Methods of PAIN relief that may be used with or in place of ANALGESICS.
The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. It is differentiated from ANESTHESIA, EPIDURAL which refers to the state of insensitivity to sensation.
The elimination of PAIN, without the loss of CONSCIOUSNESS, during OBSTETRIC LABOR; OBSTETRIC DELIVERY; or the POSTPARTUM PERIOD, usually through the administration of ANALGESICS.
Relief of PAIN, without loss of CONSCIOUSNESS, through ANALGESIC AGENTS administered by the patients. It has been used successfully to control POSTOPERATIVE PAIN, during OBSTETRIC LABOR, after BURNS, and in TERMINAL CARE. The choice of agent, dose, and lockout interval greatly influence effectiveness. The potential for overdose can be minimized by combining small bolus doses with a mandatory interval between successive doses (lockout interval).
Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.
Pain during the period after surgery.
The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle.
Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.
A widely used local anesthetic agent.
Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.
Analgesia produced by the insertion of ACUPUNCTURE needles at certain ACUPUNCTURE POINTS on the body. This activates small myelinated nerve fibers in the muscle which transmit impulses to the spinal cord and then activate three centers - the spinal cord, midbrain and pituitary/hypothalamus - to produce analgesia.
A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)
Compounds capable of relieving pain without the loss of CONSCIOUSNESS.
Procedure in which an anesthetic is injected into the epidural space.
A narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. Prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration.
Pain associated with OBSTETRIC LABOR in CHILDBIRTH. It is caused primarily by UTERINE CONTRACTION as well as pressure on the CERVIX; BLADDER; and the GASTROINTESTINAL TRACT. Labor pain mostly occurs in the ABDOMEN; the GROIN; and the BACK.
An opioid analgesic that is used as an adjunct in anesthesia, in balanced anesthesia, and as a primary anesthetic agent.
An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS.
Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain.
Introduction of therapeutic agents into the spinal region using a needle and syringe.
The repetitive uterine contraction during childbirth which is associated with the progressive dilation of the uterine cervix (CERVIX UTERI). Successful labor results in the expulsion of the FETUS and PLACENTA. Obstetric labor can be spontaneous or induced (LABOR, INDUCED).
A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth.
Organic compounds containing the -CO-NH2 radical. Amides are derived from acids by replacement of -OH by -NH2 or from ammonia by the replacement of H by an acyl group. (From Grant & Hackh's Chemical Dictionary, 5th ed)
Procedure in which an anesthetic is injected directly into the spinal cord.
A narcotic analgesic proposed for severe pain. It may be habituating.
A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.
A subclass of analgesic agents that typically do not bind to OPIOID RECEPTORS and are not addictive. Many non-narcotic analgesics are offered as NONPRESCRIPTION DRUGS.
A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors.
Extraction of the FETUS by means of abdominal HYSTEROTOMY.
Emesis and queasiness occurring after anesthesia.
Amount of stimulation required before the sensation of pain is experienced.
Injection of ANALGESICS; LOCAL ANESTHETICS; or NARCOTICS into the PLEURAL CAVITY between the two pleural membranes.
Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from DRUG RESISTANCE wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from MAXIMUM TOLERATED DOSE and NO-OBSERVED-ADVERSE-EFFECT LEVEL.
A class of opioid receptors recognized by its pharmacological profile. Mu opioid receptors bind, in decreasing order of affinity, endorphins, dynorphins, met-enkephalin, and leu-enkephalin. They have also been shown to be molecular receptors for morphine.
Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.
A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines)
A pyrrolizine carboxylic acid derivative structurally related to INDOMETHACIN. It is an NSAID and is used principally for its analgesic activity. (From Martindale The Extra Pharmacopoeia, 31st ed)
Period from the onset of true OBSTETRIC LABOR to the complete dilatation of the CERVIX UTERI.
An opioid analgesic made from MORPHINE and used mainly as an analgesic. It has a shorter duration of action than morphine.
A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE.
A form of therapy that employs a coordinated and interdisciplinary approach for easing the suffering and improving the quality of life of those experiencing pain.
Epidural anesthesia administered via the sacral canal.
An imidazoline sympatholytic agent that stimulates ALPHA-2 ADRENERGIC RECEPTORS and central IMIDAZOLINE RECEPTORS. It is commonly used in the management of HYPERTENSION.
Medical methods of either relieving pain caused by a particular condition or removing the sensation of pain during a surgery or other medical procedure.
A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (RECEPTORS, N-METHYL-D-ASPARTATE) and may interact with sigma receptors.
A nerve originating in the lumbar spinal cord (usually L2 to L4) and traveling through the lumbar plexus to provide motor innervation to extensors of the thigh and sensory innervation to parts of the thigh, lower leg, and foot, and to the hip and knee joints.
Cell membrane proteins that bind opioids and trigger intracellular changes which influence the behavior of cells. The endogenous ligands for opioid receptors in mammals include three families of peptides, the enkephalins, endorphins, and dynorphins. The receptor classes include mu, delta, and kappa receptors. Sigma receptors bind several psychoactive substances, including certain opioids, but their endogenous ligands are not known.
The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.
A diphenylpropylamine with intense narcotic analgesic activity of long duration. It is a derivative of MEPERIDINE with similar activity and usage.
Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety.
A synthetic morphinan analgesic with narcotic antagonist action. It is used in the management of severe pain.
A short-acting opioid anesthetic and analgesic derivative of FENTANYL. It produces an early peak analgesic effect and fast recovery of consciousness. Alfentanil is effective as an anesthetic during surgery, for supplementation of analgesia during surgical procedures, and as an analgesic for critically ill patients.
A narcotic used as a pain medication. It appears to be an agonist at kappa opioid receptors and an antagonist or partial agonist at mu opioid receptors.
Agents inhibiting the effect of narcotics on the central nervous system.
The use of two or more chemicals simultaneously or sequentially to induce anesthesia. The drugs need not be in the same dosage form.
Injection of an anesthetic into the nerves to inhibit nerve transmission in a specific part of the body.
Surgical incision into the chest wall.
The endogenous peptides with opiate-like activity. The three major classes currently recognized are the ENKEPHALINS, the DYNORPHINS, and the ENDORPHINS. Each of these families derives from different precursors, proenkephalin, prodynorphin, and PRO-OPIOMELANOCORTIN, respectively. There are also at least three classes of OPIOID RECEPTORS, but the peptide families do not map to the receptors in a simple way.
A form of acupuncture with electrical impulses passing through the needles to stimulate NERVE TISSUE. It can be used for ANALGESIA; ANESTHESIA; REHABILITATION; and treatment for diseases.
A local anesthetic that is chemically related to BUPIVACAINE but pharmacologically related to LIDOCAINE. It is indicated for infiltration, nerve block, and epidural anesthesia. Mepivacaine is effective topically only in large doses and therefore should not be used by this route. (From AMA Drug Evaluations, 1994, p168)
An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief.
An IBUPROFEN-type anti-inflammatory analgesic and antipyretic. It is used in the treatment of rheumatoid arthritis and osteoarthritis.
Agents that are administered in association with anesthetics to increase effectiveness, improve delivery, or decrease required dosage.
An effect usually, but not necessarily, beneficial that is attributable to an expectation that the regimen will have an effect, i.e., the effect is due to the power of suggestion.
Analogs or derivatives of morphine.
An increased sensation of pain or discomfort produced by mimimally noxious stimuli due to damage to soft tissue containing NOCICEPTORS or injury to a peripheral nerve.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
A blocking of nerve conduction to a specific area by an injection of an anesthetic agent.
Central gray matter surrounding the CEREBRAL AQUEDUCT in the MESENCEPHALON. Physiologically it is probably involved in RAGE reactions, the LORDOSIS REFLEX; FEEDING responses, bladder tonus, and pain.
Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream.
The first mixed agonist-antagonist analgesic to be marketed. It is an agonist at the kappa and sigma opioid receptors and has a weak antagonist action at the mu receptor. (From AMA Drug Evaluations Annual, 1991, p97)
The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)
A imidazole derivative that is an agonist of ADRENERGIC ALPHA-2 RECEPTORS. It is closely-related to MEDETOMIDINE, which is the racemic form of this compound.
