Analgesia: Methods of PAIN relief that may be used with or in place of ANALGESICS.Analgesia, Epidural: The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. It is differentiated from ANESTHESIA, EPIDURAL which refers to the state of insensitivity to sensation.Analgesia, Obstetrical: The elimination of PAIN, without the loss of CONSCIOUSNESS, during OBSTETRIC LABOR; OBSTETRIC DELIVERY; or the POSTPARTUM PERIOD, usually through the administration of ANALGESICS.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: Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.Pain, Postoperative: Pain during the period after surgery.Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle.Pain Measurement: Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.Bupivacaine: A widely used local anesthetic agent.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: A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)Analgesics: Compounds capable of relieving pain without the loss of CONSCIOUSNESS.Anesthesia, Epidural: Procedure in which an anesthetic is injected into the epidural space.Meperidine: A narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. Prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration.Labor Pain: Pain associated with OBSTETRIC LABOR in CHILDBIRTH. It is caused primarily by UTERINE CONTRACTION as well as pressure on the CERVIX; BLADDER; and the GASTROINTESTINAL TRACT. Labor pain mostly occurs in the ABDOMEN; the GROIN; and the BACK.Sufentanil: An opioid analgesic that is used as an adjunct in anesthesia, in balanced anesthesia, and as a primary anesthetic agent.Pain: An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS.Nerve Block: Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain.Injections, Spinal: Introduction of therapeutic agents into the spinal region using a needle and syringe.Labor, Obstetric: The repetitive uterine contraction during childbirth which is associated with the progressive dilation of the uterine cervix (CERVIX UTERI). Successful labor results in the expulsion of the FETUS and PLACENTA. Obstetric labor can be spontaneous or induced (LABOR, INDUCED).Anesthesia, Obstetrical: A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth.Amides: Organic compounds containing the -CO-NH2 radical. Amides are derived from acids by replacement of -OH by -NH2 or from ammonia by the replacement of H by an acyl group. (From Grant & Hackh's Chemical Dictionary, 5th ed)Anesthesia, Spinal: Procedure in which an anesthetic is injected directly into the spinal cord.Tramadol: A narcotic analgesic proposed for severe pain. It may be habituating.Double-Blind Method: A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.Analgesics, Non-Narcotic: A subclass of analgesic agents that typically do not bind to OPIOID RECEPTORS and are not addictive. Many non-narcotic analgesics are offered as NONPRESCRIPTION DRUGS.Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors.Cesarean Section: Extraction of the FETUS by means of abdominal HYSTEROTOMY.Postoperative Nausea and Vomiting: Emesis and queasiness occurring after anesthesia.Pain Threshold: Amount of stimulation required before the sensation of pain is experienced.Interpleural Analgesia: Injection of ANALGESICS; LOCAL ANESTHETICS; or NARCOTICS into the PLEURAL CAVITY between the two pleural membranes.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: A class of opioid receptors recognized by its pharmacological profile. Mu opioid receptors bind, in decreasing order of affinity, endorphins, dynorphins, met-enkephalin, and leu-enkephalin. They have also been shown to be molecular receptors for morphine.Anesthesia, General: Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.Conscious Sedation: A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines)Ketorolac: A pyrrolizine carboxylic acid derivative structurally related to INDOMETHACIN. It is an NSAID and is used principally for its analgesic activity. (From Martindale The Extra Pharmacopoeia, 31st ed)Labor Stage, First: Period from the onset of true OBSTETRIC LABOR to the complete dilatation of the CERVIX UTERI.Hydromorphone: An opioid analgesic made from MORPHINE and used mainly as an analgesic. It has a shorter duration of action than morphine.Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE.Pain Management: A form of therapy that employs a coordinated and interdisciplinary approach for easing the suffering and improving the quality of life of those experiencing pain.Anesthesia, Caudal: Epidural anesthesia administered via the sacral canal.Clonidine: An imidazoline sympatholytic agent that stimulates ALPHA-2 ADRENERGIC RECEPTORS and central IMIDAZOLINE RECEPTORS. It is commonly used in the management of HYPERTENSION.Anesthesia and Analgesia: Medical methods of either relieving pain caused by a particular condition or removing the sensation of pain during a surgery or other medical procedure.Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (RECEPTORS, N-METHYL-D-ASPARTATE) and may interact with sigma receptors.Femoral Nerve: A nerve originating in the lumbar spinal cord (usually L2 to L4) and traveling through the lumbar plexus to provide motor innervation to extensors of the thigh and sensory innervation to parts of the thigh, lower leg, and foot, and to the hip and knee joints.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: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Pirinitramide: A diphenylpropylamine with intense narcotic analgesic activity of long duration. It is a derivative of MEPERIDINE with similar activity and usage.Hypnotics and Sedatives: Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety.Butorphanol: A synthetic morphinan analgesic with narcotic antagonist action. It is used in the management of severe pain.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: A narcotic used as a pain medication. It appears to be an agonist at kappa opioid receptors and an antagonist or partial agonist at mu opioid receptors.Narcotic Antagonists: Agents inhibiting the effect of narcotics on the central nervous system.Anesthetics, Combined: The use of two or more chemicals simultaneously or sequentially to induce anesthesia. The drugs need not be in the same dosage form.Anesthesia, Conduction: Injection of an anesthetic into the nerves to inhibit nerve transmission in a specific part of the body.Thoracotomy: Surgical incision into the chest wall.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: A form of acupuncture with electrical impulses passing through the needles to stimulate NERVE TISSUE. It can be used for ANALGESIA; ANESTHESIA; REHABILITATION; and treatment for diseases.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: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief.Ketoprofen: An IBUPROFEN-type anti-inflammatory analgesic and antipyretic. It is used in the treatment of rheumatoid arthritis and osteoarthritis.Adjuvants, Anesthesia: Agents that are administered in association with anesthetics to increase effectiveness, improve delivery, or decrease required dosage.Placebo Effect: An effect usually, but not necessarily, beneficial that is attributable to an expectation that the regimen will have an effect, i.e., the effect is due to the power of suggestion.Morphine Derivatives: Analogs or derivatives of morphine.Hyperalgesia: An increased sensation of pain or discomfort produced by mimimally noxious stimuli due to damage to soft tissue containing NOCICEPTORS or injury to a peripheral nerve.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Anesthesia, Local: A blocking of nerve conduction to a specific area by an injection of an anesthetic agent.Periaqueductal Gray: Central gray matter surrounding the CEREBRAL AQUEDUCT in the MESENCEPHALON. Physiologically it is probably involved in RAGE reactions, the LORDOSIS REFLEX; FEEDING responses, bladder tonus, and pain.Nitrous Oxide: Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream.Pentazocine: The first mixed agonist-antagonist analgesic to be marketed. It is an agonist at the kappa and sigma opioid receptors and has a weak antagonist action at the mu receptor. (From AMA Drug Evaluations Annual, 1991, p97)Postoperative Care: The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)Dexmedetomidine: A imidazole derivative that is an agonist of ADRENERGIC ALPHA-2 RECEPTORS. It is closely-related to MEDETOMIDINE, which is the racemic form of this compound.Ambulatory Surgical Procedures: Surgery performed on an outpatient basis. It may be hospital-based or performed in an office or surgicenter.Hysterectomy: Excision of the uterus.Piperidines: A family of hexahydropyridines.Dose-Response Relationship, Drug: The relationship between the dose of an administered drug and the response of the organism to the 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.Pain, Intractable: Persistent pain that is refractory to some or all forms of treatment.Oxycodone: A semisynthetic derivative of CODEINE.Pain Perception: The process by which PAIN is recognized and interpreted by the brain.Injections, Epidural: The injection of drugs, most often analgesics, into the spinal canal without puncturing the dura mater.Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak anti-inflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage.Anesthesia, Intravenous: Process of administering an anesthetic through injection directly into the bloodstream.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: A local anesthetic that is similar pharmacologically to LIDOCAINE. Currently, it is used most often for infiltration anesthesia in dentistry.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: Delivery of the FETUS and PLACENTA under the care of an obstetrician or a health worker. Obstetric deliveries may involve physical, psychological, medical, or surgical interventions.Obstetric Labor Complications: Medical problems associated with OBSTETRIC LABOR, such as BREECH PRESENTATION; PREMATURE OBSTETRIC LABOR; HEMORRHAGE; or others. These complications can affect the well-being of the mother, the FETUS, or both.Neostigmine: A cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. Neostigmine, unlike PHYSOSTIGMINE, does not cross the blood-brain barrier.Nociceptive Pain: Dull or sharp aching pain caused by stimulated NOCICEPTORS due to tissue injury, inflammation or diseases. It can be divided into somatic or tissue pain and VISCERAL PAIN.Injections, Intravenous: Injections made into a vein for therapeutic or experimental purposes.Extraction, Obstetrical: Extraction of the fetus by means of obstetrical instruments.Dipyrone: A drug that has analgesic, anti-inflammatory, and antipyretic properties. It is the sodium sulfonate of AMINOPYRINE.