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
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- ... CS1 maint: discouraged parameter (link) Doughty, Andrew (1969). "Selective epidural analgesia and the forceps rate". British ... He was an early promoter of the use of epidural anaesthesia during childbirth. In 1973, he set up an epidural course at ...
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 ...
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 ... Anesthesia & Analgesia, 110(2), 524-525. Feldman, P. L. (2006). Discovery and Development of the Ultrashort-acting Analgesic ... Hence, it causes a reduction in sympathetic nervous system tone, respiratory depression and analgesia. The drug's effects ...
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 ...
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 ...
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, ...
Morphine - Simple English Wikipedia, the free encyclopedia
In epidural anesthesia or intrathecal analgesia. *For palliative care (i.e. to lessen pain without curing the underlying reason ...
Audioanalgesia
... (also known as audio-analgesia) is the relief of pain using white noise or music without using pharmacological ... This measure is similar to breathing exercises during cramps before administration of epidurals. It has also been suggested ... "Auditory analgesia in dental operations". J Am Dent Assoc. 59 (6): 1144-1149. doi:10.14219/jada.archive.1959.0251. PMID ... "Audio analgesia revisited". Anesthesia Progress. 16 (1): 8-14. PMC 2235527. PMID 5250548. "Nonpharmacologic Approaches to ...
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 ...
Ornipressin
An Efficient Alternative to Counteract Hypotension During Combined General/Epidural Anesthesia". Anesthesia & Analgesia. 90 (6 ...
Continuous wound infiltration
... some patients might prefer an alternative to epidural analgesia because of epidural-related side effects. Epidural analgesia ... "Major complications of epidural analgesia after surgery: results of a six-year survey: Epidural complications". Anaesthesia. 62 ... "Factors associated with the choice of delivery without epidural analgesia in women at low risk in France". Birth (Berkeley, ... "Preperitoneal or Subcutaneous Wound Catheters as Alternative for Epidural Analgesia in Abdominal Surgery: A Systematic Review ...
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 ... "Anesthesia and Analgesia. 126 (6): 2047-2055. doi:10.1213/ANE.0000000000002927. PMID 29734240. S2CID 13688396.. ... Spinal, epidural and caudal anesthesia[edit]. Further information: Neuraxial blockade and History of neuraxial anesthesia ...
Pain management
Ferrante FM, Lu L, Jamison SB, Datta S (1991). "Patient-controlled epidural analgesia: demand dosing". Anesth. Analg. 73 (5): ... The World Health Organization (WHO) recommends a pain ladder for managing analgesia. It was first described for use in cancer ... This is similar to epidural infusions used in labour and postoperatively. The major differences are that it is much more common ... Caraceni, A; Zecca, E; Martini, C; De Conno, F (June 1999). "Gabapentin as an adjuvant to opioid analgesia for neuropathic ...
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 water births have been proven to lessen pain without the need for an epidural there are no medical proven reasons why ... A 2018 Cochrane Review of water immersion in the first stages of labor found evidence of fewer epidurals and few adverse ...
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 prior to surgery. It is not approved for ... Transdermal fentanyl has also been used for many years in dogs and cats for post-operative analgesia. This is usually done with ... Supraspinal analgesia (μ1) Respiratory depression (μ2) Physical dependence Muscle rigidity It produces sedation and spinal ...
Ban Tsui
CS1 maint: discouraged parameter (link) "Usefulness of the Tsui Test in Combined Spinal-Epidural Analgesia in Labour". ... The Tsui Test is a simple protocol using a low current electrical stimulation test to confirm catheter location in the epidural ... Examples include describing the Tsui Test and developing the StimuLong Sono-Tsui for ease of pediatric epidural placement. ... Tsui is also a guest reviewer for multiple journals including: Anesthesiology Anesthesia and Analgesia British Journal of ...
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 ... Assessing the effects of transcutaneous electrical nerve stimulation (TENS) in post-thoracotomy analgesia. Rev Bras Anestesiol ...
Lower-back tattoo
Medical practitioners who administer anesthesia have questioned whether epidural analgesia should be provided to women with ... There is consensus that epidural catheters should not be placed through irritated or infected tattoos. However, harm has not ... Welliver, Dawn; Mark Welliver; Tammy Carroll; Peggy James (June 2010). "Lumbar Epidural Catheter Placement in the Presence of ... Concerns have emerged that epidural catheters may cause tattoo pigment to enter interspinous ligaments and other areas, ...
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 ...
Inhalation
... begins with the contraction of the muscles attached to the rib cage; this causes an expansion in the chest cavity. Then takes place the onset of contraction of the diaphragm, which results in expansion of the intrapleural space and an increase in negative pressure according to Boyle's law. This negative pressure generates airflow because of the pressure difference between the atmosphere and alveolus. Air enters, inflating the lung through either the nose or the mouth into the pharynx (throat) and trachea before entering the alveoli.[citation needed] Other muscles that can be involved in inhalation include:[2] ...
Herbal tea
Some feel that the term tisane is more correct than herbal tea or that the latter is even misleading, but most dictionaries record that the word tea is also used to refer to other plants beside the tea plant and to beverages made from these other plants.[4][5] In any case, the term herbal tea is very well established and much more common than tisane.[1] The word tisane was rare in its modern sense before the 20th century, when it was borrowed in the modern sense from French. (This is why some people feel it should be pronounced /tɪˈzɑːn/ as in French, but the original English pronunciation /tɪˈzæn/ continues to be more common in US English and especially in UK English).[2] The word had already existed in late Middle English in the sense of "medicinal drink" and had already been borrowed from French (Old French). The Old French word came from the Latin word ptisana, which came from the Ancient Greek word πτισάνη (ptisánē), which meant "peeled" barley, in other words pearl barley, ...
Jehovah's Witnesses
Anesthesia & Analgesia. 104 (4): 763-5. doi:10.1213/01.ane.0000250913.45299.f3. PMID 17377078. Retrieved 2008-12-30.. ... epidural blood patch, plasmapheresis, blood labeling or tagging and platelet gel (autologous) ...
Intravenous therapy
A peripheral cannula is the most common intravenous access method utilized in both hospitals and pre-hospital services. A peripheral IV line (PVC or PIV) consists of a short catheter (a few centimeters long) inserted through the skin into a peripheral vein (any vein not situated in the chest or abdomen). This is usually in the form of a cannula-over-needle device, in which a flexible plastic cannula comes mounted over a metal trocar. Once the tip of the needle and cannula are introduced into the vein via venipuncture, the cannula is advanced inside the vein over the trocar to the appropriate position and secured, the trocar is then withdrawn and discarded. Blood samples may be drawn directly after the initial IV cannula insertion. Any accessible vein can be used although arm and hand veins are used most commonly, with leg and foot veins used to a much lesser extent. In infants, the scalp veins are sometimes used. The caliber of needles and catheters can be given in Birmingham gauge or French ...
Oxygen mask
Three main kinds of oxygen masks are used by pilots and crews who fly at high altitudes: continuous flow, diluter demand, and pressure demand.[3] In a continuous-flow system, oxygen is provided to the user continuously. It does not matter if the user is exhaling or inhaling as oxygen is flowing from the time the system is activated. Below the oxygen mask is a rebreather bag that collects oxygen during exhalation and as a result allows a higher flow rate during the inhalation cycle.[4] Diluter-demand and pressure-demand masks supply oxygen only when the user inhales.[5] They each require a good seal between the mask and the user's face. In a diluter-demand system, as the altitude increases (ambient pressure, and therefore the partial pressure of ambient oxygen, decreases), the oxygen flow increases such that the partial pressure of oxygen is roughly constant. Diluter-demand oxygen systems can be used up to 40,000 ft (12,000 m).[4] In a pressure-demand system, oxygen in the mask is above ambient ...
Analgesic
Congenital analgesia (insensitivity to pain). Notes[edit]. *^ Anonymous (1990). Cancer pain relief and palliative care; report ... Epidural, IV, intrathecal, transdermal.. Protein binding = 90%; half-life = 2.5 hours; excretion = urine (80%).. Adjunct to ... Analgesia and fever reduction.. As per paracetamol. Ziconotide. Peptide.. N-type calcium-channel blocker.. Intrathecal.. ... Analgesia, especially postoperative; hiccups.. Has antimuscarinic and sympathomimetic effects.[119] Paracetamol. Comes in free ...
Jet injector
A new method of drug administration". Current Researches in Anesthesia and Analgesia. 26 (6): 221-230. PMID 18917536.. ...
Topical medication
A medication's potency often is changed with its base. For example, some topical steroids will be classified one or two strengths higher when moving from cream to ointment. As a rule of thumb, an ointment base is more occlusive and will drive the medication into the skin more rapidly than a solution or cream base.[6] The manufacturer of each topical product has total control over the content of the base of a medication. Although containing the same active ingredients, one manufacturer's cream might be more acidic than the next, which could cause skin irritation or change its absorption rate. For example, a vaginal formulation of miconazole antifungal cream might irritate the skin less than an athlete foot formulation of miconazole cream. These variations can, on occasion, result in different clinical outcomes, even though the active ingredient is the same. No comparative potency labeling exists to ensure equal efficacy between brands of topical steroids (percentage of oil vs water dramatically ...
Epinephrine autoinjector
In 2009, Teva Pharmaceuticals filed an ANDA to market a generic EpiPen in collaboration with Antares Pharma Inc, a maker of injection systems; Pfizer and King sued them for infringing US Patent 7,449,012 that was due to expire in 2025;[33] Pfizer, Mylan, and Teva settled in April 2012 in a deal that allowed Teva to start selling the device in mid-2015, pending FDA approval.[34] In 2009, Intelliject, a US startup developing a new epinephrine autoinjector, licensed their product to Sanofi.[35] King was acquired by Pfizer in 2010 for $3.6 billion in cash.[36] In 2010, Sciele/Shionogi faced a recall of Twinject devices[37] and launched Adrenaclick, a modified version of the Twinject that could deliver only one dose.[38][39] In 2010, European regulators approved Twinject,[40] and also approved a new epinephrine autoinjector made by ALK and sold under the brand name Jext.[41][42] Jext was launched in the European Union in September 2011.[43][44] Also in 2010, Shionogi authorized Greenstone, the ...
Childbirth in Nepal
Medical management of pain is rarely found in home births, but analgesia (i.e. epidural) is prevalent in the hospitals. Touch, ...
Ketamin - Vikipedi
1 Anesthesia and Analgesia in Rodents, Washington College, 2012, ss. 1-2, 4 August 2013 tarihinde kaynağından arşivlendi, ... Düşük dozlarda spinal veya epidural anestezi/analjeziyi desteklemek için.. Ağrı kesici[değiştir , kaynağı değiştir]. Ameliyat ...
Sublabial administration
... , literally "under the lip", from Latin, refers to the pharmacological route of administration by which the active substance is placed between the lip and the gingiva (gum). Sublabial administration should not be confused with sublingual administration, which is under the tongue. The frenulum of the tongue may be irritated when in contact with corrosive materials but can be avoided with this route. It is usually used for medications such as glyceryl trinitrate, for example, in angina pectoris.[1] ...