Surgery performed on an outpatient basis. It may be hospital-based or performed in an office or surgicenter.
Excision of the uterus.
A family of hexahydropyridines.
The relationship between the dose of an administered drug and the response of the organism to the drug.
The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon.
Persistent pain that is refractory to some or all forms of treatment.
A semisynthetic derivative of CODEINE.
The process by which PAIN is recognized and interpreted by the brain.
The injection of drugs, most often analgesics, into the spinal canal without puncturing the dura mater.
Analgesic antipyretic derivative of acetanilide. It has weak anti-inflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage.
Process of administering an anesthetic through injection directly into the bloodstream.
Intravenous anesthetics that induce a state of sedation, immobility, amnesia, and marked analgesia. Subjects may experience a strong feeling of dissociation from the environment. The condition produced is similar to NEUROLEPTANALGESIA, but is brought about by the administration of a single drug. (From Gilman et al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed)
A local anesthetic that is similar pharmacologically to LIDOCAINE. Currently, it is used most often for infiltration anesthesia in dentistry.
Peripheral AFFERENT NEURONS which are sensitive to injuries or pain, usually caused by extreme thermal exposures, mechanical forces, or other noxious stimuli. Their cell bodies reside in the DORSAL ROOT GANGLIA. Their peripheral terminals (NERVE ENDINGS) innervate target tissues and transduce noxious stimuli via axons to the CENTRAL NERVOUS SYSTEM.
Delivery of the FETUS and PLACENTA under the care of an obstetrician or a health worker. Obstetric deliveries may involve physical, psychological, medical, or surgical interventions.
Medical problems associated with OBSTETRIC LABOR, such as BREECH PRESENTATION; PREMATURE OBSTETRIC LABOR; HEMORRHAGE; or others. These complications can affect the well-being of the mother, the FETUS, or both.
A cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. Neostigmine, unlike PHYSOSTIGMINE, does not cross the blood-brain barrier.
Dull or sharp aching pain caused by stimulated NOCICEPTORS due to tissue injury, inflammation or diseases. It can be divided into somatic or tissue pain and VISCERAL PAIN.
Injections made into a vein for therapeutic or experimental purposes.
Extraction of the fetus by means of obstetrical instruments.
A drug that has analgesic, anti-inflammatory, and antipyretic properties. It is the sodium sulfonate of AMINOPYRINE.
Anti-inflammatory agents that are non-steroidal in nature. In addition to anti-inflammatory actions, they have analgesic, antipyretic, and platelet-inhibitory actions.They act by blocking the synthesis of prostaglandins by inhibiting cyclooxygenase, which converts arachidonic acid to cyclic endoperoxides, precursors of prostaglandins. Inhibition of prostaglandin synthesis accounts for their analgesic, antipyretic, and platelet-inhibitory actions; other mechanisms may contribute to their anti-inflammatory effects.
A cylindrical column of tissue that lies within the vertebral canal. It is composed of WHITE MATTER and GRAY MATTER.
Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience.
The space between the arachnoid membrane and PIA MATER, filled with CEREBROSPINAL FLUID. It contains large blood vessels that supply the BRAIN and SPINAL CORD.
Agents that induce NARCOSIS. Narcotics include agents that cause somnolence or induced sleep (STUPOR); natural or synthetic derivatives of OPIUM or MORPHINE or any substance that has such effects. They are potent inducers of ANALGESIA and OPIOID-RELATED DISORDERS.
Methods of delivering drugs into a joint space.
An opioid analgesic related to MORPHINE but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough.
Non-narcotic analgesic chemically similar to ORPHENADRINE. Its mechanism of action is unclear. It is used for the relief of acute and chronic pain. (From Martindale, The Extra Pharmacopoeia, 30th ed, p26)
The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.
The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it.
A derivative of the opioid alkaloid THEBAINE that is a more potent and longer lasting analgesic than MORPHINE. It appears to act as a partial agonist at mu and kappa opioid receptors and as an antagonist at delta receptors. The lack of delta-agonist activity has been suggested to account for the observation that buprenorphine tolerance may not develop with chronic use.
Interventions to provide care prior to, during, and immediately after surgery.
A narcotic analgesic that may be habit-forming. It is a controlled substance (opium derivative) listed in the U.S. Code of Federal Regulations, Title 21 Parts 329.1, 1308.11 (1987). Sale is forbidden in the United States by Federal statute. (Merck Index, 11th ed)
A method, developed by Dr. Virginia Apgar, to evaluate a newborn's adjustment to extrauterine life. Five items - heart rate, respiratory effort, muscle tone, reflex irritability, and color - are evaluated 60 seconds after birth and again five minutes later on a scale from 0-2, 0 being the lowest, 2 being normal. The five numbers are added for the Apgar score. A score of 0-3 represents severe distress, 4-7 indicates moderate distress, and a score of 7-10 predicts an absence of difficulty in adjusting to extrauterine life.
Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.
The insertion of drugs into the rectum, usually for confused or incompetent patients, like children, infants, and the very old or comatose.
A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.
The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few - MORPHINE; CODEINE; and PAPAVERINE - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic.
The period of emergence from general anesthesia, where different elements of consciousness return at different rates.
A class of opioid receptors recognized by its pharmacological profile. Kappa opioid receptors bind dynorphins with a higher affinity than endorphins which are themselves preferred to enkephalins.
A class of opioid receptors recognized by its pharmacological profile. Delta opioid receptors bind endorphins and enkephalins with approximately equal affinity and have less affinity for dynorphins.
Fluid propulsion systems driven mechanically, electrically, or osmotically that are used to inject (or infuse) over time agents into a patient or experimental animal; used routinely in hospitals to maintain a patent intravenous line, to administer antineoplastic agents and other drugs in thromboembolism, heart disease, diabetes mellitus (INSULIN INFUSION SYSTEMS is also available), and other disorders.
A 31-amino acid peptide that is the C-terminal fragment of BETA-LIPOTROPIN. It acts on OPIOID RECEPTORS and is an analgesic. Its first four amino acids at the N-terminal are identical to the tetrapeptide sequence of METHIONINE ENKEPHALIN and LEUCINE ENKEPHALIN.
An enkephalin analog that selectively binds to the MU OPIOID RECEPTOR. It is used as a model for drug permeability experiments.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
That portion of the body that lies between the THORAX and the PELVIS.
Elements of limited time intervals, contributing to particular results or situations.
Forceful administration into a muscle of liquid medication, nutrient, or other fluid through a hollow needle piercing the muscle and any tissue covering it.
A semisynthetic analgesic used in the study of narcotic receptors.
Drugs that selectively bind to and activate alpha adrenergic receptors.
Sensing of noxious mechanical, thermal or chemical stimuli by NOCICEPTORS. It is the sensory component of visceral and tissue pain (NOCICEPTIVE PAIN).
Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of NALOXONE. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence.
Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture.
A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.
One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla.
The administration of liquid medication, nutrient, or other fluid through some other route than the alimentary canal, usually over minutes or hours, either by gravity flow or often by infusion pumping.
One of the three major groups of endogenous opioid peptides. They are large peptides derived from the PRO-OPIOMELANOCORTIN precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; OPIOID PEPTIDES is used for the broader group.
An intravenous anesthetic agent which has the advantage of a very rapid onset after infusion or bolus injection plus a very short recovery period of a couple of minutes. (From Smith and Reynard, Textbook of Pharmacology, 1992, 1st ed, p206). Propofol has been used as ANTICONVULSANTS and ANTIEMETICS.
Ultrashort-acting anesthetics that are used for induction. Loss of consciousness is rapid and induction is pleasant, but there is no muscle relaxation and reflexes frequently are not reduced adequately. Repeated administration results in accumulation and prolongs the recovery time. Since these agents have little if any analgesic activity, they are seldom used alone except in brief minor procedures. (From AMA Drug Evaluations Annual, 1994, p174)
A short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. It is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. The short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. It is water-soluble at pH less than 4 and lipid-soluble at physiological pH.