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: A cylindrical column of tissue that lies within the vertebral canal. It is composed of WHITE MATTER and GRAY MATTER.Drug Administration Schedule: Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience.Subarachnoid Space: The space between the arachnoid membrane and PIA MATER, filled with CEREBROSPINAL FLUID. It contains large blood vessels that supply the BRAIN and SPINAL CORD.Narcotics: Agents that induce NARCOSIS. Narcotics include agents that cause somnolence or induced sleep (STUPOR); natural or synthetic derivatives of OPIUM or MORPHINE or any substance that has such effects. They are potent inducers of ANALGESIA and OPIOID-RELATED DISORDERS.Injections, Intra-Articular: Methods of delivering drugs into a joint space.Codeine: An opioid analgesic related to MORPHINE but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough.Nefopam: Non-narcotic analgesic chemically similar to ORPHENADRINE. Its mechanism of action is unclear. It is used for the relief of acute and chronic pain. (From Martindale, The Extra Pharmacopoeia, 30th ed, p26)Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Infusions, Intravenous: The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it.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.Perioperative Care: Interventions to provide care prior to, during, and immediately after surgery.Heroin: A narcotic analgesic that may be habit-forming. It is a controlled substance (opium derivative) listed in the U.S. Code of Federal Regulations, Title 21 Parts 329.1, 1308.11 (1987). Sale is forbidden in the United States by Federal statute. (Merck Index, 11th ed)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: Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.Administration, Rectal: The insertion of drugs into the rectum, usually for confused or incompetent patients, like children, infants, and the very old or comatose.Rats, Sprague-Dawley: A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.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: The period of emergence from general anesthesia, where different elements of consciousness return at different rates.Receptors, Opioid, kappa: A class of opioid receptors recognized by its pharmacological profile. Kappa opioid receptors bind dynorphins with a higher affinity than endorphins which are themselves preferred to enkephalins.Receptors, Opioid, delta: A class of opioid receptors recognized by its pharmacological profile. Delta opioid receptors bind endorphins and enkephalins with approximately equal affinity and have less affinity for dynorphins.ThiazinesInfusion 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: A 31-amino acid peptide that is the C-terminal fragment of BETA-LIPOTROPIN. It acts on OPIOID RECEPTORS and is an analgesic. Its first four amino acids at the N-terminal are identical to the tetrapeptide sequence of METHIONINE ENKEPHALIN and LEUCINE ENKEPHALIN.Enkephalin, Ala(2)-MePhe(4)-Gly(5)-: An enkephalin analog that selectively binds to the MU OPIOID RECEPTOR. It is used as a model for drug permeability experiments.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Abdomen: That portion of the body that lies between the THORAX and the PELVIS.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Injections, Intramuscular: Forceful administration into a muscle of liquid medication, nutrient, or other fluid through a hollow needle piercing the muscle and any tissue covering it.Dihydromorphine: A semisynthetic analgesic used in the study of narcotic receptors.Adrenergic alpha-Agonists: Drugs that selectively bind to and activate alpha adrenergic receptors.Nociception: Sensing of noxious mechanical, thermal or chemical stimuli by NOCICEPTORS. It is the sensory component of visceral and tissue pain (NOCICEPTIVE PAIN).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: Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture.Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.Enkephalins: One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla.Infusions, Parenteral: The administration of liquid medication, nutrient, or other fluid through some other route than the alimentary canal, usually over minutes or hours, either by gravity flow or often by infusion pumping.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: Compounds based on a partially saturated iminoethanophenanthrene, which can be described as ethylimino-bridged benzo-decahydronaphthalenes. They include some of the OPIOIDS found in PAPAVER that are used as ANALGESICS.Gynecologic Surgical Procedures: Surgery performed on the female genitalia.Behavior, Animal: The observable response an animal makes to any situation.Anesthesia, Dental: A range of methods used to reduce pain and anxiety during dental procedures.Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve.Doulas: Trained lay women who provide emotional and/or physical support during obstetric labor and the postpartum period for mothers and their partners.Labor Stage, Second: The period of OBSTETRIC LABOR that is from the complete dilatation of the CERVIX UTERI to the expulsion of the FETUS.Tolmetin: A non-steroidal anti-inflammatory agent (ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL) similar in mode of action to INDOMETHACIN.Piroxicam: A cyclooxygenase inhibiting, non-steroidal anti-inflammatory agent (NSAID) that is well established in treating rheumatoid arthritis and osteoarthritis and used for musculoskeletal disorders, dysmenorrhea, and postoperative pain. Its long half-life enables it to be administered once daily.Acupuncture Points: Designated locations along nerves or organ meridians for inserting acupuncture needles.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: Procedures used to treat and correct deformities, diseases, and injuries to the MUSCULOSKELETAL SYSTEM, its articulations, and associated structures.Acute Pain: Intensely discomforting, distressful, or agonizing sensation associated with trauma or disease, with well-defined location, character, and timing.Injections, Intraventricular: Injections into the cerebral ventricles.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: Procedure in which an individual is induced into a trance-like state to relieve pain. This procedure is frequently performed with local but not general ANESTHESIA.Epidural Space: Space between the dura mater and the walls of the vertebral canal.Postoperative Period: The period following a surgical operation.Arthroplasty, Replacement, Knee: Replacement of the knee joint.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: A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt.Heart Rate, Fetal: The heart rate of the FETUS. The normal range at term is between 120 and 160 beats per minute.Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug.Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Adrenergic alpha-2 Receptor Agonists: Compounds that bind to and activate ADRENERGIC ALPHA-2 RECEPTORS.Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses.Arthroscopy: Endoscopic examination, therapy and surgery of the joint.Cyclohexanecarboxylic AcidsSingle-Blind Method: A method in which either the observer(s) or the subject(s) is kept ignorant of the group to which the subjects are assigned.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: The use of specifically placed small electrodes to deliver electrical impulses across the SKIN to relieve PAIN. It is used less frequently to produce ANESTHESIA.Injections, Subcutaneous: Forceful administration under the skin of liquid medication, nutrient, or other fluid through a hollow needle piercing the skin.Vomiting: The forcible expulsion of the contents of the STOMACH through the MOUTH.Antiemetics: Drugs used to prevent NAUSEA or VOMITING.Drug Therapy, Combination: Therapy with two or more separate preparations given for a combined effect.Morphine Dependence: Strong dependence, both physiological and emotional, upon morphine.Parity: The number of offspring a female has borne. It is contrasted with GRAVIDITY, which refers to the number of pregnancies, regardless of outcome.Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.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.Tooth Extraction: The surgical removal of a tooth. (Dorland, 28th ed)Enkephalin, D-Penicillamine (2,5)-: A disulfide opioid pentapeptide that selectively binds to the DELTA OPIOID RECEPTOR. It possesses antinociceptive activity.Ketorolac Tromethamine: A pyrrolizine carboxylic acid derivative structurally related to INDOMETHACIN. It is a non-steroidal anti-inflammatory agent used for analgesia for postoperative pain and inhibits cyclooxygenase activity.Hot Temperature: Presence of warmth or heat or a temperature notably higher than an accustomed norm.Tonsillectomy: Surgical removal of a tonsil or tonsils. (Dorland, 28th ed)Intraoperative Care: Patient care procedures performed during the operation that are ancillary to the actual surgery. It includes monitoring, fluid therapy, medication, transfusion, anesthesia, radiography, and laboratory tests.Intraoperative Period: The period during a surgical operation.Enkephalin, Leucine: One of the endogenous pentapeptides with morphine-like activity. It differs from MET-ENKEPHALIN in the LEUCINE at position 5. Its first four amino acid sequence is identical to the tetrapeptide sequence at the N-terminal of BETA-ENDORPHIN.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.Drug Synergism: The action of a drug in promoting or enhancing the effectiveness of another drug.Catheterization, Peripheral: Insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes.Analysis of Variance: A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (ANTIBIOTIC PROPHYLAXIS) and anti-anxiety agents. It does not include PREANESTHETIC MEDICATION.Reaction Time: The time from the onset of a stimulus until a response is observed.