Softgel
A softgel is an oral dosage form for medicine similar to capsules. They consist of a gelatin based shell surrounding a liquid fill. Softgel shells are a combination of gelatin, water, opacifier and a plasticiser such as glycerin or sorbitol. Softgels are produced in a process known as encapsulation using the Rotary Die Encapsulation process invented by Robert Pauli Scherer. The encapsulation process has been described as a form/fill/seal process. Two flat ribbons of shell material are manufactured on the machine and brought together on a twin set of rotating dies. The dies contain recesses in the desired size and shape, which cut out the ribbons into a two-dimensional shape, and form a seal around the outside. At the same time a pump delivers a precise dose of fill material through a nozzle incorporated into a filling wedge whose tip sits between the two ribbons in between two die pockets at the point of cut out. The wedge is heated to facilitate the sealing process. The wedge injection causes ...
Intravitreal administration
Intravitreal is a route of administration of a drug or other substance, in which the substance[1] is delivered into the eye. Intravitreal administration of drugs is used to treat various conditions of the eye. The following methods are known. ...
Syringomyelia
For many patients, the main treatment is analgesia. Physicians specializing in pain management can develop a medication and ...
Liniment
... s are commonly used on horses following exercise, applied either by rubbing on full-strength, especially on the legs; or applied in a diluted form, usually added to a bucket of water and sponged on the body. They are used in hot weather to help cool down a horse after working, the alcohol cooling through rapid evaporation, and counterirritant oils dilating capillaries in the skin, increasing the amount of blood releasing heat from the body.[17] Many horse liniment formulas in diluted form have been used on humans, though products for horses which contain DMSO are not suitable for human use, as DMSO carries the topical product into the bloodstream.[18] Horse liniment ingredients such as menthol, chloroxylenol, or iodine are also used in different formulas in products used by humans.[19] Absorbine, a horse liniment product manufactured by W.F. Young, Inc., was reformulated for humans and marketed as Absorbine Jr.[20] The company also acquired other liniment brands including Bigeloil and ...
Analgesic
"Nefopam analgesia and its role in multimodal analgesia: A review of preclinical and clinical studies". Clinical and ... Epidural, IV, intrathecal, transdermal.. Protein binding = 90%; half-life = 2.5 hours; excretion = urine (80%).. Adjunct to ... Analgesia and fever reduction.. As per paracetamol. Ziconotide. Peptide.. N-type calcium-channel blocker.. Intrathecal.. ... An analgesic or painkiller is any member of the group of drugs used to achieve analgesia, relief from pain. They are distinct ...
Postoperative nausea and vomiting
A 2008 study compared 121 Japanese patients who experienced PONV after being given the general anesthetic propofol to 790 people who were free of post-operative nausea after receiving it. Those with a G at both copies of rs1800497 were 1.6 times more likely to experience PONV within six hours of surgery compared to those with the AG or AA genotypes. But they were not significantly more likely to experience PONV more than six hours after surgery.[1] Postoperative nausea and vomiting results from patient factors, surgical & anesthetic factors. Surgical factors that confer increased risk for PONV include procedures of increased length, gynecological, abdominal and laparoscopic procedures, ENT procedures, strabismus procedures in children. Anesthetic risk factors include the use of volatile anesthetics, Nitrous Oxide (N2O), Opioids, and longer duration of anesthesia. Patient factors that confer increased risk for PONV include female gender, Obesity, age less than 16 years, past history of motion ...
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 ...
Shoulder replacement
... it is still a useful alternative when continuous interscalenic analgesia cannot be performed.[13] Interscalenic analgesia is ... and inadvertent spinal/epidural anesthesia could occur and therefore, patients should be carefully monitored during the ... Post-operative analgesiaEdit. Shoulder replacement can cause severe to very severe pain especially during shoulder mobilization ... Single shot interscalenic analgesia is preferably used during minor arthroscopic surgery because of its short duration but ...
Local anesthetic
Epidural anesthesia is an LA injected into the epidural space, where it acts primarily on the spinal nerve roots; depending on ... Gow-Gates GA (April 1998). "The Gow-Gates mandibular block: regional anatomy and analgesia". Australian Endodontic Journal. 24 ... Heart and lung surgery (epidural anesthesia combined with general anesthesia). *Abdominal surgery (epidural anesthesia/spinal ... making epidural anesthesia still a highly successful technique. Besides its many uses for surgery, epidural anesthesia is ...
Sublingual administration
When a chemical comes in contact with the mucous membrane beneath the tongue, it is absorbed. Because the connective tissue beneath the epithelium contains a profusion of capillaries, the substance then diffuses into them and enters the venous circulation. In contrast, substances absorbed in the intestines are subject to "first-pass metabolism" in the liver before entering the general circulation.. Sublingual administration has certain advantages over oral administration. Being more direct, it is often faster,[quantify] and it ensures that the substance will risk degradation only by salivary enzymes before entering the bloodstream, whereas orally administered drugs must survive passage through the hostile environment of the gastrointestinal tract, which risks degrading them, either by stomach acid or bile, or by the many enzymes therein, such as monoamine oxidase (MAO). Furthermore, after absorption from the gastrointestinal tract, such drugs must pass to the liver, where they may be extensively ...
Lollipop
The main ingredient in a standard lollipop is sugar. Sugars are fully hydrated carbon chains meaning that there is a water molecule attached to each carbon. Sugars come in two forms; straight-chain and ring form. When sugars are in straight-chain form, aldehyde and ketone groups are open which leaves them very susceptible to reaction. In this state, sugars are unstable. In ring form, sugars are stable and therefore exist in this form in most foods, including lollipops.. Sugar is a very versatile ingredient and is used in many of food and products we consume every single day. What makes sugar different is the way it interacts with the other ingredients and systems within the food as well as how it is treated. When it is heated enough to break the molecules apart, it generates a complex flavor, changes the color, and creates a pleasing aroma.[10] Sugar can form two types of solids in foods; crystalline and glassy amorphous. Crystalline solids can be found in food products like fondant, fudge, and ...
Chloroprocaine
... (pKa 8.7) is the drug of choice for epidural analgesia and a decompensating fetus, because it does not ... Fetal acidosis, 2-chloroprocaine, and epidural anesthesia for cesarean section. Am J Obstet Gynecol. 1985 Feb 1;151(3):322-4. ... several cases were reported of neurological deficits after inadvertent intrathecal injections intended for epidural delivery.[4 ...
Anesthesiology
... which can be performed to induce analgesia in a region of the body. For example, epidural administration of a local anesthetic ... This is performed to permit surgery without the individual responding to pain (analgesia) during surgery or remembering ( ... The field comprises individualized strategies for all forms of analgesia, including pain management during childbirth, ...
Analgesic
Analgesia and fever reduction.. As per paracetamol. Ziconotide. Peptide.. N-type calcium-channel blocker.. Intrathecal.. ... Epidural, IV, intrathecal, transdermal.. Protein binding = 90%; half-life = 2.5 hours; excretion = urine (80%).. Adjunct to ... Analgesia and fever reduction.. Haematologic, nephrotoxicity, cancer and paracetamol AEs. Pregabalin. Comes in free form.. As ... Analgesia, especially postoperative; hiccups.. Has antimuscarinic and sympathomimetic effects.[117]. Paracetamol. Comes in free ...
Theories of general anaesthetic action
It has long been believed that general anaesthetics exert their effects (analgesia, amnesia, immobility) by modulating the ...
Epidural Anesthesia-Analgesia and Patient Outcomes: A Perspective
The available data clearly indicates that epidural analgesia with a local anesthetic-based regimen provides superior analgesia ... The use of perioperative epidural anesthesia-analgesia provides superior postoperative analgesia [1-3] versus conventional ... The use of perioperative epidural anesthesia-analgesia may confer many benefits including superior postoperative analgesia, ... patient-controlled epidural analgesia with morphine intravenous patient-controlled analgesia for perioperative analgesia and ...
Epidural analgesia
Epidural is of course the best form of labour analgesia. Aim is to find out an alternative method of labour analgesia where ... epidural analgesia for the management of acute pain associated with labour. Systematic review and meta-analysis. González ... Use of epidural analgesia in post-operative pain management. Weetman, Caroline; Allison, Wendy // Nursing Standard;7/12/2006, ... Patient-controlled epidural analgesia is superior to nitrous oxide inhalation in controlling childbirth pain. Xiaoming Feng; ...
Epidural analgesia | Children's Education Materials
Epidural analgesia. What is epidural analgesia?. Analgesia means pain relief. The word epidural refers to a place in the back ... Compared to other methods of pain control, less pain medicine is usually needed when epidural analgesia has been used. Good ... Studies have shown that epidural analgesia provides excellent pain control for children. ... Children are usually on the epidural medicine for 2 to 5 days. Your nurses and anesthesiologist will talk to you and your child ...
Epidural Analgesia Safe and Effective During Early Labor | Medpage Today
Researchers have shown that epidural analgesia administered in the early stage of labor compared to later use does not increase ... epidural analgesia provides better pain relief than systemic analgesia and is also more effective than systemic analgesia in ... The researchers compared the group of women who had received epidural analgesia early in labor with the group of women who ... Women in the other group received systemic hydromorphone at the first request for pain relief and epidural analgesia at either ...
Removal of a Tenacious Epidural Catheter : Anesthesia & Analgesia
Periosteal Entrapment of an Epidural Catheter in the Intrathecal Space * The Effects of the Reverse Trendelenburg Position on ... Home , December 1992 - Volume 75 - Issue 6 , Removal of a Tenacious Epidural Catheter ... Thought you might appreciate this item(s) I saw at Anesthesia & Analgesia.. ... Thought you might appreciate this item(s) I saw at Anesthesia & Analgesia.. ...
What is the role of epidural analgesia in the treatment of rib fractures?
... did not demonstrate significant benefit of epidural analgesia on mortality, ICU, and hospital length of stay compared with ... What is the role of epidural analgesia in the treatment of rib fractures?) and What is the role of epidural analgesia in the ... Effect of epidural analgesia in patients with traumatic rib fractures: a systematic review and meta-analysis of randomized ... Effect of epidural analgesia in patients with traumatic rib fractures: a systematic review and meta-analysis of randomized ...
Corticosteroid Lumbar Epidural Analgesia for Radiculopathy - Full Text View - ClinicalTrials.gov
Epidural versus non-epidural or no analgesia in labour
Epidural analgesia had no statistically significant impact on the risk of caesarean section, maternal satisfaction with … ... Epidural analgesia appears to be effective in reducing pain during labour. However, women who use this form of pain relief are ... Epidural versus non-epidural or no analgesia in labour Cochrane Database Syst Rev. 2011 Dec 7;(12):CD000331. doi: 10.1002/ ... all but five studies compared epidural analgesia with opiates. Epidural analgesia was found to offer better pain relief (mean ...
Epidural Analgesia | GreenMedInfo | Anti-Therapeutic Action | Natural
Why women prefer epidural analgesia during childbirth: the role of beliefs about epidural analgesia and pain catastrophizing. ... Diseases : Analgesia, Cesarean Section. Anti Therapeutic Actions : Cesarean Delivery, Epidural Analgesia, Obstetric ... Labor involving epidural analgesia is associated with a 2-fold increase in reports of partial breast feeding or formula feeding ... 7 Abstracts with Epidural Analgesia Research. Filter by Study Type. Human Study. ...