Compounds based on a partially saturated iminoethanophenanthrene, which can be described as ethylimino-bridged benzo-decahydronaphthalenes. They include some of the OPIOIDS found in PAPAVER that are used as ANALGESICS.
Surgery performed on the female genitalia.
The observable response an animal makes to any situation.
A range of methods used to reduce pain and anxiety during dental procedures.
Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve.
Trained lay women who provide emotional and/or physical support during obstetric labor and the postpartum period for mothers and their partners.
The period of OBSTETRIC LABOR that is from the complete dilatation of the CERVIX UTERI to the expulsion of the FETUS.
A non-steroidal anti-inflammatory agent (ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL) similar in mode of action to INDOMETHACIN.
A cyclooxygenase inhibiting, non-steroidal anti-inflammatory agent (NSAID) that is well established in treating rheumatoid arthritis and osteoarthritis and used for musculoskeletal disorders, dysmenorrhea, and postoperative pain. Its long half-life enables it to be administered once daily.
Designated locations along nerves or organ meridians for inserting acupuncture needles.
The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= OXYGEN CONSUMPTION) or cell respiration (= CELL RESPIRATION).
Procedures used to treat and correct deformities, diseases, and injuries to the MUSCULOSKELETAL SYSTEM, its articulations, and associated structures.
Intensely discomforting, distressful, or agonizing sensation associated with trauma or disease, with well-defined location, character, and timing.
Injections into the cerebral ventricles.
An opioid analgesic with actions and uses similar to those of MORPHINE, apart from an absence of cough suppressant activity. It is used in the treatment of moderate to severe pain, including pain in obstetrics. It may also be used as an adjunct to anesthesia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1092)
Procedure in which an individual is induced into a trance-like state to relieve pain. This procedure is frequently performed with local but not general ANESTHESIA.
Space between the dura mater and the walls of the vertebral canal.
The period following a surgical operation.
Replacement of the knee joint.
A butyrophenone with general properties similar to those of HALOPERIDOL. It is used in conjunction with an opioid analgesic such as FENTANYL to maintain the patient in a calm state of neuroleptanalgesia with indifference to surroundings but still able to cooperate with the surgeon. It is also used as a premedicant, as an antiemetic, and for the control of agitation in acute psychoses. (From Martindale, The Extra Pharmacopoeia, 29th ed, p593)
A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt.
The heart rate of the FETUS. The normal range at term is between 120 and 160 beats per minute.
The action of a drug that may affect the activity, metabolism, or toxicity of another drug.
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.
Compounds that bind to and activate ADRENERGIC ALPHA-2 RECEPTORS.
An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses.
Endoscopic examination, therapy and surgery of the joint.
A method in which either the observer(s) or the subject(s) is kept ignorant of the group to which the subjects are assigned.
An abdominal hernia with an external bulge in the GROIN region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the ABDOMINAL WALL (transversalis fascia) in Hesselbach's triangle. The former type is commonly seen in children and young adults; the latter in adults.
The use of specifically placed small electrodes to deliver electrical impulses across the SKIN to relieve PAIN. It is used less frequently to produce ANESTHESIA.
Forceful administration under the skin of liquid medication, nutrient, or other fluid through a hollow needle piercing the skin.
The forcible expulsion of the contents of the STOMACH through the MOUTH.
Drugs used to prevent NAUSEA or VOMITING.
Therapy with two or more separate preparations given for a combined effect.
Strong dependence, both physiological and emotional, upon morphine.
The number of offspring a female has borne. It is contrasted with GRAVIDITY, which refers to the number of pregnancies, regardless of outcome.
Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.
A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the TIBIAL NERVE and the PERONEAL NERVE.
The active sympathomimetic hormone from the ADRENAL MEDULLA. It stimulates both the alpha- and beta- adrenergic systems, causes systemic VASOCONSTRICTION and gastrointestinal relaxation, stimulates the HEART, and dilates BRONCHI and cerebral vessels. It is used in ASTHMA and CARDIAC FAILURE and to delay absorption of local ANESTHETICS.
The surgical removal of a tooth. (Dorland, 28th ed)
A disulfide opioid pentapeptide that selectively binds to the DELTA OPIOID RECEPTOR. It possesses antinociceptive activity.
A pyrrolizine carboxylic acid derivative structurally related to INDOMETHACIN. It is a non-steroidal anti-inflammatory agent used for analgesia for postoperative pain and inhibits cyclooxygenase activity.
Presence of warmth or heat or a temperature notably higher than an accustomed norm.
Surgical removal of a tonsil or tonsils. (Dorland, 28th ed)
Patient care procedures performed during the operation that are ancillary to the actual surgery. It includes monitoring, fluid therapy, medication, transfusion, anesthesia, radiography, and laboratory tests.
The period during a surgical operation.
One of the endogenous pentapeptides with morphine-like activity. It differs from MET-ENKEPHALIN in the LEUCINE at position 5. Its first four amino acid sequence is identical to the tetrapeptide sequence at the N-terminal of BETA-ENDORPHIN.
A subclass of alpha-adrenergic receptors found on both presynaptic and postsynaptic membranes where they signal through Gi-Go G-PROTEINS. While postsynaptic alpha-2 receptors play a traditional role in mediating the effects of ADRENERGIC AGONISTS, the subset of alpha-2 receptors found on presynaptic membranes signal the feedback inhibition of NEUROTRANSMITTER release.
The action of a drug in promoting or enhancing the effectiveness of another drug.
Insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes.
A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.
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.
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 ...
|i|Background|/i|. If conversion of labor epidural analgesia to cesarean delivery anesthesia fails, the anesthesiologist can be confronted with a challenging clinical dilemma. Optimal management of a failed epidural top up continues to be debated in the absence of best practice guidelines. |i|Method|/i|. All members of the Obstetric Anaesthetists’ Association in the United Kingdom were emailed an online survey in May 2017. It obtained information on factors influencing the decision to utilize an existing labor epidural for cesarean section and, if epidural top up resulted in no objective sensory block, bilateral T10 sensory block, or unilateral T6 sensory block, factors influencing the management and selection of anesthetic technique. Differences in management options between respondents were compared using the chi-squared test. |i|Results|/i|. We received 710 survey questionnaires with an overall response rate of 41%. Most respondents (89%) would consider topping up an existing
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 ...
TY - JOUR. T1 - Parity, prolonged labor and epidural analgesia. AU - Witter, F. R.. AU - Caulfield, L. E.. PY - 1996/6. Y1 - 1996/6. KW - Analgesia. KW - Epidural. KW - Labor. KW - Parity. UR - UR - U2 - 10.1016/0020-7292(96)02658-6. DO - 10.1016/0020-7292(96)02658-6. M3 - Letter. C2 - 8793631. AN - SCOPUS:0029938227. VL - 53. SP - 269. EP - 270. JO - International Journal of Gynecology and Obstetrics. JF - International Journal of Gynecology and Obstetrics. SN - 0020-7292. IS - 3. ER - ...
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
Pain management information for pain medicine healthcare professionals in treating and caring for their patients. Clinical Pain Advisor offers news, case studies and more.
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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?
The effect of continuous epidural analgesia on cesarean section for dystocia in nulliparous women. Am J Obstet Gynecol. 1989 Sep;161(3):670-5.
Advances in the field of labour analgesia have tread a long journey from the days of ether and chloroform in 1847 to the present day practice of comprehensive programme of labour pain management using evidence-based medicine. Newer advances include introduction of newer techniques like combined spinal epidurals, low-dose epidurals facilitating ambulation, pharmacological advances like introduction of remifentanil for patient-controlled intravenous analgesia, introduction of newer local anaesthetics and adjuvants like ropivacaine, levobupivacaine, sufentanil, clonidine and neostigmine, use of inhalational agents like sevoflourane for patient-controlled inhalational analgesia using special vaporizers, all have revolutionized the practice of pain management in labouring parturients. Technological advances like use of ultrasound to localize epidural space in difficult cases minimizes failed epidurals and introduction of novel drug delivery modalities like patient-controlled epidural analgesia (PCEA) ...
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 ...