Maternal intrapartum temperature elevation as a risk factor for cesarean delivery and assisted vaginal delivery. (1/280)

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)

Neonatal outcome and mode of delivery after epidural analgesia for labour with ropivacaine and bupivacaine: a prospective meta-analysis. (2/280)

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. (3/280)

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. (4/280)

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)

Epidural pain relief in labour: potencies of levobupivacaine and racemic bupivacaine. (5/280)

We have compared the minimum local analgesic concentrations (MLAC) of levobupivacaine relative to racemic bupivacaine in a prospective, randomized, double-blind, sequential allocation study. Women in labour were given a 20-ml bolus of epidural levobupivacaine or bupivacaine diluted to a concentration determined by up-down sequential allocation. The initial concentration was 0.07% w/v for both drugs. Efficacy was defined using a visual analogue pain score (VAPS) at 10 mm or less within 30 min. The MLAC of levobupivacaine was 0.083% w/v (95% CI 0.065-0.101) and the MLAC of bupivacaine 0.081% w/v (95% CI 0.055-0.108). In molar terms, the MLAC of levobupivacaine was 2.87 mmol litre-1 (95% CI 2.25-3.49) and the MLAC of bupivacaine 2.49 mmol litre-1 (95% CI 1.69-3.32). With regard to the commercial preparations, the potency ratio levobupivacaine: bupivacaine was 0.98 (95% CI 0.67-1.41), and this is unlikely to be of clinical relevance. In molar terms, the ratio was 0.87 (95% CI 0.60-1.25). With regard to toxicity, the evidence should be evaluated in the light of a possible 13% potency difference in molar concentration in favour of racemic bupivacaine.  (+info)

Epidural analgesia during labor and maternal fever. (6/280)

BACKGROUND: In recent observational studies, epidural analgesia during labor at patient request has been associated with maternal fever. The authors report a secondary analysis of fever in women who were randomized to receive either epidural or patient-controlled intravenous analgesia during labor. METHODS: Maternal tympanic temperature was measured during spontaneous labor in 715 women at term who were randomized to either epidural analgesia with bupivacaine and fentanyl or to patient-controlled intravenous analgesia with meperidine. Intent-to-treat analysis of women with fever (temperature > or = 38.0 degrees C) versus those without was performed using Student t test and Fisher exact test to determine statistical significance (P < 0.05). RESULTS: Epidural analgesia was associated with maternal fever (odds ratio = 4.0; 95% confidence interval = 2.0-7.7), as was nulliparity (odds ratio = 4.1; 95% confidence interval = 1.8-9.1) and labor longer than 12 h (odds ratio = 5.4; 95% confidence interval = 2.9-9.9). These factors were all independent variables for maternal fever when analyzed using logistic regression. CONCLUSIONS: Epidural analgesia is associated with maternal fever. However, nulliparity and dysfunctional labor are also significant cofactors in the fever attributed to epidural analgesia.  (+info)

Epidural analgesia in an obstetric patient with Klippel-Trenaunay syndrome. (7/280)

We describe the use of epidural analgesia for vaginal delivery of a parturient with Klippel-Trenaunay syndrome in whom the use of repeated magnetic resonance imaging during her obstetric care allowed us to see deep haemangiomata. This also allowed the safe sitting of an epidural catheter at L1-2 to provide analgesia for labour and delivery. Klippel-Trenaunay syndrome and the anaesthetic implications of the congenital vascular abnormalities and potential coagulopathy are discussed.  (+info)

Shivering and shivering-like tremor during labor with and without epidural analgesia. (8/280)

BACKGROUND: Effective treatment and prevention of hyperthermia and shivering-like tremor during labor is hindered by a poor understanding of their causes. The authors sought to identify the incidence of nonthermoregulatory shivering-like tremor and the factors associated with this activity. METHODS: The authors studied women in spontaneous full-term labor who chose epidural analgesia (n = 21) or opioid sedation (n = 31). Shivering-like tremor and sweating were evaluated by observation. Core temperature was recorded in the external auditory canal using a compensated infrared thermometer. Arteriovenous shunt tone was evaluated with forearm minus fingertip skin temperature gradients; gradients less than 0 were considered evidence of vasodilation. Tremor was considered nonthermoregulatory when core temperature exceeded 37 degrees C and the arms were vasodilated. Pain was evaluated using a visual analog scale. RESULTS: Shivering-like tremor was observed in 18% of 290, 30-min data-acquisition epochs before delivery. The patients were both normothermic and vasodilated during 15% of these epochs. Shivering was observed in 16% of 116 postdelivery epochs and was nonthermoregulatory in 28%. Sweating was observed in 30% of predelivery epochs, and the patients were both hypothermic and vasoconstricted during 12%. The mean core temperature in patients given epidural analgesia was approximately 0.2 degrees C greater than in those given sedation. Hyperthermia was observed during 10 epochs (38.4+/-0.3 degrees C) during epidural analgesia and during 10 epochs (38.4+/-0.3 degrees C) with sedation. The patients were vasoconstricted in more than 50% of these epochs in each group. Multivariate mixed-effects modeling identified high pain scores and vasoconstriction as significant predictors of shivering. There were no predictors for shivering epochs in patients who were simultaneously normothermic and vasodilated. Significant predictors of sweating were time before delivery, high pain scores, hypothermia with vasoconstriction, high thermal comfort, and low mean skin temperature. There were no predictors for sweating epochs in patients who were simultaneously hypothermic and vasoconstricted. CONCLUSIONS: This study confirms the clinical impression that some peripartum shivering-like tremor is nonthermoregulatory. The authors also identified nonthermoregulatory sweating. These data indicate that shivering-like tremor and sweating in the peripartum period is multifactorial.  (+info)