Patient-controlled analgesia not as effective as epidural for labor pain | EurekAlert! Science News
... will report findings which suggest remifentanil patient controlled analgesia is not equivalent to epidural analgesia for pain, ... Patient-controlled analgesia not as effective as epidural for labor pain Study finds remifentanil patient-controlled analgesia ... study-finds-remifentanil-patient-controlled-analgesia-not-as-effective-as-epidural-analgesia-in-managing-pain-relief-during- ... "Recent studies suggest that remifentanil patient controlled analgesia (RPCA) is equivalent to epidural analgesia (EA) with ...
Labor Epidural Analgesia to Cesarean Section Anesthetic Conversion Failure: A National Survey
If conversion of labor epidural analgesia to cesarean delivery anesthesia fails, the anesthesiologist can be confronted with a ... Optimal management of a failed epidural top up continues to be debated in the absence of best practice guidelines. ,i,Method,/i ... In evaluating whether or not to top up an existing labor epidural, the factors influencing decision-making were how effective ... i,Discussion,/i,. Our survey revealed variations in the clinical management of a failed epidural top up for cesarean delivery, ...
Epidural Injections of Autologous Blood for Postlumbar-Punct... : Anesthesia & Analgesia
Epidural Injections of Autologous Blood for Postlumbar-Puncture Headache Anesthesia & Analgesia49(2):268-271, March-April 1970 ... Epidural Injection of Autologous Blood For Postlumbar-Puncture Headache: II. Additional Clinical Experiences and Laboratory ... Finding Cerebrospinal Fluid during Epidural Blood Patch: How to Proceed * Spinal Subdural Epiarachnoid Hematoma: A Complication ... Thought you might appreciate this item(s) I saw at Anesthesia & Analgesia.. ...
Labor analgesia: Comparison of epidural patient-controlled analgesia and intravenous patient-controlled analgesia]. - PubMed -...
Labor analgesia: Comparison of epidural patient-controlled analgesia and intravenous patient-controlled analgesia].. [Article ... However, we believe that PCIVA is a good alternative to epidural analgesia in cases where epidural analgesia is contraindicated ... In our study, patient controlled epidural analgesia (PCEA) and patient controlled intravenous remifentanil analgesia (PCIVA) ... In this study, 37 pregnant women with a single fetus, who had labor analgesia, were divided into groups of PCIVA (Group 2) and ...
Myofascial Foot Pain Following Uneventful Epidural Analgesia for Labor and Delivery
... had ruled out foot injury and concluded that the pain was radicular and secondary to nerve damage from the epidural analgesia. ... Following an uneventful delivery under epidural analgesia, a 17 year old female patient was referred to the Pain Clinic because ... Following an uneventful delivery under epidural analgesia, a 17 year old female patient was referred to the Pain Clinic because ... B. Mansour, G. Wienecke, J. Cure, J. Almon and A. Armendi, "Myofascial Foot Pain Following Uneventful Epidural Analgesia for ...
Epidural Analgesia for Labor Pain
- Cochrane for Clinicians - American Family Physician
Few studies evaluated epidural analgesia in induced labors. ... epidurals offered better pain relief, but were associated with ... Compared with other types of analgesia or no analgesia, ... Epidural versus non-epidural or no analgesia in labour Cochrane ... all but five studies compared epidural analgesia with opiates. Epidural analgesia was found to offer better pain relief (mean ... singleton vaginal deliveries occur with epidural or spinal analgesia.3 Few dispute that epidural analgesia provides good pain ...
Epidural Analgesia | HealthEngine Blog
Epidural analgesia or epidural injection is a form of labour pain management. Pain relief medications are injected into the ... Types of analgesia used in Epidural Analgesia. There are different types of analgesia used in epidural analgesia, for instant ... What is Epidural Analgesia used for?. Epidural analgesia provides a reliable and excellent analgesia during childbirth without ... What is Epidural Analgesia?. Epidural analgesia is an injection of local anaesthetic alone, or more commonly in combination ...
Doula Combined Latent Phrase Epidural Analgesia in Primiparous Women - Full Text View - ClinicalTrials.gov
Procedure: Analgesia without doula Epidural analgesia in the latent phase of first stage of labor without doula accompany in ... Procedure: Doula combined analgesia Doula combined epidural analgesia in the latent phase of first stage of labor in primiparas ... Doula Combined Latent Phrase Epidural Analgesia in Primiparous Women (DCLEAP). The safety and scientific validity of this study ... Epidural analgesia in the latent phase of the first stage of labor without doula accompany ...
Single vs Double Epidural Catheter Analgesia for Scoliosis Surgery - Full Text View - ClinicalTrials.gov
Active Comparator: single epidural catheter Drug: epidural catheter epidural catheter with 0.3% ropivacaine ... Active Comparator: double epidural catheter Drug: epidural catheter epidural catheter with 0.3% ropivacaine ... Single vs Double Epidural Catheter Analgesia for Scoliosis Surgery. The safety and scientific validity of this study is the ... This is a study comparing pain control utlilizing one or two epidural catheters, along with a hydromorphone PCA, for analgesia ...
No Link Found for Exposure to Epidural Labor Analgesia and Autism - Drugs.com MedNews
Exposure to epidural labor analgesia (ELA) is not associated with offspring risk for autism spectrum disorder (ASD), according ... No Link Found for Exposure to Epidural Labor Analgesia and Autism. TUESDAY, April 20, 2021 -- Exposure to epidural labor ... analgesia (ELA) is not associated with offspring risk for autism spectrum disorder (ASD), according to a study published online ...
The effect of ultra low dose epidural analgesia on newborn breastfeeding behaviors
... J Obstet Gynecol Neonatal Nurs. May-Jun 2003 ... One group was born to mothers who received epidural analgesia, and one group was born to mothers who received no pain ... whether a difference in breastfeeding behaviors could be observed between newborns whose mothers received epidural analgesia ...
Epidural Analgesia
Summary Report | CureHunter
It is differentiated from ANESTHESIA, EPIDURAL which refers to the state of insensitivity to sensation. ... The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the ... Epidural Analgesia. Subscribe to New Research on Epidural Analgesia The relief of pain without loss of consciousness through ... epidural analgesia provides safe and effective labor pain control.". 03/01/2008 - "Epidural analgesia (EA) is an effective and ...
Does postoperative epidural analgesia increase the risk of peroneal nerve palsy after total knee arthroplasty? - PubMed - NCBI
Does postoperative epidural analgesia increase the risk of peroneal nerve palsy after total knee arthroplasty?. Horlocker TT1, ... Postoperative epidural analgesia was used in 108 cases and was not a significant risk factor for the development of peroneal ... Since diagnosis of peroneal nerve palsy may be delayed in patients with postoperative epidural analgesia, these patients must ... occurred in patients receiving postoperative epidural analgesia and were diagnosed after discontinuation of the epidural ...
Comparison of bupivacaine and fentanyl as an adjuvant of epidural morphine for postoperative analgesia | SpringerLink
We conducted a retrospective study to determine whether bupivacaine or fentanyl is a better adjuvant to epidural morphine for ... epidural morphine bupivacaine fentanyl post-operative analgesia This is a preview of subscription content, log in to check ... 1991) Combination of epidural morphine and fentanyl for postoperative analgesia. Reg Anesth 16:214-217PubMedGoogle Scholar ... 1989) Effect of diluent on analgesia produced by epidural fentanyl. Anesth Analg 68:808-810PubMedCrossRefGoogle Scholar ...
In Reply: Effect of Epidural Analgesia for Labor on Cesarean Section Rate | RTI
Tramadol Injection versus Epidural Analgesia in Controlling Labor Pain | OMICS International
To compare efficacy of tramadol injection as an opioid analgesia versus epidural analgesia on governing labor pain, progress ... Group B (epidural group) received Epidural - 0.125% bupivacaine with fentanyl 5 mcg. Epidural analgesia is adjusted to least ... Aim of the study: To compare efficacy of tramadol injection as an opioid analgesia versus epidural analgesia on governing labor ... epidural catheter was fixed with adhesive plaster at back. Epidural analgesia is adjusted to least analgesic dose (10-15 ml/hr ...
Epidural Analgesia and Any Vaginal Laceration | American Board of Family Medicine
In patients without epidural analgesia, 7.4% had OVD, versus 9.5% of patients with epidural analgesia (Table 3). χ2 testing did ... Epidural analgesia and severe perineal laceration in a community-based obstetric practice. J Am Board Fam Pract 2003;16:1-6. ... Epidural Analgesia and Any Vaginal Laceration Message Subject (Your Name) has sent you a message from American Board of Family ... Epidural analgesia and severe perineal tears: A literature review and large cohort study. J Matern Fetal Neonatal Med 2014;27: ...
The Association Between Decreasing Labor Analgesia Epidural Infusion and Forceps Delivery
... clinicaltrials.gov The objectives of this study will be to compare epidural infusion management, specifically looking at ... Patients who require a decrease in their basal labor analgesia epidural infusion rate will have an increased incidence of ... The database will be queried for the following; maternal age, parity, gestational age, type of analgesia, changes in epidural ... Home » Topics » Anesthesiology » Research » The Association Between Decreasing Labor Analgesia Epidural Infusion and Forceps ...
Can Women in Labor Give Informed Consent to Epidural Analgesia? by Kyoko Wada, Louis Charland, Geoff Bellingham :: SSRN
Can Women in Labor Give Informed Consent to Epidural Analgesia?. This is a Wiley-Blackwell Publishing paper. Wiley-Blackwell ... Can Women in Labor Give Informed Consent to Epidural Analgesia?. Bioethics, Vol. 33, Issue 4, pp. 475-486, 2019 ... Wada, Kyoko and Charland, Louis and Bellingham, Geoff, Can Women in Labor Give Informed Consent to Epidural Analgesia? (May ... Keywords: decision‐making capacity, epidural analgesia, feminism, informed consent, labor pain, mental competence ...
Postoperative analgesia with epidural fentanyl | The Journal of the American Osteopathic Association
Postoperative analgesia with epidural fentanyl. The Journal of the American Osteopathic Association, June 1991, Vol. 91, 547. ... Postoperative analgesia with epidural fentanyl You will receive an email whenever this article is corrected, updated, or cited ... Lytle S, Goldsmith D, Neuendorf T, Lowry M. Postoperative analgesia with epidural fentanyl. J Am Osteopath Assoc 1991;91(6):547 ... A retrospective analysis of 133 patients who received continuous epidural fentanyl for postoperative analgesia is presented. ...
Postoperative pain and patient-controlled epidural analgesia-related a | JPR
Keywords: adverse effect, age, elderly, epidural analgesia, pain management, patient-controlled analgesia ... data of 2,435 patients who received fentanyl and ropivacaine-based patient-controlled epidural analgesia (PCEA) for pain relief ... Differences in postoperative pain, incidence of patient-controlled analgesia (PCA)-related adverse effects, and risk factors ... rescue analgesia, and antiemetic administration. Upon multivariate analysis, low fentanyl dosage and history of smoking were ...