Eisenmenger syndrome belongs to the 0.4-4.1% (incidence) rarely encountered congenital cardiac lesions in pregnancy. Management of a pregnant patient with Eisenmenger syndrome is a challenging task for the anesthesiologist. Here, we report the successful outcome with the use of low-dose sequential combined spinal-epidural (CSE) anesthesia in a patient with Eisenmenger syndrome posted for cesarean section. Low-dose sequential CSE anesthesia was adequate for the performance of cesarean section with minimal hemodynamic changes and good fetal outcome. Low-dose sequential CSE can be a safe alternative to achieve good anesthesia with hemodynamic stability in such case.
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 ...
Patient controlled intravenous opioid analgesia vs. continuous epidural analgesia for pain after intra-abdominal surgery answers are found in the Evidence-Based Medicine Guidelines powered by Unbound Medicine. Available for iPhone, iPad, Android, and Web.
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 ...
Labor pain relief - Options: Labor Pain: Childbirth Information for Pregnant Women. Soothing, Natural Eazol Eases Your Aches, Pains and Twinges relief.
Im currently 39+4 with my first baby, I think Im in early labour. Woke up last night at about 2:30am thinking I just had bad wind pains, every time
In this disease, the woman suffers from labour pain after childbirth. She suffers from excessive pain as she faced before the delivery.
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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 ...
epidural anaesthesia and caesarean, epidural analgesia on outcomes of labor, labour epidural, association of epidural and caesarean delivery in childbirth
مجله علمی دانشگاه علوم پزشکی و خدمات درمانی بیرجند . داراي رتبه علمي- پژوهشي از كميسيون نشريات علوم پزشكي كشور Journal of Birjand University of Medical Sciencesfrom iran
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NEW YORK (Reuters Health) - Epidurals and other drug-based treatments are the tried-and-tested way to ease labor pain, but also have side effects that make...
Scared of labor? Worried about pain? Our Round Rock OBGYNs provide a number of options for managing labor pain to suit each womans labor.
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What the Anesthesiologist Should Know before the Operative Procedure Multiple modalities exist for nonpharmacologic analgesia for labor and delivery. While the laboring parturient has a sense of urgency secondary to pain, it is essential to understand that labor analgesia is considered elective. Nonpharmacologic analgesia is not relevant to operative delivery such as cesarean or forceps-assisted…. ...
The most common side effect of pain medicines and anesthesia is drowsiness. Your child may sleep more than usual after surgery because of the pain medicine, and because sleep is the bodys way of healing itself. The nurse will be checking to see how easily your child wakes up.. Other possible side effects are slow breathing, nausea (upset stomach), vomiting (throwing up), and itching. Medicines may be given to your child to help with any nausea, vomiting, or itching. Your child will be on monitors so that the nurses can watch the breathing rate and oxygen saturation.. Some children have numbness or tingling, especially in their legs. If your child has this feeling, tell your nurse. Although it is usually temporary, your nurse will check your child. A nurse will help your child the first time he or she gets out of bed. Sometimes a change in the medicine dose can decrease the numbness.. ...
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By Courtney L. Baetge, DVMIf I have learned anything during my time as an anesthesiologist, it is that for every topic there are a multitude of opinions. But I do believe most anesthesiologists are strong advocates of epidurals. The benefits of an improved anesthetic plane, smoother recovery and superior post-operative pain control well outweigh the…
Health,A study done by researchers from University of Sydney suggested that h...Researchers who studied 1300 women who gave birth between March & ...The researchers who looked at the womens childbirth and breastfeedi...The findings of the study contribute to the evidence of the fact tha...The most likely cause of the problems was due to the presence of fen...,Epidurals,Associated,With,Breastfeeding,Problems,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news
As a working doula, what can I say about epidurals today? I have three things to say about them. First, if you are giving birth in a non-rural part of the U.S., you should decide what you think about having an epidural prior to your birth. You should read about them and discuss them with your care provider (doctor or midwife) and also your doula.. Second, please realize that most mothers can give birth without an epidural and that there are distinct advantages to not having an epidural. All the mothers who have spoken to me about giving birth without pain medication have been glad that they did it! Not just some of them, all of them! That is significant. They may have different reasons, but moms who have a pain-med-free birth are proud of themselves. They have conquered their rite of passage into motherhood. They have accomplished something that no one can ever take away from them. Ever.. That isnt to say that moms who have an epidural (or other pain medications in labor) wont have a lovely ...
Women once had to endure labor and delivery without medication to ease the pain. Now, techniques like epidurals can make giving birth more calm, controlled, and comfortable.
article ,File = file ,Template = template ,Category = category ,#default = page}}}} and you wish to make a change, you can {{#ifeq:Template,Template talk,,request an edit, discuss changes on the talk page,}} request unprotection, log in, or create an account. ,move=The page may still be edited but cannot be moved until unprotected. Please discuss any suggested moves on the talk page or at Wikipedia:Requested moves. You can also request that the page be unprotected. ,office=If you are able to edit this page, please discuss all changes and additions on the talk page first. Do not remove protection from this page unless you are authorized by the Wikimedia Foundation to do so. ,create=Please see the {{#if:,[[{{{xfd}}},deletion discussion]] or the}} deletion log for details of why this page was deleted. If you would like to create a page at this title, you must first request for it to be unprotected, or contact the administrator who deleted the page for the deleted material to be restored. If ...
Marks an AccessLogElement as needing to be have the value cached at the start of the request rather than just recorded at the end as the source data for the element may not be available at the end of the request. This typically occurs for remote network information, such as ports, IP addresses etc. when the connection is closed unexpectedly. These elements take advantage of these values being cached elsewhere on first request and do not cache the value in the element since the elements are state-less ...
Shed gotten Finns first text message on her way to the hospital but decided against texting him back until she got to the hospital; however, by then hed already withdrawn his first request and told her to take a rain check. Noting that she really needed to talk to him, Addison made a mental note to contact him later. The night before had been complicated and she was sure shed led him on. Now things were different and she was going to work things out with Derek so she needed to tell him. He was a good friend and she was sure that she would need his shoulder to lean on when things got tough with Derek so she needed to be absolutely honest with him ...
Cochrane researchers say that inhaled pain relief appears to be effective in reducing pain intensity and in giving pain relief in the first stage of labour.
Background: Epidural analgesia (EA), at the present time, is one of the most effective methods to reduce labor pain. In recent years its use has increased, being used between 20-70% of all deliveries; (2) Methods ... 03-10 6,0L Air Test Fitting,Test for IPR and High pressure oil pump failures, WE CARRY A FULL LINE OF POWERSTROKE PARTS,Discount Prices, Easy Exchanges,products at discount prices,Easy Return,Effortless Shopping,All for great prices - Satisfaction Guaranteed.
Kim Kardashian was made to deliver her baby five weeks before the due date because doctors feared she was suffering from a potentially dangerous condition.
The two husbands claim that women exaggerate everything, but after getting hooked up to the electrodes and zapped repeatedly, they change their story. The electrodes simulate the pain that comes with childbirth and ramps up from a level one which is the very beginning of labor to level 10, which demonstrates what it feel like during full-blown delivery time ...
Postpartum peripheral nerve issues are an unusual obstetrical complication, with most instances ensuing from intrinsic obstetric palsies. We current the case of a full-term nulliparous pregnant 33-year-old girl with a vacuum-assisted vaginal supply as a result of a protracted second stage of labour and occipitoposterior place of the fetal head. For analgesia, a mixed spinal-epidural approach was used.… Continue reading. ...
Justice Weilers concerns about the 12-month cap were echoed in Minott v. OShanter in 1999, where the Court of Appeal clarified that Cronk didnt establish a hard ceiling. Yet the result was still something of a soft ceiling, like the 24-month overall ceiling for notice periods - it was hard to get past, and impossible to get much past. (In Minott itself, the Court of Appeal upheld an award of a 13-month notice period to a non-supervisory unskilled labourer who was 43 years old with 11 years of *that* one to Mr. Rubin ...
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Romagnoli A, Korman D (1962). "Methoxyflurane in obstetrical anaesthesia and analgesia". 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 (October 1959). "Use of premixed pethidine and antagonists in obstetrical analgesia; with special reference to cases ... 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., ... 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 ... analgesia during labor and delivery. However, a 2014 Cochrane Systematic Review concluded that from the included studies, there ...
