antagonist and a potent anxiolytic, is another drug that ICU clinicians should consider within the multimodal analgesia approach. (sonosite.com)
Methods4
- METHODS: We performed a computer-assisted MEDLINE search for articles and a review of bibliographies from articles on epidural analgesia. (afar.info)
- In Western cultures, epidural analgesia (EA), as well as a number of other methods, is widely used, and its benefits (and risks) are well documented. (amsj.org)
- Narcotics delivered by spinal or epidural methods function at the same site in the spinal cord. (cfp.ca)
- Previous studies have used varying methods to estimate the depth of the epidural space prior to placement of an epidural catheter. (hindawi.com)
Placement6
- and 2,045 g, Apgar scores 8/9/9) under epidural analgesia with placement of a urinary catheter. (cdc.gov)
- Correct placement of an epidural catheter into the epidural space using the loss of resistance (LOR) technique is a difficult skill to teach because it is performed "blind" and anatomical variations can lead to the identification of false LOR. (hindawi.com)
- however, estimation of SES in this model is dependent on the angle of needle insertion, which would not be known prior to epidural placement [ 5 ]. (hindawi.com)
- also proposed a CT-based prediction model for epidural placement at the T10-T11 interspace using the paramedian approach, but the clinical relevance of this model is minimized by the fact that the model assumes a constant angle of needle insertion [ 6 ]. (hindawi.com)
- The caudally angled spinous processes at the thoracic vertebral level make placement of a thoracic epidural more challenging. (hindawi.com)
- We also noted the epidural placement approach (midline or paramedian) and the LOR to the nearest half centimeter as reported by the attending anesthesiologist performing the epidural. (hindawi.com)
Dural puncture2
- The insertion of the epidural catheter can be complicated by unintentional dural puncture that may result in postdural puncture headache. (medrxiv.org)
- Cases were women who received epidural analgesia and sustained an unintentional dural puncture and controls were women who received epidural analgesia but did not sustain such complication. (medrxiv.org)
Lidocaine1
- In France, the latest recommendations date from 2007 and recommend the practice of epidural extension with 15 to 20 ml of 2% adrenaline lidocaine. (centerwatch.com)
Analgesic1
- Pre-emptive analgesia is a treatment whereby a preoperative analgesic regimen is introduced to reduce noxious stimuli in the surgical process. (healthcmi.com)
Anesthesiology1
- Epidural blockade is becoming one of the most useful and versatile procedures in modern anesthesiology. (ispub.com)
Paravertebral1
- Conclusions: In this anatomical study, PICB at the 2nd and 4th ICS produced lateral spread along the corresponding intercostal space, medial spread to the adjacent paravertebral/epidural space and cranio-caudal spread along the endothoracic fascial plane. (researchsquare.com)
Nerve1
- Options for analgesia may be non-pharmacological, such as massage, breathing exercises and transcutaneous electrical nerve stimulation (TENS), which have limited evidence of efficacy but appear to improve satisfaction with the childbirth experience (compared to placebo). (amsj.org)
Sufentanil1
- Epidural analgesia with sufentanil in relation to OPRM1 and ABCB1 polymorphisms. (cdc.gov)
Clinical2
- 2016). Clinical evidence shows that epidural analgesia can decrease mortality, complications, and morbidity after surgery. (sonosite.com)
- The goals of this study were to examine the anatomical spread of PICB injectate and explore its translation into clinical analgesia after breast surgery. (researchsquare.com)
Cardiac2
Preoperative1
- Preoperative computed tomography scans were reviewed to measure the skin to epidural space distance. (hindawi.com)