TY - JOUR. T1 - Effects of combined spinal-epidural analgesia on first stage of labor. T2 - a cohort study. AU - Poma, Silvia. AU - Scudeller, Luigia. AU - Verga, Chiara. AU - Mirabile, Giorgio. AU - Gardella, Barbara. AU - Broglia, Federica. AU - Ciceri, Maria. AU - Fuardo, Marinella. AU - Pellicori, Simona. AU - Gerletti, Maddalena. AU - Zizzi, Silvia. AU - Masserini, Elena. AU - Delmonte, Maria Paola. AU - Iotti, Giorgio Antonio. PY - 2018/5/16. Y1 - 2018/5/16. N2 - Background: Neuraxial anesthesia is considered as the gold standard in the control labor of pain. Its variants are epidural analgesia and combined spinal-epidural analgesia. Few studies, as yet, have investigated the duration of labor as a primary outcome. Some authors have suggested that combined spinal-epidural analgesia may reduce labor duration but at the moment the benefit of shortening labor is uncertain. The main aim of this study was to compare combined spinal-epidural with epidural analgesia in terms of their effect on ...
Fifteen days later, the patient was treated for a back skin abscess with surgical incision and oral antibiotics in view of the increase of the tumefaction. The results of bacteriologic investigations were negative. The patient did not experience any pain or fever. The results of clinical and neurologic examinations were unremarkable. Biologic samples were within the reference ranges, except for the inflammation test result. Two months after her delivery, the patient was referred to the hospital because the wound had still not healed, despite her good health. Magnetic resonance imaging (fig. 1) and computed tomography were performed and revealed a displacement of the nerve roots by an expansive mass in the posterior extradural space, which took up more than 50% of the spinal canal. This mass began at the L2-L3 level with an L2 neural arch lysis and continued down to L4-L5. Inflammatory infiltrate extended in both psoas and sacroiliac joints. Soft tissues were involved with collections in both ...
Marc and Eddy Verbessem the two deaf twins killed by legal euthanasia in Belgium had their first requests to die refused in their local hospital.
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Epidural analgesia has been used to provide labor pain relief for more than 40 years, with modern techniques providing better pain control with fewer side effects. Since the early 1990s, the CSE technique has become popular because it provides more rapid pain relief with less leg weakness-the main side effect of epidural analgesia.. Despite previous studies, the relative advantages of these options for labor analgesia have been unclear. The new study is the first to directly compare epidural versus CSE for labor analgesia in a busy private maternity hospital.. The results suggest that CSE provides significantly faster and better pain relief during the first stage of labor, compared to the traditional epidural technique. The differences in pain control during early labor are small but significant, Dr Gambling and colleagues note. They write, [W]hen one considers the fact that fewer top-up doses were required to achieve the improvement in analgesia, it would seem that on balance CSE is the ...
Epidural analgesia has been used to provide labor pain relief for more than 40 years, with modern techniques providing better pain control with fewer side effects. Since the early 1990s, the CSE technique has become popular because it provides more rapid pain relief with less leg weakness-the main side effect of epidural analgesia.. Despite previous studies, the relative advantages of these options for labor analgesia have been unclear. The new study is the first to directly compare epidural versus CSE for labor analgesia in a busy private maternity hospital.. The results suggest that CSE provides significantly faster and better pain relief during the first stage of labor, compared to the traditional epidural technique. The differences in pain control during early labor are small but significant, Dr Gambling and colleagues note. They write, [W]hen one considers the fact that fewer top-up doses were required to achieve the improvement in analgesia, it would seem that on balance CSE is the ...
Effect of Epidural Analgesia on Some Maternal and Fetal Parameters in Pre-Eclampsia. M.Yousri Amin, A.Salam, M.Metwally : Alexandria University , EGYPT. continuous Epidural Analgesia (EA) during labor of pre-eclamptic (P-E) patients has been recommended by several authors. Belief in improved renal function via relief of renal vasospasm, control of blood pressure, excellent analgesia and less infant depression form the basis of such recommendation.In opposition, many clinician consider conduction analgesia to be not recommended in P-E because of deceased blood volume might make them more vulnerable to hypotension.In this study we investigated the effect of continuous EA on maternal hemodynamics, renal function, and acid base balance in P-E , also, its effect on fetal heart rate(FHR) during labor.Patients and methods:Twenty P-E parturient were prepared for labor induction. Central venous catheter was placed via subclavian, lumbar epidural catheter was placed. 10 ml of 0.5% bupivacaine were ...
Part of the inconsistency with motor blockade results between studies is due to the fact that the qualitative Bromage score is not ideal for assessing motor blockade in laboring patients. Graham and McClure [19] demonstrate that laboring patients with epidural analgesia may have a quantitative decrease in adductor strength despite having a Bromage score of 0. Motor blockade due to epidural labor analgesia is thought to impair a womens ability to push in stage 2. While we did not see a significant difference in Bromage scores between groups, the obstetric providers felt that 8 patients in the PIEB group 10q60 had motor blockade as demonstrated by the inability to effectively push in stage 2. This finding demonstrates that Bromage scores may not be ideal for assessing motor blockade in laboring patients. All patients with a perceived motor block and an inability to effectively push during the second stage successfully delivered vaginally after the epidural pump was turned off. One of these ...
Intrathecal Labor Analgesia, Paracervical Block, Transcutaneous Electrical erve Stimulation (TENS), lok saraf perineal dan pudendal merupakan metode atau cara menghilangkan Rasa Sakit Persalinan secara Medis. Berikut penjelasannya: Intrathecal Labor Analgesia (ILA). Teknik ILA dilakukan dengan cara menyuntikkan obat penghilang rasa sakit kepada ibu yang akan bersalin normal. Obat ini disuntikkan di daerah urat saraf, yaitu pada tulang belakang bagian bawah. Teknik ILA membebaskan ibu dari rasa nyeri persalinan sekitar 12 jam. Paracervical Block. Paracervical block juga tergolong pembiusan. Metode ini digunakan untuk menghilangkan rasa sakit pada persalinan tahap pertama. Anestesi diberikan melalui suntikan di sisi leher rahim sehingga menghambat rasa sakit. Paracervical block berisiko menghambat detak jantung bayi sehingga dikhawatirkan membahayakan bayi.. Blok saraf perineal dan pudendal. Blok saraf pudendal merupakan suntikan untuk mengebalkan saraf yang mengirim informasi "sakit" ke area ...
Objective: Patient-controlled epidural analgesia (PCEA) and intermittent epidural dosing are widely accepted methods for labor analgesia. The outcomes of duration of labor, Cesarean section, and instrumented deliveries of PCEA compared to intermittent epidural dosing are uncertain. We have performed a meta-analysis to further examine this issue. Method: This project is exempt from the Johns Hopkins IRB. A systematic literature search of the National Library of Medicine s PubMed database was conducted for terms related to PCEA for labor analgesia (epidural or extradural, patient-controlled or PCEA or patient controlled, labor or labour or pregnant or pregnancy or parturient). Only randomized controlled trials in the English language comparing PCEA to intermittent epidural dosing for labor analgesia were included for analysis. Data on pertinent study characteristics and relevant outcomes were extracted from accepted articles. Meta-analysis was performed using the Review Manager 4.2.10 (The ...
Six RCTs with a total of 458 patients were included in the review. Five RCTs were included in the meta-analyses (n=355 with adequate data). In terms of study quality, 4 studies reported prior power analysis, two reported adequate allocation concealment, five were at least double-blinded and three used intention-to-treat analysis. One study reported no exclusions from analysis; rates of exclusion from analysis in the other 5 studies ranged from 17 to 23.6%.. Acute pain at rest at 24 hours post-surgery (5 studies).. There was no significant difference between interventions in acute pain at rest at 24 hours (WMD -0.27, 95% CI: -0.91, 0.37; favours preemptive TEA). A sixth study, which could not be pooled, also showed no significant difference between the groups. Statistically significant heterogeneity between the studies was detected (I-squared 98.6%). The results of the analysis were not changed by the exclusion of a study in which no opioid was used.. Acute pain at rest at 48 hours post-surgery ...
Labor results in severe pain in most women and epidural analgesia is well established technique to alleviate the pain for over 50 years. After the …