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Patient controlled epidural19
- Patient-controlled epidural analgesia is superior to nitrous oxide inhalation in controlling childbirth pain. (ebscohost.com)
- In our study, patient controlled epidural analgesia (PCEA) and patient controlled intravenous remifentanil analgesia (PCIVA) were compared for VAS, and also their side effects on mother and newborn. (nih.gov)
- In this retrospective study, data of 2,435 patients who received fentanyl and ropivacaine-based patient-controlled epidural analgesia (PCEA) for pain relief after elective surgery under general or spinal anesthesia were reviewed. (dovepress.com)
- This study aimed to determine the effects of patient-controlled epidural analgesia (PCEA) on postoperative pain management and short-term recovery after GC resection compared with those of patient-controlled intravenous analgesia (PCIA). (dovepress.com)
- All women received epidural analgesia for the first stage of labor using 0.08% ropivacaine with 0.4 micrograms/mL sufentanil with patient-controlled epidural analgesia. (ovid.com)
- i] Patient-controlled epidural analgesia versus continuous infusion for labour analgesia: a meta-analysis. (anaesthesiauk.com)
- The objective of this study is pain at rest and coughing in addition to determine the effect of intraoperative and postoperative thoracic patient-controlled epidural analgesia (PCEA) compared to postoperative intravenous patient-controlled analgesia (PCA) on postoperative recovery parameters, such as time to potential discharge and resumption of intestinal function after major open gynecologic surgery. (knowcancer.com)
- Subjects will be randomized to either general anesthesia with postoperative intravenous patient controlled analgesia (control group) or general anesthesia with intraoperative thoracic epidural anesthesia and postoperative thoracic patient-controlled epidural analgesia (treatment group). (knowcancer.com)
- Epidural analgesia can be administered by three methods: single-injection and intermittent boluses, continuous infusion via an indwelling catheter or patient-controlled epidural analgesia (PCEA). (oncologynurseadvisor.com)
- After initial epidural or intrathecal injection, both groups received patient-controlled epidural analgesia. (iars.org)
- Some of the included studies maintained post-operative analgesia with patient-controlled epidural analgesia. (york.ac.uk)
- To compare the efficacy and safety of patient controlled epidural analgesia with basal continuous infusion versus intermittent bolus for labor analgesia using fentanyl and bupivacaine. (springermedizin.de)
- 30 parturients were allocated to receive patient controlled epidural analgesia + basal continuous infusion (Group-A) and 30 received intermittent bolus on demand (Group-B). Efficacy of technique was assessed in terms of quality of analgesia on 0-10 cm verbal analogue scale. (springermedizin.de)
- In a busy obstetric unit with increased demand of epidural analgesia, patient controlled epidural analgesia with basal continuous infusion may be preferred. (springermedizin.de)
- Comparison of midwife top-ups, continuous infusion and patient controlled epidural analgesia for maintaining mobility after a low-dose combined spinal epidural. (springermedizin.de)
- patient controlled epidural analgesia patient controlled analgesia in which a narcotic or local anesthetic is administered into the epidural space via a catheter. (thefreedictionary.com)
- The authors studied the efficacy of sufentanil patient-controlled epidural analgesia (PCEA) for postoperative analgesia after cesarean delivery and compared these results to a morphine intravenous-patient-controlled-analgesia (IV-PCA) regimen. (elsevier.com)
- The purpose of this investigation is to determine whether analgesia provided by Patient Controlled Epidural Analgesia (PCEA) is more effective than Continuous Epidural Infusion Analgesia (CEIA) in patients undergoing major abdominal surgery. (isrctn.com)
- Patient-controlled epidural analgesia (PCEA) is a related term describing the patient-controlled administration of analgesic medicine in the epidural space , by way of intermittent boluses or infusion pumps. (wikipedia.org)
Infusion27
- This article provides an overview of the use of epidural infusion analgesia in the management of patients with post-operative pain. (ebscohost.com)
- However, all cases of peroneal nerve palsy with motor deficits and partial neurologic recovery occurred in patients receiving postoperative epidural analgesia and were diagnosed after discontinuation of the epidural infusion. (nih.gov)
- The objectives of this study will be to compare epidural infusion management, specifically looking at infusion rate changes, in patients who receive forceps deliveries versus normal spontaneous vaginal deliveries. (bioportfolio.com)
- Patients who require a decrease in their basal labor analgesia epidural infusion rate will have an increased incidence of forceps delivery. (bioportfolio.com)
- The primary endpoint is to evaluate if decreasing the epidural infusion rate was associated with a forceps delivery. (bioportfolio.com)
- To evaluate whether maintaining a motor-sparing epidural analgesia infusion affects the duration of the second stage of labor in nulliparous parturients compared with a placebo control. (ovid.com)
- Maintaining the infusion of epidural medication had no effect on the duration of the second stage of labor compared with a placebo infusion. (ovid.com)
- PCEA has become the standard method of epidural pain relief in some centres, or is offered as an alternative to continuous infusion. (anaesthesiauk.com)
- Influence of naloxone infusion on analgesia and respiratory depression following epidural morphine. (lu.se)
- The influence of two different concentrations of iv naloxone infusion on the analgesia and adverse effects of epidural morphine were compared in a double-blind, placebo-controlled study. (lu.se)
- However, naloxone infusion at the rate of 10 micrograms X kg-1 X h-1 reduced the duration of analgesia by about 25%, and more frequent injections of epidural morphine were required to give effective analgesia. (lu.se)
- Continuous epidural infusion offers the distinct advantage of providing steady-state analgesia when compared with single-injection administration or intermittent boluses, especially when short-acting opioids are used for infusion. (oncologynurseadvisor.com)
- Patients then begin an epidural infusion of ropivacaine hydrochloride and fentanyl immediately after surgery (postoperative day 0). (knowcancer.com)
- Arm I: Patients continue to receive the epidural infusion until they can be weaned to oral pain medication. (knowcancer.com)
- Arm II: Patients undergo daily weaning of the fentanyl concentration of the epidural infusion. (knowcancer.com)
- In both groups, the Gynecologic Oncology pain service may make adjustments to the epidural infusion or PCA for optimal pain management until the patient can be weaned to oral pain medication. (knowcancer.com)
- 420 patients undergoing elective CABG surgery Standard GA with 72hrs narcotic analgesia v standard GA with 96hrs TEA Elective CABG pts with normal preoperative coagulation status Epidurals inserted at T2/3 or T3/4 in OR immediately preoperatively operation postponed if "bloody tap" obtained Bilateral T1-T10 block instituted with Bupivacaine 0.5% and maintained with Bupivacaine / Clonidine infusion perioperatively +/- additional Bupivacaine top-ups postop. (bestbets.org)
- Efficacy of postoperative patient-controlled and continuous infusion epidural analgesia versus intravenous patient-controlled analgesia with opioids: a meta-analysis. (springermedizin.de)
- Continuous compared with intermittent epidural infusion on progress of labor and patient satisfaction. (springermedizin.de)
- Finegold H, Mandell G, Ramanathan S. Comparison of ropivacaine.1%-fentanyl and bupivacaine.125%-fentanyl infusion for epidural labor analgesia. (springermedizin.de)
- Sia AT, Lim Y, Ocampo C. A comparison of basal infusion with automated mandatory boluses in parturient-controlled epidural analgesia during labor. (springermedizin.de)
- Unpredictability of regression of analgesia during the continuous postoperative extradural infusion of bupivacaine. (semanticscholar.org)
- This knowledge would allow acute pain services to plan either to provide PCEA as a routine service, or to confine their services to continuous infusion epidural analgesia. (isrctn.com)
- [10] The Analgizer was widely utilized for analgesia and sedation until the early 1970s, in a manner that foreshadowed the patient-controlled analgesia infusion pumps of today. (wikipedia.org)
- Epidural anesthesia can be continued for longer duration during longer surgeries by either giving top ups of local anesthetics or by continuous infusion of local anesthetics by infusion pumps. (wikipedia.org)
- When a catheter is placed into the epidural space (see below) a continuous infusion can be maintained for several days, if needed. (wikipedia.org)
- An epidural injection or infusion for pain relief (e.g. in childbirth) is less likely to cause loss of muscle power, but has to be augmented to be sufficient for surgery. (wikipedia.org)
PCEA6
- In this study, 37 pregnant women with a single fetus, who had labor analgesia, were divided into groups of PCIVA (Group 2) and PCEA (Group 1). (nih.gov)
- PCEA is the gold standard in labor analgesia. (nih.gov)
- Satisfactory epidural blockade must be established before the PCEA regimen is instituted. (anaesthesiauk.com)
- PCEA is a useful and safe alternative for labour analgesia, provided that bolus doses of dilute local anaesthetic are small, that the lockout period and hourly maximum dose are appropriate and that the mother is regularly assessed by the labour ward anaesthetist. (anaesthesiauk.com)
- Fifty patients were randomized into two groups to receive sufentanil PCEA or morphine IV-PCA after cesarean delivery under epidural anesthesia. (elsevier.com)
- Although sufentanil PCEA provided satisfactory sustained postoperative analgesia, sufentanil PCEA appears to offer no clear advantage over morphine IV-PCA beyond the effects of the initial physician-administered loading dose. (elsevier.com)
Benefits of epidural analgesia3
- This study will address the potential benefits of epidural analgesia on multiple measurements of postoperative recovery. (knowcancer.com)
- Could benefits of epidural analgesia following oesophagectomy be measured by perceived perioperative patient workload? (diva-portal.org)
- Therefore, it is critical to quantify the real benefits of epidural analgesia over other modes of pain treatment. (northwestern.edu)
Analgesic17
- A meta-analysis that included 8 studies (232 patients) did not demonstrate significant benefit of epidural analgesia on mortality, ICU, and hospital length of stay compared with other analgesic modalities in adult patients with traumatic rib fractures. (medscape.com)
- The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. (curehunter.com)
- Both commonly used pharmacological options for pain relief during labour - epidural and opioid analgesic options - have advantages and disadvantages. (who.int)
- A controversy exists whether beneficial analgesic effects of epidural analgesia over intravenous analgesia influence the rate of post-operative complications and the length of hospital stay. (diva-portal.org)
- Higher costs and better analgesic effects of epidural analgesia compared with intravenous analgesia do not reduce total costs for post-operative care following major surgery. (diva-portal.org)
- For the patient selected for epidural analgesia administration, an appropriately placed and functioning epidural catheter can produce pain relief that is superior to other routes of analgesic administration. (oncologynurseadvisor.com)
- In this prospective, double-blind, randomized experimental study the analgesic, physiologic, and behavioral effects of the epidural administration of tiletamine/zolazepam in horses are evaluated. (vetcontact.com)
- A variety of neuraxial (primarily epidural) and peripheral regional analgesic techniques may be employed for the effective treatment of postoperative pain. (omicsonline.org)
- This blinded, randomised experimental study was designed to compare the analgesic effects of lumbosacral epidural administration of lidocaine-epinephrine or lidocaine-xylazine combinations in fat-tailed sheep. (scielo.org.za)
- Therefore, the objective of the study reported here was to evaluate the analgesic efficacy of lidocaine-epinephrine or lidocaine-xylazine combinations following lumbosacral epidural administration in fat-tailed sheep. (scielo.org.za)