... and some clinicians prefer to use morphine to get a wider spread of analgesia. However, it is widely used in obstetrical ... It is FDA approved to provide four days of analgesia after a single application prior to surgery. It is not approved for ... Transdermal fentanyl has also been used for many years in dogs and cats for post-operative analgesia. This is usually done with ... Supraspinal analgesia (μ1) Respiratory depression (μ2) Physical dependence Muscle rigidity It produces sedation and spinal ...
MeSH E03.091.048 - acupuncture analgesia MeSH E03.091.080 - analgesia, epidural MeSH E03.091.110 - analgesia, obstetrical MeSH ... obstetrical MeSH E03.155.441 - cryoanesthesia MeSH E03.155.519 - electroacupuncture MeSH E03.155.675 - hypnosis, anesthetic ... E03.091.120 - analgesia, patient-controlled MeSH E03.091.214 - audioanalgesia MeSH E03.091.646 - neuroleptanalgesia MeSH ...
Mont, M. A., Beaver, W. B., Dysart, S. H., Barrington, J. W., & Gaizo, D. J. (2018). "Local Infiltration Analgesia With ... However, it is approved for use at term in obstetrical anesthesia. Bupivacaine is excreted in breast milk. Risks of ... It is also contraindicated in obstetrical paracervical blocks and intravenous regional anaesthesia (Bier block) because of ... is indicated for acute postsurgical analgesia (pain relief) for up to 24 hours in adults following open inguinal hernia repair ...
Obstetrical & Gynecological Survey. 60 (10): 663-671. doi:10.1097/ ISSN 0029-7828. PMID 16186783. ... Anesthesia and Analgesia. 124 (1): 216-232. doi:10.1213/ANE.0000000000001473. ISSN 1526-7598. PMC 5161642. PMID 27557476. ...
"Patient controlled opioid analgesia versus non-patient controlled opioid analgesia for postoperative pain". The Cochrane ... Obstetrical, the very young and the very old are all at greater risk of complication so extra precautions may need to be taken ... Klomp T, van Poppel M, Jones L, Lazet J, Di Nisio M, Lagro-Janssen AL (September 2012). "Inhaled analgesia for pain management ... Klomp T, van Poppel M, Jones L, Lazet J, Di Nisio M, Lagro-Janssen AL (September 2012). "Inhaled analgesia for pain management ...
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- ...
Some choose to narrow the focus of care to sub-specialize in the provision of cardiac, pediatric, pain, or obstetrical care. ... and ensuring optimal analgesia throughout. Some sub-specialty physician anesthesiologists are an integral member of the ...
... perform obstetrical assessments, and provide pharmacological pain relief for various conditions. Several sites in Canada have ... analgesia, platelet inhibitors (including nitroglycerin, glucose, nitrous oxide, acetylsalicylic acid, salbutamol, intravenous ...
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 has been associated with longer ... Epidural analgesia has no statistically significant impact on the risk of caesarean section, and does not appear to have an ... Anim-Somuah M, Smyth RM, Cyna AM, Cuthbert A (May 2018). "Epidural versus non-epidural or no analgesia for pain management in ...
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 ...
... and the Apgar Score: How the Apgar Score Came to Be". Anesthesia & Analgesia. 120 (5): 1060-4. doi:10.1213/ANE. ... She was a leader in the fields of anesthesiology and teratology, and introduced obstetrical considerations to the established ... Virginia Apgar (June 7, 1909 - August 7, 1974) was an American physician, obstetrical anesthesiologist and medical researcher, ... Analgesia. 32 (4): 260-267. PMID 13083014. Archived from the original on November 30, 2012. Retrieved November 7, 2012. " ...
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, ...
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 ... "Local anaesthetics and regional anaesthesia versus conventional analgesia for preventing persistent postoperative pain in ...
It describes 4 stages of obstetrical hemorrhage after childbirth and its application reduces maternal mortality. Stage 0: ... Anesthesia and Analgesia. 119 (5): 1140-1147. doi:10.1213/ANE.0000000000000450. ISSN 1526-7598. PMID 25329026. S2CID 23461056. ... the aim being to improve shock in a mother with obstetrical bleeding long enough to reach a hospital. External aortic ...
Not only is there no analgesia or skilled attendance, but there is no emotional support; on the contrary, the mother's mental ... la névrose traumatique post obstétricale. Perspectives Psychiatriques 4: 321-328. James S (2015) Women's experiences of ...
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. PMID 25988638. Behrman RE, Butler AS, Outcomes, ...
Injection of anesthetic into a nerve for analgesia (05) Operations on sympathetic nerves or ganglia (05.2) Sympathectomy (05.21 ... Pubiotomy to assist delivery Obstetrical symphysiotomy (73.99) Other (74) Cesarean section and removal of fetus (75) Other ...
Gynecological, obstetrical, and urological operations (spinal/epidural anesthesia). *Bone and joint surgery of the pelvis, hip ... Gow-Gates GA (April 1998). "The Gow-Gates mandibular block: regional anatomy and analgesia". Australian Endodontic Journal. 24 ... Kampe S, Warm M, Kasper SM, Diefenbach C (July 2003). "Concept for postoperative analgesia after pedicled TRAM flaps: ...
Inadequate analgesia could cause traumatic flashbacks of the extreme pain during and after the anaesthetic-less circumcision in ... According to a 1985 paper in the Obstetrical & Gynecological Survey, clitoridectomy was performed in the United States into the ... Cutner, Lawrence P. (July 1985). "Female genital mutilation". Obstetrical & Gynecological Survey. 40 (7): 437-443. doi:10.1097/ ... doctors in London accused him of quackery and expelled him from the Obstetrical Society. Later in the 19th century, A. J. Bloch ...
Wang SM, Kain ZN, White P (February 2008). "Acupuncture analgesia: I. The scientific basis". Anesthesia and Analgesia. 106 (2 ... obstetrical conditions, opioid addiction, Parkinson's disease, polycystic ovary syndrome, posttraumatic stress disorder, ... Wang SM, Kain ZN, White PF (February 2008). "Acupuncture analgesia: II. Clinical considerations". Anesthesia and Analgesia. 106 ... Staud R, Price DD (May 2006). "Mechanisms of acupuncture analgesia for clinical and experimental pain". Expert Review of ...
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 ...
Other obstetrical/gynecological causes of similar abdominal pain in women include pelvic inflammatory disease, ovarian torsion ... Anderson M, Collins E (November 2008). "Analgesia for children with acute abdominal pain and diagnostic accuracy". Archives of ...
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.. ...
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. ...
1. Bitsch M, Emmrich J, Hary J, Lippach G, Rindt W. Obstetrical analgesia with tramadol. Fortschr Med. 1980 Apr 24;98(16):632-4 ... Husslein P, Kubista E, Egarter C. Obstetrical analgesia with tramadol--results of a prospective randomized comparative study ... Because tramadol does not exhibit a depressive effect on ventilatory activity it is often be used in the obstetrical analgesia ... Analgesia provided by meperidine and tramadol is comparable and approximately 50% of women rated the analgesia as good. ...
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.. ...
... control was changed to Analgesia, Obstetrical and the combination Fetus/injuries was changed to Prenatal Injuries). Searchers ...
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.. ...
... during epidural anesthesia were randomly assigned to receive one of three opioid analgesics via patient-controlled analgesia ( ... A comparison of morphine, meperidine, and oxymorphone as utilized in patient-controlled analgesia following cesarean delivery ... Whereas morphine is a more commonly utilized PCA analgesic, the excellent analgesia, low incidence of sedation, and high ... All patients achieved an excellent level of analgesia at rest (NS); however, onset was most rapid with oxymorphone (P less than ...
Epidural analgesia had no statistically significant impact on the risk of caesarean section, maternal satisfaction with … ... Epidural analgesia appears to be effective in reducing pain during labour. However, women who use this form of pain relief are ... Analgesia, Epidural* / adverse effects * Analgesia, Obstetrical / adverse effects * Analgesia, Obstetrical / methods* * ... Epidural versus non-epidural or no analgesia in labour Cochrane Database Syst Rev. 2011 Dec 7;(12):CD000331. doi: 10.1002/ ...