Numerous study designs, including randomized controlled trials (RCTs), before-and-after studies, and observational studies with concurrent controls (analyzed by propensity scores), have asked whether labor epidural analgesia (LEA) influences the probability of Cesarean section (C/S). One limitation of the RCTs is the high rate of crossovers in many of these studies. In contrast to our previous analysis, a recent RCT meta-analysis using instrumental variables to adjust for crossovers [1] concluded that LEA increased the probability of C/S. To further investigate this topic, we updated a previous analysis based on the paired availability design (PAD), a meta-analysis of before-and-after studies adjusted for different availabilities of treatment [3]. The revised PAD (with 1 additional study and modified data extractions) yielded similar results as before, namely no effect of epidural analgesia on the probability of C/S (Figure 1). We also updated our previous meta-analysis of randomized trials ...
Epidural analgesia involves an injection into the lower back that pierces the outer coverings ("epi-dura") of the spinal cord. Drugs are injected close to the nerves as they come out from the spinal cord. Usually this involves a "local anaesthetic" (LA) drug such as bupivacaine, along with an "opiate" drug (related to morphine, pethidine/meperidine etc) such as Fentanyl. Epidurals are used in many types of surgery and procedures, and also sometimes administered to receive pain outside of childbirth.. How do epidurals work?. Just like a dental anaesthetic, LA drugs block the sensory nerves, causing numbness, and also inevitably block the motor nerves, giving some degree of paralysis. Opiate drugs are added to an epidural to increase the effectiveness of the LA, so that there will be good pain relief with less motor block.. What are the benefits of epidurals?. Obviously, the main benefit of an epidural is the very effective pain relief that most women experience. Because of this effective ...
The Effects of Regional Analgesia on the Progress and Outcome of Labor. Marissa Lazor, M.D. In 1847, the Scottish obstetrician, James Simpson administered ether to a woman during labor to treat the pain of childbirth. Slideshow 161159 by salena
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Video created by Johns Hopkins University for the course Capstone: Photo Tourist Web Application. In this module, you will learn how to development model, request, and feature specs using RSpec and to leverage gems like DatabaseCleaner, ...
Obstetric Analgesia and Anesthesia: A Manual for Physicians, Nurses and Other Health Personnel, Prepared for the World Federation of Societies of
SELF - LEARNING MODULE ADDED NURSING COMPETENCY FOR MONITORING AND CARE OF THE PATIENT RECEIVING NEURAXIAL ANALGESIA. Originally developed by Susan Warman , BN., Helen Gourlay,BN /MN. ,and Janet Walker, BN. January 1997 Slideshow 607940 by tallys
In general, your choice of where you deliver will be linked to your care provider. The majority of physicians take care of women in a hospital setting, where most birth in the US take place. Midwives also take care of women in a hospital setting, although they also deliver babies in birthing center.. Hospital birth. There are three potential advantages to choosing deliver in a hospital. First, if you are among the 30-40 percent of women over 35 who require a cesarean delivery, there will be no need for you to be moved from home or the birthing center. Although most cesarean deliveries are not urgent, in which case the delay will not cause you or your baby any harm, in an obstetric emergencies, time can be of the essence. The second advantage is that you will have more pain control options. Although many first time mothers wish to avoid epidural analgesia, you may not know what type of pain relief you want until you are actually in labor. If you are highly motivate to avoid an epidural analgesia, ...
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Facilitate teaching of cervical effacement and dilation with this cervical stacker model. The model features 10 rings from 1 cm to 10 cm. Learn more here!
Of the approximately 8 million Americans who suffer from ischemic peripheral arterial occlusive disease (PAOD), many present with intermittent claudication, or pain associated with exercise. Impaired vasodilation of resistance vessels is a potential explanation for this symptom. Occluded arteries can lead to increased flow through collateral vessels, which function as natural bypasses around the obstruction. This increase in blood flow and resulting shear stress can cause outward remodeling, or arteriogenesis, which improves the efficacy of collaterals. However, following femoral artery ligation in a mouse model of chronic ischemia, vasodilation in the stem region of collateral vessels is impaired at day 7. In the outwardly remodeled collateral stem, the vessel diameter increase is not associated with cell proliferation, suggesting the functionality of the present smooth muscle cells (SMCs) may account for the impaired vasodilation. A potential mechanism for increased vessel diameter in the collateral
OK we all know that Dr. Chu was a run a way Chu Chu and wasted billions of dollars so lets get back to the EVs and the market leader The Nissan Leaf. Nissan received $1.4 billion in DOE loan guarantees on the promise they would produce 150,000 Leaves per year. The Leaf has been on market for four years and 1 month. In that entire time they sold 72,303 or about half of what they promised for one year. This is a fulfillment of one eighth of a promise! Kind of like getting one year of work out of Mr. Obama in two terms ...
We are finishing up a 12 x 38 cone bottom (25,300 Gallon capacity) steel tank. This tank features a 45 degree cone bottom complete with an open-bottom skirted construction. Squibb Tank Company manufactures several custom cone bottom tanks throughout the year for various industrial applications. The customer for this cone bottom tank is utilizing the tank to store fertilizer. Will post updated photographs when complete. This is a great looking tank!. ...
Looking for online definition of epidural analgesia in the Medical Dictionary? epidural analgesia explanation free. What is epidural analgesia? Meaning of epidural analgesia medical term. What does epidural analgesia mean?
Cervical dilation (or cervical dilatation) is the opening of the cervix, the entrance to the uterus, during childbirth, miscarriage, induced abortion, or gynecological surgery. Cervical dilation may occur naturally, or may be induced by surgical or medical means. In the later stages of pregnancy, the cervix may already have opened up to 1-3 cm (or more in rarer circumstances), but during labor, repeated uterine contractions lead to further widening of the cervix to about 6 centimeters. From that point, pressure from the presenting part (head in vertex births or bottom in breech births), along with uterine contractions, will dilate the cervix to 10 centimeters, which is "complete." Cervical dilation is accompanied by effacement, the thinning of the cervix. General guidelines for cervical dilation: Latent phase: 0-3 centimeters Active Labor: 4-7 centimeters Transition: 8-10 centimeters Complete: 10 centimeters. Delivery of the infant takes place shortly after this stage is reached (although the ...
Surgeon-administered regional analgesia to replace anaesthetist-administered regional analgesia - need for communication and collaboration ...
This article undertakes a systemic review of the evidence of benefit or harm of continuous epidural analgesia (CEA) vs other analgesic interventions from RCTs in patients with traumatic rib fractures as of July 2014. It uses the guidelines recommended by the Cochrane Collaboration . Overall it included six trials including 223 patients, and determined that in these studies there was currently no evidence of statistical difference in outcomes of mortality, duration of mechanical ventilation or pneumonia between CEA and other analgesic interventions. It pointed out that the included trials showed a potential for a high risk of bias. The analysis showed that the amount of information currently available to accurately determine whether there is a clinical benefit or harm with the use of continuous epidural analgesia vs other analgesic techniques (such as systemic opioids, paravertebral block etc) is inadequate and that a good quality large RCT is required in this patient population to provide ...
TY - JOUR. T1 - Post-Pancreaticoduodenectomy Outcomes and Epidural Analgesia. T2 - A 5-year Single-Institution Experience. AU - Simpson, Rachel E.. AU - Fennerty, Mitchell L.. AU - Colgate, Cameron L.. AU - Kilbane, E. Molly. AU - Ceppa, Eugene P.. AU - House, Michael. AU - Zyromski, Nicholas. AU - Nakeeb, Attila. AU - Schmidt, C.. PY - 2019/4/1. Y1 - 2019/4/1. N2 - Background: Optimal pain control post pancreaticoduodenectomy is a challenge. Epidural analgesia (EDA) is used increasingly, despite inherent risks and unclear effects on outcomes. Methods: All pancreaticoduodenectomies (PDs) performed from January 2013 through December 2017 were included. Clinical parameters were obtained from a retrospective review of a prospective clinical database, the American College of Surgeons NSQIP prospective institutional database, and medical record review. Chi-square, Fishers exact test, and independent-samples t-tests were used for univariable analyses. Multivariable regression was performed. Results: ...