- They write, 'The findings…highlight that fact that both CSE and epidural analgesia are an excellent analgesic option during labor. (iars.org)
- Early initiation of epidural analgesic infusions (before HIPEC) was associated with significantly less surgical blood loss and fluid requirements ( P = 0.005 and 0.02, respectively). (springermedizin.de)
- Epidural local anaesthetics versus opioid-based analgesic regimens on postoperative gastrointestinal paralysis, PONV and pain after abdominal surgery. (springermedizin.de)
- epidural analgesia analgesia induced by introduction of the analgesic agent into the epidural space of the vertebral canal. (thefreedictionary.com)
- Neuraxial analgesia in the form of a labour epidural has been shown to be the most effective analgesic strategy for the labouring mother. (sun.ac.za)
- Conclusion Epidural analgesia, regardless of analgesic agent, location of catheter placement, and type and time of pain assessment, provided better postoperative analgesia compared with parenteral opioids. (jamanetwork.com)
- The epidural route is frequently employed by certain physicians and nurse anaesthetists to administer diagnostic (e.g. radiocontrast agents ) and therapeutic (e.g., glucocorticoids ) chemical substances, as well as certain analgesic and local anaesthetic agents. (wikipedia.org)
Anesthesia and Analgesia2
- These statements present the safety, efficacy, and risks of neuraxial anesthesia and analgesia based on the timing of needle insertion and catheter removal in relation to the time anticoagulants are administered. (oncologynurseadvisor.com)
- A prospective randomized study of the potential benefits of thoracic epidural anesthesia and analgesia in patients undergoing coronary artery bypass grafting. (springermedizin.de)
Opioid analgesia4
- An additional finding was that Apgar scores at one minute were lower in the neonates whose mothers had been given systemic opioid analgesia. (medpagetoday.com)
- To compare efficacy of tramadol injection as an opioid analgesia versus epidural analgesia on governing labor pain, progress and outcomes (maternal and fetal). (omicsonline.org)
- Epidural analgesia appears to be the more effective pain relief option but compared with opioid analgesia it also requires more resources to implement and to manage its adverse effects, which are more common with epidural analgesia. (who.int)
- Forceps delivery and the use of synthetic opioid analgesia during epidural anaesthesia. (afar.info)
Incidence18
- However, our analyses of Medicare patients undergoing lower-risk procedures (e.g., total hip and total knee replacement) showed that the use of postoperative epidural analgesia was not associated with a lower incidence of mortality and major morbidity [ 9 , 10 ]. (hindawi.com)
- Nevertheless, concern persists that the initiation of regional analgesia in early labor will result in a higher incidence of cesarean delivery than does its initiation during a later stage. (medpagetoday.com)
- Labor epidural top up for cesarean section can fail, the incidence of which has been reported to range from 0% to 21% [ 4 ]. (hindawi.com)
- Studies have shown increased incidence of severe vaginal lacerations (third and fourth degree) in women under the influence of epidural analgesia. (jabfm.org)
- Differences in postoperative pain, incidence of patient-controlled analgesia (PCA)-related adverse effects, and risk factors for the need for rescue analgesics for 48 hours postsurgery in young (age 20-39 years) and elderly (age ≥70 years) patients were evaluated. (dovepress.com)
- While younger patients exhibited greater incidence of numbness, motor weakness, and discontinuation of PCA postsurgery, elderly patients exhibited greater incidence of hypotension, nausea/vomiting, rescue analgesia, and antiemetic administration. (dovepress.com)
- A recent meta-analysis of 4 studies post-1990 which involved more than 1 million obstetric patients found an incidence of 1 in 168,000, but with only 6 epidural hematomas the accuracy of this estimate cannot be relied upon. (oncologynurseadvisor.com)
- Theoretically epidural ropivacain combined with oral oxycodone could decrease the incidence of these side effects. (diva-portal.org)
- Incidence of epidural catheter-associated infections after continuous epidural analgesia in children. (harvard.edu)
- Despite controversies and concerns, more rapid onset of analgesia, early bilateral sacral analgesia, lower incidence of asymmetric block and fewer maternal and fetal side effects are provided with DPE when compared to epidural. (springer.com)
- The authors concluded that preemptive thoracic epidural analgesia (TEA) appeared to reduce the severity of acute post-operative pain compared with TEA initiated after completion of surgery for patients undergoing unilateral thoracotomy, but did not affect the incidence of chronic post-thoracotomy pain. (york.ac.uk)
- To determine whether preemptive thoracic epidural analgesia (TEA) initiated before surgical incision reduces the severity of acute post-thoracotomy pain and incidence of chronic post-thoracotomy pain compared with TEA initiated after completion of surgery. (york.ac.uk)
- Epidural analgesia on top of general anesthesia in cardiac surgery might improve relevant clinical outcomes but the incidence of epidural hematoma is under-reported. (biomedcentral.com)
- Out of the 66 randomized and case-matched studies, 57 trials reported the incidence of all-cause mortality at the longest available follow-up with a significant reduction in the epidural group (59/3,137 (1.9%) in the epidural group vs. 108/3,246 (3.3%) in the control arm, RR 0.64 (95% CI 0.48 to 0.85), P = 0.002, NNT = 69). (biomedcentral.com)
- Epidural analgesia on top of general anesthesia in cardiac surgery might reduce the incidence of all-cause mortality (NNT 69). (biomedcentral.com)
- The incidence of epidural hematoma in this setting is 1:3,436 (95% CI = 1:2,325 to 1:5,076) including both published and unpublished data. (biomedcentral.com)
- This audit revealed a low incidence of labour epidural analgesia at RMMCH during the study period. (sun.ac.za)
- The incidence of subdural injection ranges between 0.024% reported by Jenkins in 145550 epidurals [ 1 ] to 0.82% reported by Lubenow, et al. (clinmedjournals.org)
Obstetric8
- Introduction: Remifentanil has an attractive pharmacological profile for use in obstetric analgesia as a technique for mass application, with similar benefits and satisfaction as epidural analgesia. (ebscohost.com)
- Other surveys have found no cases in more than 700,000 obstetric epidural procedures. (oncologynurseadvisor.com)
- A novel approach called dural puncture epidural (DPE) which is a modification of CSE in terms of practice has gained popularity after its description and use in the obstetric population. (springer.com)
- 369 women (mean age 24 y) at first pregnancy who were in spontaneous full-term labor had a normal obstetric and medical history, had no contraindication to either form of analgesia, were willing to participate, and had continued eligibility at time of labor. (acpjc.org)
- OBJECTIVE: To verify whether the use of sufentanil during obstetric epidural anaesthesia (EA) was accompanied by an increase in the rate of instrumental extraction. (afar.info)
- To report a rare case of Pourfour du Petit Syndrome (PDPS), presenting clinically as Subdural Block (SDB), as a complication of Obstetric Epidural Analgesia (OEA). (clinmedjournals.org)
- Obstetric Epidural Analgesia (OEA) is presently considered to be one of the most effective and commonly utilized techniques for providing pain relief during labor and delivery. (clinmedjournals.org)
- In obstetric patients, regional analgesia refers to partial or complete loss of pain sensation below the T8 to T10 spinal level. (medscape.com)
Local anesthetic8
- If the sensory block level was higher or unilateral, then a lower dose of intrathecal local anesthetic was selected and alternative options such as combined-spinal epidural and general anesthesia were increasingly favored. (hindawi.com)
- If a cesarean delivery is needed in a parturient with an existing labor epidural, it is common practice to convert or "top up" the epidural catheter [ 2 ], with the aim of initiating surgical anesthesia by injecting more concentrated local anesthetic, usually combined with a lipid soluble opioid. (hindawi.com)
- The loosely packed epidural fat may facilitate the spread of local anesthetic and help achieve a quicker block onset. (nysora.com)
- Since most pediatric patients receive epidural analgesia in conjunction with a general anesthetic, the main purpose of the epidural catheter is to deliver enough local anesthetic solution for effective intraoperative and postoperative analgesia. (nysora.com)
- As with epidural anesthesia in adults, local anesthetic concentration and volume are important factors in determining the density and level of blockade. (nysora.com)
- 4. The use of a dilute concentration of local anesthetic for continuous epidural analgesia should not result in a dense motor block, aiding diagnosis in patients who develop symptoms of an epidural hematoma. (oncologynurseadvisor.com)
- A low concentration of epidural local anesthetic does not affect the duration of the second stage of labor. (ovid.com)
- In this technique, local anesthetic and pain medications are injected into the epidural space-inside the membranes (dura) covering the spinal cord. (iars.org)
Complications12
- We will review our group's work on perioperative epidural anesthesia-analgesia on patient outcomes which includes mortality, major morbidity, and patient centered outcomes but not technical failures or complications. (hindawi.com)
- To avoid complications and preserve as much motor function as possible, the lowest possible effective concentration of local anaesthetic should be used when administering epidural analgesia (1). (who.int)
- Conclusions TEA provided superior analgesia following TA-TAVI, and was associated with a dramatic reduction in periprocedural respiratory complications, and both, short- and long-term mortality. (bmj.com)
- No significant thoracic epidural related complications occurred. (koreamed.org)
- Epidural blockade can reduce such complications ( 2 ). (acpjc.org)
- The perioperative coagulopathy, hemodynamic instability, and infectious complications that may occur during cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has raised concerns about the safety of epidural analgesia in patients undergoing such procedures. (springermedizin.de)
- We reviewed epidural-related complications and analyzed the effect of early initiation of continuous epidural analgesia on estimated blood loss, intraoperative fluid administration, blood transfusion and vasopressor requirements, time to extubation, and length of stay. (springermedizin.de)
- Even if from the public health point of view the benefits seem to encourage the use of epidural analgesia in cardiac surgery with a possible reduction in perioperative mortality, this topic merits further investigation and the decision to insert the epidural catheter should be discussed with the patient considering both local experience and legal dispute in case of medical complications. (biomedcentral.com)
- Thoracic epidural analgesia (TEA) is associated with greater pain control, lower need for narcotics, and fewer complications after hepatopancreatobiliary (HPB) surgery compared with intravenous patient-controlled analgesia (IV-PCA), according to results of a randomized controlled trial published in the Annals of Surgery . (clinicalpainadvisor.com)
- However, epidural analgesia has sometimes been associated with rare but serious complications. (northwestern.edu)
- During epidural administration, there are four possible sites into which an epidural catheter or needle may be unintentionally placed, causing complications: The subdural [ 1 , 2 ], intradural [ 3 , 4 ], subarachnoid and intravascular spaces. (clinmedjournals.org)
- Continuous thoracic epidural analgesia (C-TEA) allows earlier postoperative mobilisation of patients and decreases the rate of complications. (viamedica.pl)
Systemic17
- Women in the other group received systemic hydromorphone at the first request for pain relief and epidural analgesia at either a cervical dilation of 4 cm or at the third request for analgesia. (medpagetoday.com)
- The median time from the initiation of analgesia to complete dilation (and also to vaginal delivery) was significantly shorter after intrathecal analgesia was administered than it was after systemic analgesia was administered. (medpagetoday.com)