... após analgesia obstétrica, em especial após o bloqueio combinado raqui-peridural,... ... Epidural analgesia. Fetal monitoring. Obstetric labor. Obstetrical analgesia. Uterine contraction. Uterine monitoring. ... Analgesia epidural. Analgesia obstétrica. Contração uterina. Monitorização fetal. Monitorização uterina. Trabalho de parto. ... Efeito da analgesia obstétrica combinada raqui-peridural no tônus uterino e na freqüência cardíaca fetal: ensaio clínico ...
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 ...
Reported Analgesia, No.. Timing of OMT in Pregnancy. Osteopathic and Obstetrical Providers. Significant Statistical Analysis ... Reported Analgesia, No.. Timing of OMT in Pregnancy. Osteopathic and Obstetrical Providers. Significant Statistical Analysis ... Reported Analgesia, No.. Timing of OMT in Pregnancy. Osteopathic and Obstetrical Providers. Significant Statistical Analysis ... Reported Analgesia, No.. Timing of OMT in Pregnancy. Osteopathic and Obstetrical Providers. Significant Statistical Analysis ...
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. * ...
Bullough J (October 1959). "Use of premixed pethidine and antagonists in obstetrical analgesia; with special reference to cases ... 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. ...
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 ...
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, ... Epidural analgesia for labor and delivery. (An evidence-based review of the risks and benefits of epidural analgesia for labor ... Neuraxial analgesia is preferred for labor analgesia as it is the most effective and least depressant analgesic technique that ...
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 ...
  • Obstetrical Anesthesia and Analgesia. (
  • There have been various studies on the complications of obstetric anesthesia and analgesia. (
  • Anesthesia and Analgesia Practice Pathway Options for Total Knee Arthroplasty: An Evidence-Based Review by the American and European Societies of Regional Anesthesia and Pain Medicine. (
  • Three months prior to that study's release, researchers from Sunnybrook and Women's College Health Sciences Centre in Toronto reported in the November issue of Anesthesia and Analgesia that patient-controlled epidural analgesia did not result in an increased incidence of obstetrical intervention. (
  • Coverage of anesthesia and analgesia includes the latest information on pharmacokinetics of anesthetic drugs, chemical restraint, injectable and inhalation anesthesia, neuroanesthesia, and pain management. (
  • The anesthesiology team provides clinical anesthesia for obstetrical cases, including high-risk deliveries, vaginal deliveries and Cesarean sections (C-sections). (
  • The Department of Anesthesiology at Newton-Wellesley Hospital provides a full range of anesthetic and pain management services to patients in the operating rooms, Preoperative Evaluation Center, obstetrical suite and other areas of the hospital. (
  • Demerol Injection is indicated for preoperative medication, support of anesthesia, and obstetrical analgesia. (
  • Demerol is used to relieve moderate to severe pain, as a preoperative medication, and the support of anesthesia and for obstetrical analgesia. (
  • For preoperative medication, support of anesthesia, obstetrical analgesia, and for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. (
  • Labor Analgesia With Ropivacaine Added to Clonidine. (
  • In order to investigate the association between uterine tone elevation and fetal heart rate (FHR) abnormalities following labor analgesia - mainly with combined spinal-epidural (CSE) technique - a prospective double-blinded randomized study was conducted with seventy seven parturients who requested labor analgesia. (
  • Patients who require a decrease in their basal labor analgesia epidural infusion rate will have an increased incidence of forceps delivery. (
  • Confounding the relationship between OMT and labor duration is the lack of standardization between treatment settings, gestational ages at the time of treatment, OMT techniques, and overall obstetrical management principles from foundational and modern osteopathic approaches. (
  • To evaluate the effect of OMT on labor duration when applied in tandem with standard obstetrical management in the inpatient setting. (
  • Obstetrical decisions regarding labor management were made by 1 senior attending osteopathic obstetrician. (
  • Pregnancy and labor present many musculoskeletal and neurovisceral challenges to obstetrical patients and, to the authors' knowledge, this is the first study to present an effective, efficient, and feasible approach to intrapartum osteopathic obstetrical management in the inpatient setting to reduce labor duration. (
  • Approximately 60 percent of women, or 2.4 million each year, choose epidural or combined spinal-epidural analgesia for pain relief during labor. (
  • Neuraxial analgesia is the preferred method of providing analgesia for labor and vaginal delivery. (
  • Labor analgesia is elective, although ethically and in the interest of good customer service, parturients expect their request for pain medication to be responded to in an expeditious way. (
  • The obstetrician can usually tell the anesthesiologist if there are medical issues that might complicate or preclude provision of neuraxial analgesia for labor. (
  • Neuraxial analgesia for labor is always elective, although the discomfort and anxiety of the parturient will give a sense of urgency, especially late in labor. (
  • Analgesia for labor is always elective and the provider should not proceed if further evaluation is deemed necessary. (
  • In addition, neuraxial blockade techniques such as the combined spinal-epidural, continuous spinal anesthetic techniques, or patient-controlled intravenous analgesia for labor are available. (
  • She helped draft the College's 2002 guidance about analgesia for labor, which, she says, "did not discuss nitrous oxide as an option since its use in the U.S. was exceedingly rare at the time. (
  • Almost 3000 deliveries were performed in 12 labor rooms and 3 Obstetrical Operating Rooms. (
  • In the early 20th century, women used laughing gas to ease the pain of labor, but its use declined in favor of more potent analgesia. (
  • Nalbuphine hydrochloride can also be used as a supplement to balanced anesthesia, for preoperative and postoperative analgesia, and for obstetrical analgesia during labor and delivery. (
  • Demographic data, obstetrical interventions, duration from rupture of membrane to delivery, and durations of labor stages were recorded. (
  • Type of labor analgesia was also documented. (
  • Multiple modalities exist for nonpharmacologic analgesia for labor and delivery. (
  • While the laboring parturient has a sense of urgency secondary to pain, it is essential to understand that labor analgesia is considered elective. (
  • As previously mentioned, analgesia for labor and delivery is elective. (
  • Not applicable to labor analgesia. (
  • Labor analgesia is elective. (
  • 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. (
  • The decision to delay labor analgesia or anesthesia for an operative delivery would be at the discretion of the anesthesiologist and obstetrician. (
  • A variety of regional analgesia services are available for women in labor including epidural, spinal, combined spinal epidural and patient-controlled epidural. (
  • 1. What specific issues are involved in providing analgesia for labor in an uncomplicated pre-eclamptic patient? (
  • Laboring patients must be educated about the different available methods of labor analgesia. (
  • Many pharmacological and nonpharmacological methods of labor analgesia have been adopted over the years. (
  • Approximately 60% of laboring women (2.4 million each year) choose regional analgesia for pain relief during labor. (
  • Besides providing analgesia in labor, regional analgesia may facilitate atraumatic vaginal delivery of twins, preterm neonates, and neonates with breech presentation. (
  • Only opioids could be used for labor analgesia in these situations, as they do not decrease systemic vascular resistance. (
  • Earlier this year, in the Feb. 17 issue of The New England Journal of Medicine, Northwestern researchers found Cesarean rates did not significantly differ among 750 nulliparous women who either received epidural analgesia during early labor (less than four centimeters dilation) or during later labor (4 cm dilation or more). (
  • Even though maternal health care providers in this environment have a positive attitude to pain relief in labor, most women go through labor without the benefit of analgesia. (
  • The staff serves more than 13,000 patients of all ages each year, and provides many of the hospital's obstetrical patients with analgesia, using the most current epidural and spinal techniques for labor and delivery. (
  • Obstetric Epidural Analgesia (OEA) is presently considered to be one of the most effective and commonly utilized techniques for providing pain relief during labor and delivery. (
  • Ideally, pregnant patients with cardiovascular disease would present in the latent phase of labor, allowing time to review diagnostic studies, draw any necessary laboratory studies, place indicated invasive monitors, and establish early epidural analgesia. (