Anesthesiology. vol. 106. 2007. pp. 843-63. Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia. (These are the ASA Practice Guidelines that cover analgesia for labor.). Reg Anesth Pain Med. vol. 35. 2010. pp. 64-101. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition). (ASRA has evidence-based guidelines for providing neuraxial techniques in parturients who are taking anticoagulant medications.). Anesth Analg. vol. 109. 2009. pp. 648-60. Neuraxial techniques in obstetric and non-obstetric patients with common bleeding diatheses. (This review uses ASRA and other society guidelines to make recommendations for neuraxial techniques in patients with coagulopathies.). Anesth Analg. vol. 112. 2011. pp. 648-52. The unanticipated difficult intubation in obstetrics. (An excellent ...
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. Doulas, women with labor experience trained for parturients, is a new way to alleviate the psychological stress from the laboring pain. Previous data in our study showed that doula accompany is a good method in shortening the progress of labor used in the active phrase of the first stage of labor, and decreasing the rate of cesarean delivery. 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 ...
Article Risk-based sequential allocation of competing sanitation infrastructure investments. Given severe sanitation service shortages, infrastructure interdependencies and extreme scarcity of funding that prevail in many developing countries, the al...
Occasionally painkillers may be given by infusion into the space just outside the membranes surrounding the spinal cord. This is known as epidural analgesia. Sometimes the painkiller is given into the fluid around the spinal cord -- this is known as intrathecal analgesia. These specialised techniques are usually used only to control severe pain and are managed by anaesthetists.. If you need to have your painkillers by injection or infusion, your doctor or nurse will discuss this with you.. Please see our leaflet on Strong Painkillers for more information.. ...
We included 38 studies involving 9658 women; all but five studies compared epidural analgesia with opiates. Epidural analgesia was found to offer better pain relief (mean difference (MD) -3.36, 95% confidence interval (CI) -5.41 to -1.31, three trials, 1166 women); a reduction in the need for additional pain relief (risk ratio (RR) 0.05, 95% CI 0.02 to 0.17, 15 trials, 6019 women); a reduced risk of acidosis (RR 0.80, 95% CI 0.68 to 0.94, seven trials, 3643 women); and a reduced risk of naloxone administration (RR 0.15, 95% CI 0.10 to 0.23, 10 trials, 2645 women). However, epidural analgesia was associated with an increased risk of assisted vaginal birth (RR 1.42, 95% CI 1.28 to 1.57, 23 trials, 7935 women), maternal hypotension (RR 18.23, 95% CI 5.09 to 65.35, eight trials, 2789 women), motor-blockade (RR 31.67, 95% CI 4.33 to 231.51, three trials, 322 women), maternal fever (RR 3.34, 95% CI 2.63 to 4.23, six trials, 2741 women), urinary retention (RR 17.05, 95% CI 4.82 to 60.39, three trials, ...
Pencil-point needles have been shown to cause less tissue and nerve damage than beveled cutting needles. Despite this, trauma to the spinal cord or conus medullaris is probably more closely associated with the level of needle insertion than the type of needle. Studies have shown that clinicians are not good at accurately identifying the lumber intervertebral spaces, often inserting the needle one, two, or more spaces higher than intended.. Tuffiers line, drawn between the superior iliac crests, is commonly used as a starting point to identify lumber interspaces. It usually crosses at the level of the L4 spinous process, but not reliably so. Obesity, pregnancy, and the lateral position, often used for neuraxial block placement, all increase the inaccuracy of this method.. It is recommended that spinal needle insertion should ideally be below L3 to minimize the chance of spinal cord injury. It is also worth noting that the position of the orifice in pencil-point needles is further back from the ...
BACKGROUND: Epidural analgesia leads to increased risk of instrumental vaginal delivery (IVD). There is debate about whether or not posture in second-stage labour influences the incidence of spontaneous vaginal birth (SVB). OBJECTIVES: In nulliparous women with epidural analgesia, does a policy of adopting an upright position throughout second-stage labour increase the incidence of SVB compared with a policy of adopting a lying-down position? DESIGN: Two-arm randomised controlled trial. SETTING: Maternity units in England and Wales. PARTICIPANTS: Nulliparous women aged ≥ 16 years, at ≥ 37 weeks gestation with singleton cephalic presentation and intended SVB, in second-stage labour with an epidural providing effective pain relief. INTERVENTIONS: (1) Upright position to maintain the pelvis in as vertical a plane as possible; and (2) lying-down position to maintain the pelvis in as horizontal a plane as possible. MAIN OUTCOME MEASURES: The primary outcome measure was incidence of SVB. Secondary
It was also hoped that the opioid-related side effects of nausea, vomiting, pruritus, sedation and respiratory depression could be reduced. However, all of these side effects can occur as well as two additional ones, urinary retention and late onset respiratory depression.. The specific benefits for epidural analgesia are particularly attractive and relevant in some subgroups of patients such as the elderly, the obese or those with chronic respiratory disease. An effective epidural will enable a patient to deep breathe, cough and move with ease. This in turn facilitates a more speedy recovery with a reduction in co-morbidities such as chest infections and deep. Results of studies are inconsistent and must be interpreted cautiously; it is difficult to show a benefit in low-risk patients. At least one study has shown a shorter hospital stay and reduced morbidity in morbidly obese patients who received epidural opioids postoperatively [2]. The effects on the metabolic stress response (increase of ...
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Materials and Methods: This was a prospective study carried out in department of obstetrics and gynaecology in Rajah muthiah Medical College and Hospital from 2015-2017 after ethical clearance and written knowledgeable concent. A total of 100 parturients in both latent and active phase of labour were to receive an epidural injection of 12 ml of bupivacaine 0.125% as initial bolus dose. Same dose regimen was used as subsequent top-up dose on patients demand for pain relief. The duration and quality of analgesia, motor block, top-up doses required consumption of bupivacaine and feto-maternal outcome were observed ...
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Epidurals are associated with prolongation of labour and may increase the operative vaginal delivery rate but there is no evidence that they increase the caesarean section rate. Several studies have compared ropivacaine and bupivacaine for labour analgesia and studies consistently show that ropivacaine is less potent than bupivacaine. Several studies suggest intrathecal opioids may increase the incidence of fetal bradycardia; however the magnitude of this increase is difficult to determine and may be small ...
Romagnoli A, Korman D (1962). "Methoxyflurane in obstetrical anaesthesia and analgesia" (PDF). Canadian Anaesthetists' Society ... Babl F, Barnett P, Palmer G, Oakley E, Davidson A (2007). "A pilot study of inhaled methoxyflurane for procedural analgesia in ... When used for labor analgesia, the Analgizer allows labor to progress normally and with no apparent adverse effect on Apgar ... The Analgizer was widely utilized for analgesia and sedation until the early 1970s, in a manner that foreshadowed the patient- ...
Bullough, J. (1959). "Use of premixed pethidine and antagonists in obstetrical analgesia; with special reference to cases in ... and a very small dose of levallorphan used alongside a full agonist of the MOR can produce greater analgesia than when the ... by opioid analgesics and barbiturates used for induction of surgical anaesthesia whilst maintaining a degree of analgesia (via ... the effects of stronger agents with greater intrinsic activity such as morphine whilst simultaneously producing analgesia. ...
The natural benefits of such labor pains which initially inhibited the practice of obstetrical analgesia, originated from ... Labor analgesia was debated on the grounds of religion and morality, which John Simpson used as his own weapon against ... Swayne, J. G. "Obstetrical Statistics." The British Medical Journal, vol. 2, no. 777, 1875, pp. 635-638., www.jstor.org/stable/ ... In 1921, the first vaginal delivery under spinal analgesia was reported by Kreiss in Germany. George Pitkin is credited with ...
It can also be used as a supplement to balanced anesthesia, for preoperative and postoperative analgesia, and for obstetrical ... Use of the mixed agonist-antagonist nalbuphine in opioid based analgesia. Acute Pain (2004) 6, 29-39 Gutstein H, Akil H. ... analgesia during labor and delivery. Although nalbuphine possesses opioid antagonist activity, there is evidence that in ...
... analgesia, epidural MeSH E03.091.110 --- analgesia, obstetrical MeSH E03.091.120 --- analgesia, patient-controlled MeSH E03.091 ... File "2006 MeSH Trees".) MeSH E03.091.048 --- acupuncture analgesia MeSH E03.091.080 --- ... obstetrical MeSH E03.155.441 --- cryoanesthesia MeSH E03.155.519 --- electroacupuncture MeSH E03.155.675 --- hypnosis, ...
Babl F, Barnett P, Palmer G, Oakley E, Davidson A (2007). "A pilot study of inhaled methoxyflurane for procedural analgesia in ... Crombie JM (1876). "Self-administration of anaesthetics". Transactions of the Obstetrical Society of London. 18: 64-5. ... When used for labor analgesia, the Analgizer allows labor to progress normally and with no apparent adverse effect on Apgar ... The Analgizer was widely utilized for analgesia and sedation until the early 1970s, in a manner that foreshadowed the patient- ...