- Pain scores after the first intervention were significantly lower following intrathecal analgesia than they were following systemic analgesia. (medpagetoday.com)
- Moreover, they noted, epidural analgesia provides better pain relief than systemic analgesia and is also more effective than systemic analgesia in shortening the duration of labor. (medpagetoday.com)
- Epidural analgesia provides a reliable and excellent analgesia during childbirth without resulting in concomitant maternal or foetal central depression seen with systemic opioids. (healthengine.com.au)
- 1984) Postthoracotomy pain and pulmonary function following epidural and systemic morphine. (springer.com)
- This protocol avoids epidural analgesia, systemic opioids and nerve blockade. (hss.edu)
- In general, these techniques can provide superior analgesia (especially when local anesthetics are used) compared with systemic opioids and use of these techniques can even reduce morbidity and mortality. (omicsonline.org)
- 2 The alpha 2 -agonists can be absorbed from the epidural space and have systemic effects (sedation and cardiopulmonary depression) that are most obvious in the ruminants because of their increased sensitivity to this group of drugs. (scielo.org.za)
- There are numerous pain management options for VATS, including non-steroidal anti-inflammatory drugs (NSAIDs), epidural analgesia, systemic opioids, paravertebral block (PVB), patient-controlled analgesia (PCA), and surgical wound infiltration. (isrctn.com)
- Epidural anesthesia is contraindicated in patients receiving systemic anticoagulation and antiplatelet therapy, e.g., aspirin products or NSAIDs, patients with abnormal or reduced concentrations of clotting factors, patients in hypovolemic shock, with abruptio placentae, and whenever there is evidence of active infection near the site of the insertion of the epidural catheter. (thefreedictionary.com)
- Compared with systemic analgesia alone, epidural analgesia may offer better pain control. (northwestern.edu)
- Objectives To assess the effectiveness and safety of epidural analgesia compared with systemic analgesia for acute postoperative pain control after thoraco-lumbar spine surgery in children. (northwestern.edu)
- Selection criteria We included all randomized controlled trials performed in children undergoing any type of thoraco-lumbar spine surgery comparing epidural analgesia with systemic analgesia for postoperative pain. (northwestern.edu)
- Main results We included 11 trials (559 participants) in the review, and seven trials (249 participants) in the analysis: 140 participants received epidural analgesia and 109 received systemic analgesia. (northwestern.edu)
- Compared with systemic analgesia, epidural analgesia reduced pain at rest at all time points. (northwestern.edu)
- Only opioids could be used for labor analgesia in these situations, as they do not decrease systemic vascular resistance. (medscape.com)
Intravenous patient-controlle2
- Labor analgesia: Comparison of epidural patient-controlled analgesia and intravenous patient-controlled analgesia]. (nih.gov)
- It has been demonstrated that paravertebral block, which resulted in lower cumulative dezocine doses and produced fewer side effects than intravenous patient-controlled analgesia, can provide effective pain relief for patients undergoing video-assisted thoracic surgery. (isrctn.com)
Outcomes4
- The use of perioperative epidural anesthesia-analgesia may confer many benefits including superior postoperative analgesia, decreased morbidity, and improvement in patient-centered outcomes. (hindawi.com)
- Further research may be helpful to evaluate rare but potentially severe adverse effects of epidural analgesia on women in labour and long-term neonatal outcomes. (nih.gov)
- For management of labor pain, how does epidural analgesia compare with nonepidural pain control or no analgesia in terms of maternal and newborn outcomes? (aafp.org)
- Objective To determine the impact of perioperative thoracic epidural analgesia (TEA) on acute and late outcomes following transapical transcatheter aortic valve implantation (TA-TAVI). (bmj.com)
Spinal analgesia5
- Wong CA. Epidural and spinal analgesia for labor and vaginal delivery. (springer.com)
- To achieve epidural analgesia or anaesthesia, a larger dose of drug is typically necessary than with spinal analgesia or anaesthesia. (wikipedia.org)
- The onset of analgesia is slower with epidural analgesia or anaesthesia than with spinal analgesia or anaesthesia. (wikipedia.org)
- An indwelling catheter is more commonly placed in the setting of epidural analgesia or anaesthesia than with spinal analgesia or anaesthesia. (wikipedia.org)
- Possible regional anesthesia techniques include epidural analgesia, spinal analgesia (sometimes referred to as the intrathecal or subarachnoid space), or a combination of epidural and spinal analgesia. (medscape.com)
Catheters4
- This is a study comparing pain control utlilizing one or two epidural catheters, along with a hydromorphone PCA, for analgesia following surgery for correction of scoliosis. (clinicaltrials.gov)
- Precise placement of epidural needles for single-injection techniques and catheters for continuous epidural anesthesia ensures that the dermatomes involved in the surgical procedure are selectively blocked, allowing for lower doses of local anesthetics to be used and sparing unnecessary blockade in nondesired regions. (nysora.com)
- It may also allow the unimpeded advancement of epidural catheters from the caudal epidural space to the lumbar and thoracic levels. (nysora.com)
- Through an anonymous, web-based, viral, international survey, we identified at least 16 further nonpublished epidural hematomas together with at least 72,400 epidural analgesia catheters positioned in cardiac surgery in the last 20 years. (biomedcentral.com)
Opioids7
- There are different types of analgesia used in epidural analgesia, for instant the local anaesthetics and or opioids. (healthengine.com.au)
- Lipophilic (fat soluble) opioids, such as fentanyl, are able to penetrate the dura or the arachnoid membranes and spinal tissues resulting in a rapid onset of analgesia, but a limited duration. (healthengine.com.au)
- Cousins MJ, Mather LE (1984) Intrathecal and epidural administration of opioids. (springer.com)
- Single-injection or intermittent epidural bolus requires the use of longer-acting opioids (e.g. preservative-free morphine) to achieve a realistic duration of analgesia. (oncologynurseadvisor.com)
- Context Whether epidural analgesia is a better method than parenteral opioids for postoperative pain control remains controversial. (jamanetwork.com)
- Objective To systematically review the efficacy of postoperative epidural analgesia vs parenteral opioids, the primary alternative technique. (jamanetwork.com)
- Study Selection Inclusion criteria were a comparison of epidural therapy vs parenteral opioids for postoperative analgesia, measurement of pain using a visual analog scale (VAS) or numeric rating scale, randomization of patients to either therapy, and adult patients (≥18 years). (jamanetwork.com)
Methods7
- However, reassure them that several other randomized, controlled trials have convincingly demonstrated that regional analgesia during labor as compared with other methods of pharmacologic pain relief, does not necessarily increase the risk of cesarean delivery. (medpagetoday.com)
- Over the past decade, however, several studies, involving many thousands of patients, have convincingly demonstrated that regional analgesia during labor, as compared with other methods of pharmacologic pain relief, does not necessarily increase the risk of cesarean delivery. (medpagetoday.com)
- We investigated the effect of epidural analgesia after median sternotomy METHODS: Fifty-six patients were randomized to epidural patient controlled analgesia (PCA) or conventional analgesia (control). (koreamed.org)
- Studies comparing TEA only to nonepidural methods of analgesia were excluded from the review, as were studies that examined the effects of lumbar epidural analgesia for upper abdominal surgery. (york.ac.uk)
- Methods: The study was a randomized, double-blind, controlled trial of parous women at greater than 38 weeks gestation who planned to breastfeed, had successfully breastfed a prior infant, and who received neuraxial labor analgesia. (northwestern.edu)
- Laboring patients must be educated about the different available methods of labor analgesia. (medscape.com)
- Many pharmacological and nonpharmacological methods of labor analgesia have been adopted over the years. (medscape.com)
Onset6
- The onset of analgesia was relatively rapid in Group 2 followed by Group 3 then Group 1. (curehunter.com)
- The lockout time ensures that the drug has had enough time to work before the next dose is given, because there is usually a lag of 5-10 minutes between delivery of drug into the epidural catheter and onset of effect. (anaesthesiauk.com)
- 1. Time of onset of analgesia in minutes: It was recorded a interval between the time of injection into the epidural space and development of loss of sensation to pin prick. (thefreelibrary.com)
- 4. Duration of analgesia: This was measured as the interval between onset of analgesia and regression of analgesia by 2 segments or when the patient complained of pain, whichever occurred first. (thefreelibrary.com)
- Wilson SH, Wolf BJ, Bingham K, Scotland QS, Fox JM, Woltz EM, Hebbar L. Labor analgesia onset with dural puncture epidural versus traditional epidural using a 26-Gauge Whitacre needle and 0.125% bupivacaine bolus: a randomized clinical trial. (springer.com)
- A CSE technique provides more rapid onset of analgesia and more first-stage analgesia compared with a traditional epidural technique,' concludes the new study, led by Dr David Gambling of Sharp Mary Birch Hospital for Women and Newborns, San Diego, Calif. (iars.org)
Post-operative analgesia1
- For post-operative analgesia, after an operation where the epidural technique is employed as the sole anaesthetic, or in conjunction with general anaesthesia. (wikipedia.org)
Thoracic epidural anesthesia3
- A letter to the editor is presented about a study on the efficacy and safety of thoracic epidural anesthesia after abdominal surgery for acute post-operative pain. (ebscohost.com)
- Combination of Thoracic Epidural Anesthesia Does Not Always Induce Hypothermia during General Anesthesia. (ebscohost.com)
- The article presents a study about the effect of the combination of general anesthesia and thoracic epidural anesthesia, which has been considered to induce hypothermia. (ebscohost.com)
Pain89
- A quiz concerning the use of epidural analgesia for pain management is presented. (ebscohost.com)
- A Study of Pain Management during Labour by Epidural V/S Pentazocine & Tramadol. (ebscohost.com)
- Early Post operative Pain Management and Early Extubation after Off-pump Coronary Artery Bypass Graft Surgery is better managed with Thoracic Epidural Analgesia. (ebscohost.com)
- Preperitoneal catheter analgesia is an effective method for pain management after colorectal surgery: the results of 100 consecutive patients. (ebscohost.com)
- Remifentanil vs. epidural analgesia for the management of acute pain associated with labour. (ebscohost.com)
- Comparison of transversus abdominis plane block and epidural analgesia for pain relief after surgery. (ebscohost.com)
- Objectives: To compare the effects of different labor analgesia in controlling childbirth pain and seek more effective and reliable pain management strategy during natural childbirth in order to reduce maternal pain and promote natural childbirth. (ebscohost.com)
- Use of epidural analgesia in post-operative pain management. (ebscohost.com)
- Epidural analgesia is an effective method for relieving pain and has minimal side effects. (ebscohost.com)
- In one group, the subjects received intrathecal (neuraxial) fentanyl at the first request for pain relief and epidural analgesia at the second request. (medpagetoday.com)
- Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain and is widely used as a form of pain relief in labour. (nih.gov)
- To assess the effects of all modalities of epidural analgesia (including combined-spinal-epidural) on the mother and the baby, when compared with non-epidural or no pain relief during labour. (nih.gov)
- Randomised controlled trials comparing all modalities of epidural with any form of pain relief not involving regional blockade, or no pain relief in labour. (nih.gov)
- Epidural analgesia appears to be effective in reducing pain during labour. (nih.gov)