  • Unless the cessation of contractions is indicated for obstetrical reasons, patients who present in labor will be delivered, and their care must be optimized using information already obtained or readily gathered. (
  • Early analgesia does not block labor in first pregnancies]. (
  • Peridural analgesia may prevent pain, but some physicians prefer to administrate this until labor has progressed in order to avoid blocking labor so a cesarean surgery would be required. (
  • In this case, the mother suffers pain until labor has progressed enough to apply analgesia. (
  • Cesarean surgery increases maternal morbidity, thus it is important to evaluate labor progression when analgesia is applied at an early or advanced stage of labor. (
  • In 2011, a liposomal formulation of bupivacaine, EXPAREL, was approved by the FDA for single-dose infiltration in surgical site to produce postsurgical analgesia. (
  • EXPAREL is indicated for single-dose administration into the surgical site to produce postsurgical analgesia. (
  • Levallorphan was also used in combination with opioid analgesics to reduce their side effects, mainly in obstetrics, and a very small dose of levallorphan used alongside a full agonist of the MOR can produce greater analgesia than when the latter is used by itself. (
  • Enflurane analgesia in obstetrics. (
  • Comparison between particular methods of obstetrics analgesia, their analgetic efects and influence on progress of delivery and postpartum adaptation of fetus. (
  • Long and Yue (2) evaluated the safety and analgesic efficacy of patient controlled intravenous analgesia (PCIA) with tramadol , and compared its benefits and risks with combined spinal-epidural analgesia (CSEA)+ patient controlled epidural analgesia (PCEA). (
  • Options for post-cesarean analgesia include neuraxial opioids or catheters, patient-controlled intravenous analgesia, and transversus abdominal plain blockade. (
  • Epidurals provided "superior analgesia and less maternal and neonatal sedation compared with patient-controlled intravenous opioid analgesia," the randomized, controlled trial found. (
  • A prospective study of 644 patients who received intravenous increments of nalbuphine (196 women) or epidural analgesia (217 women) or pethidin (231 women). (
  • These events should be anticipated and managed as part of opioid analgesia therapy. (
  • The safety of this drug product has only been established in a highly selected group of cancer patients, and only after an adequate trial of opioid analgesia. (
  • TAP infiltration is being increasingly utilized for postsurgical analgesia in abdominal procedures as clinicians aim to maintain pain control while reducing reliance on opioid analgesics. (
  • In May, Pacira announced the completion of the end-of-review process with the U.S. Food and Drug Administration (FDA) Division of Anesthesia, Analgesia and Addiction Products (DAAAP) of the Center for Drug Evaluation and Research regarding the supplemental New Drug Application (sNDA) for the use of EXPAREL for administration as a nerve block to provide postsurgical analgesia. (
  • A pivotal study in third molar extraction will evaluate the use of EXPAREL administered as an infiltration to provide postsurgical analgesia in oral surgery. (
  • Logically, with increased use of regional analgesia, there are now reports of complications with these techniques. (
  • The ASA Task Force on Guidelines for Obstetrical Anesthesia has suggested that in healthy women, obtaining a routine platelet count does not reduce complications of neuraxial anesthesia. (
  • 2 For example, investigators found that the incidence of serious complications of obstetric epidural analgesia did not change over a 17-yr study period. (
  • Immediate and delayed complications of epidural analgesia in labour and delivery. (
  • A prospective controlled, longitudinal study investigated the immediate and delayed complications of epidural analgesia in labour. (
  • Dr. Waters discusses the complications of obstetrical analgesia and anesthesia, and reviews treatment options and proper management of spinal anesthetics. (
  • Epidural analgesia managed by the obstetrician doesn't result in more complications by the method itself, the increase of operative deliveries is found even in clinics where the PDA is carried out by the anesthetist. (
  • Obstetric analgesia and anesthesia have some specific aspects, which in particular are directly related to pathophysiological alterations during pregnancy and also to the circumstance that two or even more individuals are always affected by complications or therapeutic measures. (
  • Subgroup analyses included policy regarding the presence of companion, availability of epidural analgesia, policy on routine electronic fetal monitoring and variations in provider characteristics. (
  • The most significant factor linked to lower maternal mortality rates is the greater use of regional analgesia ( Hawkins, 2011 ). (
  • Epidural analgesia had no statistically significant impact on the risk of caesarean section, maternal satisfaction with pain relief and long-term backache and did not appear to have an immediate effect on neonatal status as determined by Apgar scores. (
  • Analgesia is indicated for patients with certain risk factors even in the absence of maternal request. (
  • Other maternal conditions such as aortic stenosis , pulmonary hypertension , or right-to-left shunts are also relative contraindications to the use of regional analgesia. (
  • Unfortunately, in developed countries the hospital admission of labouring women leads obstetrical practice to restrain spontaneous and instinctive attitude and to focus strictly on intrapartum fetal wellbeing and maternal comorbidities [ 1 , 2 ]. (
  • Effect of maternal ambulation on labour with low-dose combined spinal-epidural analgesia. (
  • 2009). Since the maternal airway is more difficult to manage, it is very important for nurse practice to understand the difference between an obstetrical and a non-obstetrical airway in order to provide adequate care for pregnant women. (
  • The primary maternal outcomes were any analgesia/anaesthesia (pain medication), synthetic oxytocin during labour, spontaneous vaginal birth, postpartum depression and negative rating of/negative feelings about the birth experience. (
  • Nalbuphine at maternal analgesia]. (
  • The success of an epidural analgesia catheter placement depends on the parturient position. (
  • Identified factors for difficult epidural analgesia catheter placement were: non-palpable spinous processes, obesity, spine deformity, inability for the patient to maintain an adequate position and poor experience of the operator. (
  • In all cases 'usual care' did not involve continuous intrapartum support, but it could have involved other measures, such as routine epidural analgesia for pain relief in labour. (
  • Seventy-five patients (n = 75) undergoing elective cesarean delivery during epidural anesthesia were randomly assigned to receive one of three opioid analgesics via patient-controlled analgesia (PCA) when they first complained of pain in the recovery room. (
  • Possible regional anesthesia techniques include epidural analgesia, spinal analgesia (sometimes referred to as the intrathecal or subarachnoid space), or a combination of epidural and spinal analgesia. (
  • In most cases drugs given upon the request of the patient, the sufficient level of analgesia is never achieved. (
  • 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). (
  • It has also been used in obstetrical practice as a low-risk and low-cost anesthetic technique during repair of obstetrical lacerations. (
  • 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. (
  • Bupivacaine is indicated for the production of local or regional anesthesia or analgesia for surgery, dental and oral surgery procedures, diagnostic and therapeutic procedures, and for obstetrical procedures. (
  • Thought you might appreciate this item(s) I saw at Obstetrical & Gynecological Survey. (
  • Obstetrical and Gynecological Survey 13.6 (1958): 820-21. (
  • The analgesia is limited to the body regions innervated by the spinal segments where analgesic concentrations of clonidine are present. (
  • Whereas morphine is a more commonly utilized PCA analgesic, the excellent analgesia, low incidence of sedation, and high patient satisfaction provided by meperidine and oxymorphone suggested useful alternatives. (
  • Various clinical studies have indicated that preemptive analgesia can effectively reduce pain as well as analgesic requirements in the post-operative period. (
  • Failed procedures result in the loss of diagnostic information, 4 inability to deliver treatment, or inadequate analgesia. (
  • NOTE: Cloniodine hydrochloride injection is not recommended for obstetrical, postpartum, or peri-operative pain management. (
  • Clonidine hydrochloride injection (epidural clonidine) is not recommended for obstetrical, postpartum, or perioperative pain management. (
  • However, in a rare obstetrical, postpartum or perioperative patient, potential benefits may outweigh the possible risks. (
  • The secondary outcomes included labour events (regional analgesia/anaesthesia, duration of labour, severe labour pain), caesarean birth, instrumental vaginal birth, perineal trauma (episiotomy or laceration requiring suturing), low 5-minute Apgar score and prolonged newborn hospital stay, difficulty mothering, and low self-esteem in the postpartum period. (