Speert H (October 1957). "Obstetrical-gynecological eponyms: James Young Simpson and his obstetric forceps". The Journal of ... Keys TE (1973). "Sir James Young Simpson (1811-1870)". Anesthesia and Analgesia. 52 (4): 562. doi:10.1213/00000539-197307000- ...
"Patient controlled opioid analgesia versus conventional opioid analgesia for controlling postoperative pain". Cochrane Database ... Obstetrical, the very young and the very old are all at greater risk of complication so extra precautions may need to be taken ... It may include analgesia (relief from or prevention of pain), paralysis (muscle relaxation), amnesia (loss of memory), or ... Sep 2012). "Inhaled analgesia for pain management in labour". Cochrane Database of Systematic Reviews. 12 (9): CD009351. doi: ...
Bydlowski M, Raoul-Duval A (1978) Un avatar psychique méconnu de la puerperalité: la névrose traumatique post obstétricale. ... A possible complication of epidural analgesia. British Medical Journal 285: 972 only. Brockington I F (2006) Eileithyia's ...
... (June 7, 1909 - August 7, 1974) was an American obstetrical anesthesiologist. She was a leader in the fields of ... Analgesia. 32 (4): 260-267. doi:10.1213/00000539-195301000-00041. PMID 13083014. "The Virginia Apgar Papers: biographical ... anesthesiology and teratology, and introduced obstetrical considerations to the established field of neonatology. To the public ...
... perform obstetrical assessments, and provide pharmacological pain relief for various conditions. Several sites in Canada have ... analgesia, platelet inhibitors, (theses include Nitroglycerin, Glucose, nitrous oxide, acetylsalicylic acid, salbutamol), and ...
December - Robert Gwyn Macfarlane and colleagues publish the first identification of Haemophilia B. American obstetrical ... Current Research in Anesthesia and Analgesia. 32 (4): 260-267. doi:10.1213/00000539-195301000-00041. PMID 13083014. Finster, M ...
This turned out to be such a success that two whole wards were soon dedicated to obstetrical and gynaecological patients, and ... Naguib Mahfouz was a prolific author on a wide variety of subjects ranging from urinary and faecal fistulae, spinal analgesia, ...
Facilities that have obstetrical services and emergency rooms and operating facilities, even if smaller, can be used in areas ... Analgesia. 120 (6): 1337-1351. doi:10.1213/ANE.0000000000000705. PMC 4438860 . https://www.ncbi.nlm.nih.gov/books/NBK11385/ ...
Regional anaesthesia during Caesarean section is different from the analgesia (pain relief) used in labor and vaginal delivery ... Elective caesarean sections may be performed on the basis of an obstetrical or medical indication, or because of a medically ...
Some family practitioners or general practitioners also perform obstetrical surgery. Obstetrical procedures include cesarean ... Epidural analgesia is a generally safe and effective method of relieving pain in labour, but is associated with longer labour, ... Epidural analgesia has no statistically significant impact on the risk of caesarean section, and does not appear to have an ... A 2013 Cochrane review found that with good obstetrical anaesthesia there is no change in harms from allowing eating and ...
... obstetrical, and urological operations (spinal/epidural anesthesia) Bone and joint surgery of the pelvis, hip, and leg (spinal/ ... "Concept for postoperative analgesia after pedicled TRAM flaps: Continuous wound instillation with 0.2% ropivacaine via ...
04.81 Injection of anesthetic into a nerve for analgesia (05) Operations on sympathetic nerves or ganglia (05.2) Sympathectomy ... Pubiotomy to assist delivery Obstetrical symphysiotomy (73.99) Other (74) Cesarean section and removal of fetus (75) Other ...
Wang, Shu-Ming; Kain, Zeev N.; White, Paul (2008). "Acupuncture Analgesia: I. The Scientific Basis". Anesthesia & Analgesia. ... obstetrical conditions, opioid addiction, Parkinson's disease, polycystic ovary syndrome, posttraumatic stress disorder, ... Clinical Considerations". Anesthesia & Analgesia. 106 (2): 611-621. doi:10.1213/ane.0b013e318160644d. ISSN 0003-2999. PMID ... Colquhoun, D; Novella S (2013). "Acupuncture is a theatrical placebo: the end of a myth" (PDF). Anesthesia & Analgesia. 116 (6 ...
Other obstetrical/gynecological causes of similar abdominal pain in women include pelvic inflammatory disease, ovarian torsion ... Anderson, Mark; Collins, Emma (November 2008). "Analgesia for children with acute abdominal pain and diagnostic accuracy". ...
The onset of analgesia is slower with epidural analgesia or anaesthesia than with spinal analgesia or anaesthesia. ... Epidural analgesia during childbirth[edit]. Epidural analgesia provides rapid pain relief in most cases. It is more effective ... Epidural analgesia after surgery[edit]. Epidural analgesia has been demonstrated to have several benefits after surgery, ... Epidural analgesia may be used:. *For analgesia alone, where surgery is not contemplated. An epidural injection or infusion for ...
Obstetrical surgery and other procedures (ICD-9-CM V3 72-75, ICD-10-PCS 1) ... Regional anaesthesia during Caesarean section is different from the analgesia (pain relief) used in labor and vaginal delivery ... Elective caesarean sections may be performed on the basis of an obstetrical or medical indication, or because of a medically ...
Other obstetrical/gynecological causes of similar abdominal pain in women include pelvic inflammatory disease, ovarian torsion ... "Analgesia for children with acute abdominal pain and diagnostic accuracy". Archives of Disease in Childhood. 93 (11): 995-7. ...
Obstetrical and Gynecological Survey (página oficial). *Obstetrics and gynaecology ([3]). *Obstetrics and Gynecology Clinics of ... Anesthesia and Analgesia (página oficial). *Anesthesiology (página oficial). *Annals of Emergency Medicine ...
Obstetrical surgery and other procedures (ICD-9-CM V3 72-75, ICD-10-PCS 1) ... Analgesia. 112 (1): 207-12. doi:10.1213/ANE.0b013e31820034f0. PMID 21081771.. ...
Geburtshilfiche Anasthesie und Analgesie.(Obstetrical Anesthesia and Analgesia.). Anesthesiology 1 1970, Vol.32, 91. doi: ... Geburtshilfiche Anasthesie und Analgesie.(Obstetrical Anesthesia and Analgesia.) You will receive an email whenever this ... L. BECK, BRUNO J. URBAN; Geburtshilfiche Anasthesie und Analgesie.(Obstetrical Anesthesia and Analgesia.). Anesthesiology 1970; ...
Lumbar Sympathetic Nerve Block for Obstetrical Analgesia; Preliminary Report of Over 1,200 Cases. Anesthesiology 1 1958, Vol.19 ... MARY LOU BYRD, EDWARD Y. POSTMA, GLENN M. VAN DOMMELEN; Lumbar Sympathetic Nerve Block for Obstetrical Analgesia; Preliminary ... Lumbar Sympathetic Nerve Block for Obstetrical Analgesia; Preliminary Report of Over 1,200 Cases ... Lumbar Sympathetic Nerve Block for Obstetrical Analgesia; Preliminary Report of Over 1,200 Cases ...
2. 5 For Obstetrical Analgesia. ​The usual dosage is 50 mg to 100 mg intramuscularly or subcutaneously when pain becomes ... Demerol Injection is indicated for preoperative medication, support of anesthesia, and obstetrical analgesia. ... Have not provided adequate analgesia, or are not expected to provide adequate analgesia ... The principal actions of therapeutic value are analgesia and sedation.. Pharmacodynamics. Effects on the Central Nervous System ...
Use in Postoperative or Obstetrical Analgesia. Duraclon (epidural clonidine) is not recommended for obstetrical, post-partum, ... Epidurally administered clonidine produces dose-dependent analgesia not antagonized by opiate antagonists. The analgesia is ... Successful analgesia, defined as a decrease in either morphine use or Visual Analog Score (VAS) pain, was significantly more ... NOTE: Duraclon® (epidural clonidine) is not recommended for obstetrical, post-partum, or peri-operative pain management. The ...
"Obstetrical Analgesia and Anesthesia." Williams Obstetrics, 25e Cunningham F, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey ... Obstetrical Analgesia and Anesthesia. In: Cunningham F, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, Spong CY. ... We are indebted to Sir James Y. Simpson, the discoverer of chloroform, for the introduction of anaesthesia into obstetrical ... That said, obstetrical anesthesia presents unique challenges. Labor begins without warning, and anesthesia may be required ...
2. 5 For Obstetrical Analgesia 2.6 Dosage Modifications with Concomitant Phenothiazines 2. 7 Instructions for Use of the ... Obstetrical Analgesia:. 50 mg to 100 mg intramuscularly or subcutaneously; may be repeated at 1 to 3 hour intervals. (2.4) ... 2. 5 For Obstetrical Analgesia. The usual dosage is 50 mg to 100 mg intramuscularly or subcutaneously when pain becomes regular ... DEMEROL Injection is indicated for preoperative medication, support of anesthesia, for obstetrical analgesia, and for the ...
Use in Postoperative or Obstetrical Analgesia. Epidural clonidine hydrochloride is not recommended for obstetrical, post-partum ... Epidurally administered clonidine produces dose-dependent analgesia not antagonized by opiate antagonists. The analgesia is ... Successful analgesia, defined as a decrease in either morphine use or Visual Analog Score (VAS) pain, was significantly more ... However, in a rare obstetrical, post-partum or peri-operative patient, potential benefits may outweigh the possible risks. ...
AN EVALUATION OF ACUPUNCTURE ANALGESIA IN OBSTETRICS. WALLIS, LINDSAY; SHNIDER, SOL M.; PALAHNIUK, RICHARD J.; More ... Thought you might appreciate this item(s) I saw at Obstetrical & Gynecological Survey.. ...