- Epidural analgesia had no statistically significant impact on the risk of caesarean section, maternal satisfaction with pain relief and long-term backache and did not appear to have an immediate effect on neonatal status as determined by Apgar scores. (nih.gov)
- Why women prefer epidural analgesia during childbirth: the role of beliefs about epidural analgesia and pain catastrophizing. (greenmedinfo.com)
- CST, at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting™, in New Orleans, researchers will report findings which suggest remifentanil patient controlled analgesia is not equivalent to epidural analgesia for pain, pain appreciation scores, and overall satisfaction in women who request for pain relief during labor. (eurekalert.org)
- Remifentanil patient controlled analgesia (RPCA) is a short-acting pain reliever, an opiate, similar to pethidine. (eurekalert.org)
- It relieves pain rapidly, but also wears off very quickly, which makes it very suitable for administration through patient controlled analgesia. (eurekalert.org)
- Recent studies suggest that remifentanil patient controlled analgesia (RPCA) is equivalent to epidural analgesia (EA) with respect to pain appreciation (satisfaction with pain relief). (eurekalert.org)
- Following an uneventful delivery under epidural analgesia, a 17 year old female patient was referred to the Pain Clinic because of numbness and pain of the left big toe for 2 and a half Months. (scirp.org)
- An Orthopedic consultation had ruled out foot injury and concluded that the pain was radicular and secondary to nerve damage from the epidural analgesia. (scirp.org)
- B. Mansour, G. Wienecke, J. Cure, J. Almon and A. Armendi, "Myofascial Foot Pain Following Uneventful Epidural Analgesia for Labor and Delivery," Open Journal of Anesthesiology , Vol. 2 No. 1, 2012, pp. 11-13. (scirp.org)
- L. C. Tsen and W. R. Camann, "Trigger Point Injections for Myofascial Pain During Epidural Analgesia for Labor," Regional Anesthesia, Vol. 22, No. 5, 1997, pp. 466-468. (scirp.org)
- Compared with other types of analgesia or no analgesia, epidurals offered better pain relief, but were associated with a longer second stage of labor and increased risk of instrumental vaginal delivery, maternal fever, and oxytocin (Pitocin) administration. (aafp.org)
- Epidural analgesia had no statistically significant impact on the risk of cesarean delivery, maternal satisfaction with pain relief, or long-term backache, and did not appear to have an immediate effect on neonatal status as determined by Apgar scores. (aafp.org)
- Epidural analgesia is an injection of local anaesthetic alone, or more commonly in combination with pain . (healthengine.com.au)
- Epidural analgesia provides complete motor (causing paralysis ) and sensory blockade (causing loss of sensation), around or near the site of pain. (healthengine.com.au)
- Investigators hypothesized that doula combined neuraxial (epidural) analgesia in the latent phrase would be a superior means for effective pain relief, decreased rate of cesarean section, and shortened duration of labor. (clinicaltrials.gov)
- To determine whether a difference in breastfeeding behaviors could be observed between newborns whose mothers received epidural analgesia for labor pain relief and those newborns whose mothers received no pain medication in labor. (nih.gov)
- One group was born to mothers who received epidural analgesia, and one group was born to mothers who received no pain medication for labor. (nih.gov)
- thoracic epidural analgesia represented the "gold standard" for post-thoracotomy pain relief in combination with intravenous analgesia. (curehunter.com)
- 1983) Epidural morphine for the relief of postoperative pain after Cesarean delivery. (springer.com)
- Saleh HS, Abdelsalam WA, Helal KF, Abdelhamid Attiya AM (2015) Tramadol Injection versus Epidural Analgesia in Controlling Labor Pain. (omicsonline.org)
- There were no significant differences.In the tramadol group, pain relief was excellent in 13.3%, good in 30.6% and average in 54.6% versus 29.3%, 48% and 22.6% in epidural group. (omicsonline.org)
- Epidural anesthesia and tramadol provided excellent pain relief in majority of the patients. (omicsonline.org)
- Epidural analgesia is becoming more commonly available 2 and provides superior pain relief compared with noninvasive musculoskeletal techniques or intravenous analgesics. (jabfm.org)
- 11 Analysis of results have concluded that epidural analgesia increases the likelihood of severe vaginal laceration by increasing the likelihood of OVD, 8 or that it reduces the likelihood of vaginal laceration as reduced pain results in a more controlled delivery. (jabfm.org)
- A systematic literature search identified a total of 20 empirical studies focused on women's decision‐making about epidural analgesia for labor pain. (ssrn.com)
- These data show that epidural fentanyl provides good to excellent pain relief with minimal side effects. (jaoa.org)
- Epidural analgesia is commonly used in addition to general anesthesia and to manage postoperative pain. (nysora.com)
- Effective postoperative pain relief from epidural analgesia has numerous benefits including earlier ambulation, facilitating weaning from ventilators, reducing time spent in a catabolic state, and lowering circulating stress hormone levels. (nysora.com)
- Epidural analgesia is recommended for healthy pregnant women requesting pain relief during labour, depending on a woman's preferences. (who.int)
- The GDG agreed that while there is limited evidence on the impact of epidural analgesia compared with no epidural analgesia for pain relief during labour, epidural analgesia is a proven method for relieving pain related to surgery, including abdominal surgery, and chose to recommend it as a pain relief option. (who.int)
- Health care professionals should be aware that women's desire for epidural analgesia might be moderated by the clinical context in which they receive antenatal and intrapartum care, whether labour is spontaneous or not, and their access to and knowledge of a range of other forms of pain relief measures. (who.int)
- All patients received catheter-based pain control, either via TEA (TEA group, n=74) or intercostal local analgesia with a catheter placed at the surgical incision site (non-TEA group, n=61), depending on the preference of the anaesthesiologist responsible for the case. (bmj.com)
- To relieve this pain, epidural analgesia is both the most effective and the safest technique. (centerwatch.com)
- These include patient autonomy in determining level of pain relief, more easily titrated sensory level with minimisation of drug dose, optimal analgesia with minimal side-effects, high patient satisfaction and a reduced demand on professional time. (anaesthesiauk.com)
- When the pain of contractions begins to be felt, she presses the button and a small amount of pain relieving medication is delivered via the epidural catheter. (anaesthesiauk.com)
- For total knee arthroplasty at HSS, femoral nerve blockade is commonly added to epidural analgesia, as this reduces pain with physical therapy. (hss.edu)
- HealthDay)-In the first stage of labor, a combined spinal-epidural technique provides faster and better pain relief compared to traditional epidural pain relief, a new study suggests. (medicalxpress.com)
- HealthDay)-Dual continuous epidural analgesia (CEA) is the most effective pain control method following surgery for adolescent idiopathic scoliosis, according to a study published in the Sept. 1 issue of Spine. (medicalxpress.com)
- Higher calculated costs of epidural vs. intravenous pain treatment, 1,037 vs. 410 Euros/patient, were outweighed by lower post-operative costs of intensive care 5,571 vs. 7,921 Euros/patient (NS). (diva-portal.org)
- Epidural analgesia with bupivacain, epinephrine and fentanyl provides excellent pain control after lumbar fusion surgery, but pruritus and motor block are frequent side effects. (diva-portal.org)
- Pruritus could be reduced with a combination of epidural ropivacain and oral oxycodone, at the price of a slightly higher pain level. (diva-portal.org)
- High thoracic epidural analgesia may reduce postoperative pain and improve the pulmonary function. (koreamed.org)
- This allows maximum analgesia using relatively small doses at the site where pain fibers enter the spinal cord. (oncologynurseadvisor.com)
- Epidural analgesia is a pharmacologic approach to pain management that should be considered following an appropriate assessment of a patient's pain. (oncologynurseadvisor.com)
- Anticoagulation, once considered a relative contraindication to the use of epidural analgesia, has been a focus for the American Society of Regional Anesthesia and Pain Medicine (ASRA), which has published consensus statements concerning regional anesthesia and anticoagulation. (oncologynurseadvisor.com)
- Determine whether the gradual weaning of an epidural opioid can shorten the duration of postoperative ileus, without worsening pain control, in patients who have undergone surgery for gynecologic cancer. (knowcancer.com)
- Compare postoperative pain management in patients treated with perioperative epidural analgesia vs patient controlled analgesia. (knowcancer.com)
- Patients choose between epidural analgesia or patient controlled analgesia (PCA) for perioperative pain management. (knowcancer.com)
- The day after surgery (postoperative day 1), patients are randomized (as long as there is adequate pain control) to 1 of 2 epidural management arms. (knowcancer.com)
- Comparison of continuous thoracic epidural analgesia with bilateral erector spinae plane block for perioperative pain management in cardiac surgery. (medworm.com)
- Efficacy and safety of thoracic epidural analgesia after major abdominal surgery for acute post-operative pain. (ebscohost.com)
- Epidural analgesia during labor is an effective method of relieving pain and has been used extensively since the mid-1970s, even in developing countries. (acpjc.org)
- Women in labor who request pain relief should be fully informed about the benefits and possible risks of their choice of analgesia ( 1 ). (acpjc.org)
- Postoperative epidural analgesia was associated with lower pain scores during the first 3 days after surgery. (acpjc.org)
- The epidural group in the study by Riggs and colleagues also had less postoperative pain, an important goal in itself. (acpjc.org)
- Newswise - San Francisco, CA. (February 27, 2013) - During the first stage of labor, a combined spinal-epidural (CSE) technique offers faster and better-quality analgesia (pain relief) compared to traditional epidural analgesia, according to a report in the March issue of Anesthesia & Analgesia , official journal of the International Anesthesia Research Society (IARS). (iars.org)
- The researchers compared CSE with epidural analgesia in 800 healthy women requiring pain control during labor. (iars.org)
- During the first stage of labor, the typical pain score was 1.4 for women receiving CSE versus 1.9 for those receiving standard epidural analgesia. (iars.org)
- Women in the CSE group also had a shorter time to complete pain control-an average of 11 minutes faster than the epidural group. (iars.org)
- Women in the CSE group were less likely to need additional epidural 'top-up' doses to maintain good pain control. (iars.org)
- Epidural analgesia has been used to provide labor pain relief for more than 40 years, with modern techniques providing better pain control with fewer side effects. (iars.org)
- Since the early 1990s, the CSE technique has become popular because it provides more rapid pain relief with less leg weakness-the main side effect of epidural analgesia. (iars.org)
- The results suggest that CSE provides significantly faster and better pain relief during the first stage of labor, compared to the traditional epidural technique. (iars.org)
- Participants in the second group receive thoracic epidural analgesia for pain relief and then undergo single intercostal VATS. (isrctn.com)
- However, epidural analgesia has been regarded as the gold standard for managing acute pain after thoracic surgery. (isrctn.com)
- This randomized study was designed to test whether paravertebral block has similar pain control when compared with epidural analgesia. (isrctn.com)
- continuous epidural analgesia continuous injection of an anesthetic solution into the sacral and lumbar plexuses within the epidural space to relieve the pain of childbirth, in general surgery to block the pain pathways below the navel, or to relieve chronic unremitting pain. (thefreedictionary.com)
- patient controlled analgesia (PCA) an apparatus used to relieve acute pain. (thefreedictionary.com)
- Patient-controlled extradural analgesia to compare bupivacaine, fentanyl and bupivacaine with fentanyl in the treatment of postoperative pain. (semanticscholar.org)