  • Incidence of Epidural Hematoma, Infection, and Neurologic Injury in Obstetric Patients with Epidural Analgesia/Anesthesia. (
  • 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. (
  • The aim of this study was to compare addition of dexmedetomidine and tramadol to lidocaine 5% in the period of postoperative analgesia of spinal anesthesia among women candidated for caesarean. (
  • Two hundred and twenty-nine nulliparous women who requested regional analgesia during labour were given a combined spinal-epidural block. (
  • Services include epidural, patient-controlled analgesia for postoperative pain, medication management, therapeutic/diagnostic blocks and implanted devices. (
  • Dr. Jonathan H. Waters and Dr. Mary Angela O'Neal present during the UPMC 2018 Obstetrical Neuro Conference. (
  • In obstetric patients, regional analgesia refers to partial or complete loss of pain sensation below the T8 to T10 spinal level. (
  • In cancer patients who received 14 days of clonidine HCl epidural infusion (rate=30 mcg/hr) plus morphine by patient-controlled analgesia (PCA), steady state clonidine plasma concentrations of 2.2±1.1 and 2.4±1.4 ng/mL were obtained on dosing days 7 and 14, respectively. (
  • It acts as an antagonist of the μ-opioid receptor (MOR) and as an agonist of the κ-opioid receptor (KOR), and as a result, blocks the effects of stronger agents with greater intrinsic activity such as morphine whilst simultaneously producing analgesia. (
  • Successful analgesia, defined as a decrease in either morphine use or Visual Analog Score (VAS) pain, was significantly more common with epidural clonidine than placebo (45% vs 21%, p=0.016). (
  • De plus, la perte de poids est essentielle dans la prise en charge des patients obèses. (
  • L'identification des patients à risque de déficits visuels permanents, tels que les patients de race noire-américaine, les hommes, les patients très obèses et les patients avec une forme fulminante d'HIC idiopathique permet une prise en charge et un suivi adaptés à chaque situation clinique. (
  • Une meilleure compréhension de la physiopathologie de l'HIC idiopathique ainsi que les essais thérapeutiques en cours permettront de développer des recommandations et un consensus pour la prise en charge et le traitement des patients atteints d'HIC idiopathique. (
  • It is important to determine the main indications and limitations for their application in various groups of surgical patients (neurosurgical, pediatric, obstetrical patients, etc. (
  • For patients with mitral stenosis , regional analgesia (epidural) is the preferred method. (
  • A fim de investigar a associação entre alterações do tônus uterino e a ocorrência de anormalidades da freqüência cardíaca fetal (FCF) após analgesia obstétrica, em especial após o bloqueio combinado raqui-peridural, foi conduzido estudo prospectivo randomizado e encoberto, com setenta e sete parturientes que solicitaram analgesia regional durante o trabalho de parto. (
  • Monitorizou-se o tônus uterino por meio de cateter intra-amniótico de aferição da pressão intra-uterina e a freqüência cardíaca fetal durante 15 minutos antes e 30 minutos após a indução da analgesia. (
  • The primary outcomes were the occurrence of an elevation of 10mmHg or more on uterine tone compared to the values before analgesia and the presence of prolonged fetal heart rate decelerations or fetal bradycardia. (
  • A significant association was noticed between elevation of uterine tone and fetal heart rate abnormalities with combined spinal-epidural analgesia, at the first 15 minutes of administration. (
  • 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. (
  • Epidural analgesia was routinely available in 14 trials and electronic fetal monitoring was used routinely in nine of them. (
  • 1) used in 1980 parenteral analgesia with Tramal in 23 normal deliveries. (
  • Epidural analgesia is provided for about 70% of deliveries. (
  • In deliveries in epidural analgesia (PDA) there are more obstetrical operations than in deliveries without PDA. (
  • Intra-uterine pressure was monitored with intra-amniotic pressure device and FHR with external transducer, both for at least 15 minutes before and 30 minutes after analgesia induction. (
  • We are indebted to Sir James Y. Simpson, the discoverer of chloroform, for the introduction of anaesthesia into obstetrical practice. (
  • But a study published in the March 2005 issue of the journal Best Practice & Research Clinical Anaesthsiology , University of Pennsylvania researchers reported that while "epidural analgesia does prolong labor…the clinical significance of this prolongation has not been shown. (
  • Hereby, this work is intended to explore the current situation both in the scholar research and empirical practice concerning the issues of obstetrical airways and their management. (
  • Besides a synopsis of a German translation of the current "Practice Guidelines for Obstetric Anaesthesia 2016" [1], written by the American Society of Anesthesiologists, the authors provide personal information regarding major topics of obstetric anaesthesia including pre-anaesthesia patient evaluation, equipment and staff at the delivery room, use of general anaesthesia, peridural analgesia, spinal anaesthesia, combined spinal-epidural anaesthesia, single shot spinal anaesthesia, and programmed intermittent epidural bolus. (
  • NOTE: Duraclon ® (epidural clonidine) is not recommended for obstetrical, post-partum, or peri-operative pain management. (
  • However, in a rare obstetrical, post-partum or peri-operative patient, potential benefits may outweigh the possible risks. (
  • Epidurally administered clonidine produces dose-dependent analgesia not antagonized by opiate antagonists. (
  • Levallorphan was formerly widely used in general anesthesia, mainly to reverse the respiratory depression produced by opioid analgesics and barbiturates used for induction of surgical anaesthesia whilst maintaining a degree of analgesia (via KOR agonism). (
  • 1 Epidural catheterisations provide regional anaesthesia and analgesia during childbirth or surgical procedures. (
  • Study group (41 cases) received CSE with sufentanil and bupivacaine and control group (36 cases) received epidural analgesia with the same drugs. (
  • Healthcare facilities across North America are experiencing a shortage of several bupivacaine formulations affecting analgesia and anesthesia care, particularly for obstetric services. (
  • Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain and is widely used as a form of pain relief in labour. (
  • Regional analgesia is also contraindicated in cases of patient refusal or inadequate practitioner training and experience. (
  • meperidine and tramadol with epidural analgesia. (
  • Ninety percent of women rated analgesia as good to excellent in the epidural group as compared with 72% of women in the meperidine group and 65% in tramadol group. (
  • Analgesia provided by meperidine and tramadol is comparable and approximately 50% of women rated the analgesia as good. (
  • Obstetrical anesthesia for a parturient with a ventriculoperitoneal shunt and third ventriculostomy. (
  • One hundred and twenty-two parturients were studied: 81 had epidurals in labour and 41 had other forms of analgesia. (
  • A study comparing pudendal block with placebo after transvaginal reconstructive surgery did not produce any differences in post-operative pain intensity or the consumption of narcotic analgesia. (
  • Vet J. Postoperative analgesia with transversus abdominis plane catheter infusions of levobupivacaine after major gynecological and obstetrical surgery. (
  • The general therapeutic effects of this drug are analgesia and sedation. (
  • To assess the effects of all modalities of epidural analgesia (including combined-spinal-epidural) on the mother and the baby, when compared with non-epidural or no pain relief during labour. (
  • The American College of Obstetricians and Gynecologists and the American Society of Anesthesiologists stand by the safety of epidural analgesia and say they support epidural pain relief "on demand. (
  • Disorders of pregnancy such as preeclampsia, placental abruption, or sepsis further compound provision of obstetrical anesthesia. (
  • 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. (
  • The team provides a wide range of anesthesia services from basic inpatient and outpatient services to the subspecialties of cardiac, obstetrical, ambulatory and neurosurgical anesthesia. (
  • Further research may be helpful to evaluate rare but potentially severe adverse effects of epidural analgesia on women in labour and long-term neonatal outcomes. (
  • The 2016 national perinatal survey conducted by the National Institute of Health and Medical Research (INSERM) and the Directorate of Research, Studies, Evaluation and Statistics (DREES) in France revealed that more than 80% of women had chosen to benefit from an epidural analgesia during labour. (
  • In particular, obstetrical women often have problems with breathing, and there are a number of reasons for that. (
  • Lumbar epidural is the most effective analgesia technique available. (
  • Treatments found to have been used at one time or another include parenteral opioids, 3 - 5 epidural analgesia, 6 , 7 and inhalational agents like nitrous oxide. (