Analgesia. Obstetrical. Anesthesia. Epidural. Newborn. Anesthetics, local. Clonidine. Pregnant women. Infant, newborn. ... Labor Analgesia With Ropivacaine and Clonidine (LA). The safety and scientific validity of this study is the responsibility of ... Labor analgesia with ropivacaine added to clonidine: a randomized clinical trial. Sao Paulo Med J. 2008 Mar 6;126(2):102-6. ...
Obstetrical Analgesia and Anaesthesia. Infections in Pregnancy. Recent Advances in Medical and Surgical Management. Normal ... Primary care in women is to give exhaustive care, quality obstetrical care, gynecological care and advancing physical ...
Obstetrical analgesia. Suppository. *Increased intracranial pressure resulting from intracranial lesion; conditions resulting ... Patient-controlled analgesia. Usual concentration, 0.2 mg/mL; demand dose, 0.1-0.2 mg; dose range is 0.05-0.4 mg Lockout ... Controlled-release formulation should only be used when continuous analgesia is required over an extended period of time; not ...
Analgesia, Obstetrical. *Anesthesia, Obstetrical. *Device: Epidural delivery system. *Drug: Entonox. *Drug: Meperidine ...
Romagnoli A, Korman D (1962). "Methoxyflurane in obstetrical anaesthesia and analgesia". Canadian Anaesthetists Society ... A method of sedation analgesia in routine dentistry". Journal of the Dental Association of South Africa. 29 (2): 77-80. PMID ... Lewis LA (1984). "Methoxyflurane analgesia for office surgery: surgical gem". Journal of Dermatologic Surgery and Oncology. 10 ... Babl F, Barnett P, Palmer G, Oakley E, Davidson A (2007). "A pilot study of inhaled methoxyflurane for procedural analgesia in ...
Patient-Controlled Analgesia: Does a Concurrent Opioid Infusion Improve Pain Management After Surgery?. PARKER, ROBERT K.; ... Thought you might appreciate this item(s) I saw at Obstetrical & Gynecological Survey.. ...
The obstetrical anesthesia database will be queried for all forceps deliveries between the dates of January 2004 - January 2005 ... 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 ...
Patient attitudes and ethnic preferences towards obstetric analgesia. Other projects have been performed in conjunction with ... Obstetrical Anesthesia*Pain Management*Pediatric Anesthesia*Management of Perioperative Services*Regional Anesthesia. ... Optimization of neuraxial techniques for labor and cesarean analgesia. *Predicting individual labor and cesarean pain and ... Management of maternal cardiac arrest and other obstetrical emergencies. * ...
Experience with spinal analgesia in a British obstetric unit. Br J Anaesth 1979; 51: 531-4.PubMedCrossRefGoogle Scholar ... The quality of PDPH literature in obstetrical anesthesia: results from an obstetrical PDPH bibliographic database. ... Obstetrical epidural anaesthesia in a rural Canadian hospital. Can J Anaesth 1992; 39: 390-3.PubMedGoogle Scholar ... The effect of intrathecal analgesia on the success of external cephalic version. Anesth Analg 2001; 93: 410-3.PubMedCrossRef ...
Embolism, Amniotic Fluid; Cesarean Section; Analgesia, Obstetrical; Pregnancy; Anesthesia, Spinal Academic: 336-718-8278. ...
The Effects of Regional Analgesia on the Progress and Outcome of Labor. Marissa Lazor, M.D. In 1847, the Scottish obstetrician ... Obstetrical practice styles. *Small sample size in Thorps study - only one more c-section in the control group would have ... Debate on Labor Analgesia -Debate on labor analgesia. chan wei-hung md department of anesthesiology ntuh. labor analgesia. ... labor analgesia: an update -Labor analgesia: an update . is there an advantage ofcse over epidural?. dr. fatma al dammas ...
Obstetrical anesthesia requires balancing these considerations; however, the life and well-being of the mother should come ... analgesia. The benefits of the combined technique are more rapid onset of analgesia within 5 minutes, better sacral analgesia, ... Patient-controlled epidural analgesia for labor. (A review of PCEA regimens for labor analgesia.) Anesthesiology. vol. 111. ... Epidural analgesia for labor and delivery. (An evidence-based review of the risks and benefits of epidural analgesia for labor ...
Anesthesia, Obstetric, Anesthesia, Obstetrical, Obstetric Anesthesia, Obstetrical Anesthesia, anesthesia for obstetrics, ... Consider Patient Controlled Analgesia with Fentanyl, alfenta, or remifentanil. III. Preparations: Spinal Anesthesia (3-6 hours ... Ontology: Anesthesia, Obstetrical. (C0002922) Definition (CSP) state characterized by loss of feeling or sensation caused by ... anesthesia obstetrics, obstetrics anesthesia, anesthesia in obstetrics, anesthesia obstetric, obstetric anesthesia, obstetrical ...
Bullough, J. (1959). "Use of premixed pethidine and antagonists in obstetrical analgesia; with special reference to cases in ... and a very small dose of levallorphan used alongside a full agonist of the MOR can produce greater analgesia than when the ... by opioid analgesics and barbiturates used for induction of surgical anaesthesia whilst maintaining a degree of analgesia (via ... the effects of stronger agents with greater intrinsic activity such as morphine whilst simultaneously producing analgesia. ...
What is obstetrical anesthesia? Meaning of obstetrical anesthesia medical term. What does obstetrical anesthesia mean? ... Looking for online definition of obstetrical anesthesia in the Medical Dictionary? obstetrical anesthesia explanation free. ... See: interpleural analgesia. intrathecal anesthesia. Intrathecal analgesia.. intratracheal anesthesia. Anesthesia administered ... We focus on obstetrical care and obstetrical anesthesia.. Anesthesia provider model, hospital resources, and maternal outcomes ...
Analgesia, Obstetrical; Cesarean Section. Interventions: Drug: Morphine; Drug: Hydromorphone. Outcome Measures: Visual analog ... Epidural Analgesia Versus IV Analgesia in Lumbar Spine Fusions Conditions: Lumbar Spine Fusion; Pain; Back Pain. ... True Functional Restoration and Analgesia in Non-Radicular Low Back Pain Condition: Low Back Pain. ... Patient satisfaction with perioperative analgesia; Number of participants with adverse events. ...
Use in Postoperative or Obstetrical Analgesia. Epidural clonidine is not recommended for obstetrical, postpartum, or ... Obstetrical, postpartum, or perioperative pain management: Clonidine hydrochloride injection (epidural clonidine) is not ... Obstetrical, postpartum, or perioperative pain management: Clonidine hydrochloride injection (epidural clonidine) is not ... Successful analgesia, defined as a decrease in either morphine use or Visual Analog Score (VAS) pain, was significantly more ...
  • Subgroup analyses included policy regarding the presence of companion, availability of epidural analgesia, policy on routine electronic fetal monitoring and variations in provider characteristics. (who.int)
  • Despite the potential for renal impairment when used at anesthetic doses, no significant adverse effects have been reported in the literature when it is used at the lower doses (up to 6 milliliters) used for producing analgesia and sedation. (wikipedia.org)
  • PARSIPPANY, N.J., Nov. 14, 2017 (GLOBE NEWSWIRE) -- Pacira Pharmaceuticals, Inc. (NASDAQ:PCRX) today announced that the U.S. Food and Drug Administration (FDA) has notified the company that its supplemental New Drug Application (sNDA) for EXPAREL ® (bupivacaine liposome injectable suspension) as a nerve block for regional analgesia will be discussed at a meeting of the Anesthetic and Analgesic Drug Products Advisory Committee (AADPAC). (businessinsider.com)
  • It has also been used in obstetrical practice as a low-risk and low-cost anesthetic technique during repair of obstetrical lacerations. (clinicaltrials.gov)
  • The editorial provides evidenced-based guidance regarding alternative analgesic and anesthetic management strategies for the obstetrical patient to address both bupivacaine and other drug shortages that may occur. (aana.com)
  • Patients who require a decrease in their basal labor analgesia epidural infusion rate will have an increased incidence of forceps delivery. (bioportfolio.com)
  • Compared with usual care, the provision of continuous support to women during labour increases the likelihood of spontaneous vaginal birth, reduces the duration of labour and use of analgesia and lowers the incidence of caesarean section and instrumental delivery. (who.int)
  • Obstetric and neonatal conditions such as acute bleeding or hemorrhage, severe preeclampsia and ongoing fetal compromise warrant further assessment, workup, consultation, and stabilization prior to initiating any method of labor analgesia. (oncologynurseadvisor.com)
  • 225 women were recruited (69 in Group-A and 156 in Group-B). We found significant differences between the groups in terms of labour length, Numeric Rating Scale score and analgesia request rate, type of delivery, need of episiotomy, and fetal occiput rotation. (hindawi.com)
  • Epidural analgesia was routinely available in 14 trials and electronic fetal monitoring was used routinely in nine of them. (who.int)
  • Disorders of pregnancy such as preeclampsia, placental abruption, or sepsis further compound provision of obstetrical anesthesia. (mhmedical.com)
  • These tests evaluate inhibitory and excitatory mechanisms of pain processing and are here utilized to evaluate endogenous analgesia at different time-points during pregnancy and the peripartum period to help reveal individual s risk for persistent pain. (jove.com)
  • Citations on PDPH in the obstetrical population were identified by computerized searches, citation review, and hand searches of abstracts and conference proceedings. (springer.com)