- Use of epidural analgesia in patients with critically acute pancreatitis may reduce 30-day mortality rates compared with the absence of a pain management strategy, according to a multicenter retrospective observational study published in Critical Care Medicine . (clinicalpainadvisor.com)
- Patient-controlled analgesia ( PCA [1] ) is any method of allowing a person in pain to administer their own pain relief . (wikipedia.org)
- For analgesia , 25% of animals in G4 had a pain score considered insufficient. (oatd.org)
- An epidural is a type of pain relief for women in labour or who are having a caesarean section. (gyno-talk.com)
- It usually takes between 5 and 30 minutes for your pain to be relieved by the epidural. (gyno-talk.com)
- Approximately 60% of laboring women (2.4 million each year) choose regional analgesia for pain relief during labor. (medscape.com)
Acute4
- This study was therefore designed to assess the impact of epidural analgesia on mortality in ICU patients with acute pancreatitis. (ovid.com)
- Among critically ill patients with acute pancreatitis, mortality at 30 days was lower in patients who received epidural analgesia than in comparable patients who did not. (ovid.com)
- These findings support ongoing research on the use of epidural analgesia as a therapeutic intervention in acute pancreatitis. (ovid.com)
- Indications for epidural anesthesia (EA) in the ICU include blunt trauma with or without rib fractures, thoracic, abdominal, orthopedic and vascular surgery, as well as nonsurgical problems such as intractable angina pectoris and acute pancreatitis. (oncologynurseadvisor.com)
Catheter placement3
- The success of an epidural analgesia catheter placement depends on the parturient position. (centerwatch.com)
- Identified factors for difficult epidural analgesia catheter placement were: non-palpable spinous processes, obesity, spine deformity, inability for the patient to maintain an adequate position and poor experience of the operator. (centerwatch.com)
- Contraindication to epidural catheter placement. (knowcancer.com)
Regional Anesthesia1
- Regional anesthesia is contraindicated in the presence of actual or anticipated serious maternal hemorrhage , refractory maternal hypotension, coagulopathy, untreated bacteremia , raised intracranial pressure, skin or soft tissue infection at the site of the epidural or spinal placement, and anticoagulant therapy. (medscape.com)
Standard care without epidural analgesia2
- The primary exposure was thoracic epidural analgesia versus standard care without epidural analgesia. (ovid.com)
- Patients receiving thoracic epidural analgesia (n=46) were compared with patients receiving standard care without epidural analgesia (n=957). (clinicalpainadvisor.com)
Abstract1
- Erel S, Gunaydin B. Neuraxial analgesia for labor: standard techniques versus novel approach (in Turkish with English abstract). (springer.com)
Analgesics3
- The included studies evaluated epidural analgesics inserted at the upper thoracic level. (york.ac.uk)
- Drugs for epidural anesthesia include anesthetics such as lidocaine, analgesics such as morphine, or steroids such as methylprednisolone acetate. (thefreedictionary.com)
- Analgesics are administered into the epidural space typically for a few days after surgery, provided a catheter has been inserted. (wikipedia.org)
Bolus1
- If analgesia is inadequate, the bolus dose and lockout interval can be adjusted, and/or extra local anaesthetic can be given. (anaesthesiauk.com)
Fentanyl for postoperative analgesia2
- 1991) Combination of epidural morphine and fentanyl for postoperative analgesia. (springer.com)
- A retrospective analysis of 133 patients who received continuous epidural fentanyl for postoperative analgesia is presented. (jaoa.org)
Efficacy3
- Objective: To assess the efficacy, equivalence and safety of remifentanil vs. epidural analgesia. (ebscohost.com)
- A twenty-year retrospective analysis of the efficacy of epidural analgesia-anesthesia when administered and/or managed by obstetricians. (afar.info)
- OBJECTIVE: The purpose of this study was to retrospectively determine the safety and efficacy of epidural anesthesia when administered by obstetricians in a community hospital. (afar.info)
Adverse effects of epidural1
- No studies reported on rare but potentially serious adverse effects of epidural analgesia. (nih.gov)
Influence of epidural analgesia1
- however, the influence of epidural analgesia on mortality remains under investigated in this setting. (ovid.com)
Association between epidural analgesia2
- 9 The association between epidural analgesia and vaginal laceration has been extensively studied. (jabfm.org)
- The researchers were unable to evaluate the association between epidural analgesia timing and clinical outcome. (clinicalpainadvisor.com)
Labour analgesia2
- Epidural is of course the best form of labour analgesia. (ebscohost.com)
- Aim is to find out an alternative method of labour analgesia where epidural is not a choice. (ebscohost.com)
Bupivacaine fentanyl1
- Combination of Bupivacaine-Clonidine was found to be a better option than Bupivacaine-Fentanyl for postoperative epidural analgesia in hip surgery patients. (omicsonline.org)
Vaginal delivery3
- The spontaneous vaginal delivery rate was also similar (epidural 193 [96.5%] compared with saline 198 [99%], P =.17). (ovid.com)
- Odds ratios were calculated to determine the associations of epidural anesthesia with oxytocin stimulation, episiotomy, assisted vaginal delivery (forceps or vacuum extraction), and cesarean section. (afar.info)
- Besides providing analgesia in labor, regional analgesia may facilitate atraumatic vaginal delivery of twins, preterm neonates, and neonates with breech presentation. (medscape.com)
Produced by epidural fentanyl1
- 1989) Effect of diluent on analgesia produced by epidural fentanyl. (springer.com)
General anesthesia combined with epidural5
- We investigated 64 consecutive patients undergoing gynecological laparotomy under general anesthesia combined with epidural. (ebscohost.com)
- The effect of general anesthesia combined with epidural analgesia on post-operative recovery was investigated to improve the therapeutic effectiveness of laparoscopic radical resection of rectal carcinoma. (alliedacademies.org)
- Patients accepting general anesthesia comprised the control group, and those accepting general anesthesia combined with epidural analgesia comprised the test group. (alliedacademies.org)
- The application of general anesthesia combined with epidural analgesia to patients who will undergo laparoscopic radical resection of rectal carcinoma leads to improved therapeutic effect and facilitates their recovery. (alliedacademies.org)
- Hence, administering general anesthesia combined with epidural analgesia is worthy of promotion and application. (alliedacademies.org)
Perioperative6
- However, the benefits of perioperative epidural anesthesia-analgesia are not definitive in part due to some of the methodological issues present in available studies. (hindawi.com)
- The overall effect of epidural anesthesia-analgesia on perioperative mortality is controversial. (hindawi.com)
- We have used a 5% nationally random sample of Medicare beneficiaries (1997-2001) to examine the association between the presence or absence of postoperative epidural analgesia and perioperative (7- and 30-day) mortality [ 6 - 10 ]. (hindawi.com)
- Subsequent analyses of the Medicare claims data also revealed that the presence of postoperative epidural analgesia may be associated with lower perioperative mortality in patients undergoing higher-risk surgical procedures (e.g., lung lobectomy, colectomy) [ 7 , 8 ]. (hindawi.com)
- The use of combined general and epidural anesthesia has developed concurrently with improvements in preoperative assessment and perioperative management. (acpjc.org)
- We conducted a retrospective review of the perioperative anesthetic management of 215 adult patients who had undergone CRS with HIPEC with epidural analgesia. (springermedizin.de)
Blockade5
- In the setting of a failed epidural top up, the most influential factors determining further anesthetic management were the category of cesarean section (92%), dermatomal level of blockade (78%), and the assessment of maternal airway. (hindawi.com)
- Bupivacaine is suitable for continuous epidural blockade. (healthengine.com.au)
- We propose to compare peri-articular injection to femoral nerve blockade and epidural PCA. (hss.edu)
- INTRODUCTION: Although the techniques of epidural analgesia do not offer the economy of the drug dosage of motor blockade of spinal anaesthesia, they are currently more versatile and better studied. (thefreelibrary.com)
- Other measures (e.g., β-blockade) may have more effect on outcome than epidural blockade. (acpjc.org)
Neuraxial analgesia3
- Accumulating evidence indicated that neuraxial analgesia in the latent phase of the first stage of labor would be an effective and safe health care procedure for nulliparas. (clinicaltrials.gov)
- Neuraxial analgesia techniques are not limited to just standard epidural and CSE blocks. (springer.com)
- DPE offers a favorable risk-benefit ratio for management of neuraxial analgesia as a novel option. (springer.com)
Cesarean12
- Some studies have consistently demonstrated a strong association between the use of epidural analgesia and an elevated risk of cesarean delivery. (medpagetoday.com)
- Based on their study, the researchers concluded that neuraxial administration of analgesia in early labor does not increase the rate of cesarean delivery when compared to later administration. (medpagetoday.com)
- Epidural analgesia is associated with an increased risk of cesarean delivery. (greenmedinfo.com)
- If conversion of labor epidural analgesia to cesarean delivery anesthesia fails, the anesthesiologist can be confronted with a challenging clinical dilemma. (hindawi.com)
- It obtained information on factors influencing the decision to utilize an existing labor epidural for cesarean section and, if epidural top up resulted in no objective sensory block, bilateral T10 sensory block, or unilateral T6 sensory block, factors influencing the management and selection of anesthetic technique. (hindawi.com)
- Most respondents (89%) would consider topping up an existing labor epidural for a category-one cesarean section. (hindawi.com)
- Our survey revealed variations in the clinical management of a failed epidural top up for cesarean delivery, suggesting guidelines to aid decision-making are needed. (hindawi.com)
- Between 2017 and 2018, over 100 000 emergency cesarean deliveries were carried out in England, 21% of which were undertaken with epidural anesthesia alone [ 1 ]. (hindawi.com)
- In view of the lack of consensus and guidance for what constitutes the most frequently or optimal considered practice in the setting of a failed labor epidural top up for cesarean delivery, we conducted a survey to assess current practice. (hindawi.com)
- 1990) Epidural sufentanil and morphine for post-cesarean delivery analgesia. (springer.com)
- Epidural analgesia is a routine procedure in cattle, used in various surgical procedures e.g. cesarean section, foreign body removement etc. (vetcontact.com)
- Purpose: Failed conversion of epidural labor analgesia (ELA) to epidural surgical anesthesia (ESA) for intrapartum Cesarean delivery (CD) has been observed in clinical practice. (eur.nl)
Morphine for postoperative analgesia1
- We conducted a retrospective study to determine whether bupivacaine or fentanyl is a better adjuvant to epidural morphine for postoperative analgesia using 108 patients. (springer.com)
Patients receivin1
- In this study, we aimed at comparing the post-operative costs of intensive care in patients receiving epidural or intravenous analgesia. (diva-portal.org)
Labor epidural analgesia2
- Successful neuraxial anesthesia conversion is a useful measure of quality and safety, indicating the prior presence of functional labor epidural analgesia and limiting the use of general anesthesia in obstetrics [ 3 ]. (hindawi.com)
- Gupta D, Srirajakalisindi A, Soskin V. Dural puncture epidural analgesia is not superior to continuous labor epidural analgesia. (springer.com)
Lumbar Epidural Analgesia1
- Corticosteroid Lumbar Epidural Analgesia for Radiculopathy (C.L.E.A.R. (clinicaltrials.gov)
Anaesthesia and analgesia3
- In: Veterinary Anaesthesia and Analgesia 31 (2), 79-85. (vetcontact.com)
- Thoracic epidural anaesthesia and analgesia. (ebscohost.com)
- Epidural anaesthesia and analgesia and outcome of major surgery: a randomised trial. (acpjc.org)