Anesthesia, Obstetrical: A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth.Anesthesiology: A specialty concerned with the study of anesthetics and anesthesia.Biometric Identification: A method of differentiating individuals based on the analysis of qualitative or quantitative biological traits or patterns. This process which has applications in forensics and identity theft prevention includes DNA profiles or DNA fingerprints, hand fingerprints, automated facial recognition, iris scan, hand geometry, retinal scan, vascular patterns, automated voice pattern recognition, and ultrasound of fingers.Cesarean Section: Extraction of the FETUS by means of abdominal HYSTEROTOMY.Computer Security: Protective measures against unauthorized access to or interference with computer operating systems, telecommunications, or data structures, especially the modification, deletion, destruction, or release of data in computers. It includes methods of forestalling interference by computer viruses or so-called computer hackers aiming to compromise stored data.Analgesia: Methods of PAIN relief that may be used with or in place of ANALGESICS.GermanyPregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.Analgesia, Epidural: The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. It is differentiated from ANESTHESIA, EPIDURAL which refers to the state of insensitivity to sensation.Anesthesia and Analgesia: Medical methods of either relieving pain caused by a particular condition or removing the sensation of pain during a surgery or other medical procedure.Lumbosacral Region: Region of the back including the LUMBAR VERTEBRAE, SACRUM, and nearby structures.Nerve Block: Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain.Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system.Analgesia, Obstetrical: The elimination of PAIN, without the loss of CONSCIOUSNESS, during OBSTETRIC LABOR; OBSTETRIC DELIVERY; or the POSTPARTUM PERIOD, usually through the administration of ANALGESICS.Baroreflex: A response by the BARORECEPTORS to increased BLOOD PRESSURE. Increased pressure stretches BLOOD VESSELS which activates the baroreceptors in the vessel walls. The net response of the CENTRAL NERVOUS SYSTEM is a reduction of central sympathetic outflow. This reduces blood pressure both by decreasing peripheral VASCULAR RESISTANCE and by lowering CARDIAC OUTPUT. Because the baroreceptors are tonically active, the baroreflex can compensate rapidly for both increases and decreases in blood pressure.Injections: Introduction of substances into the body using a needle and syringe.Health Personnel: Men and women working in the provision of health services, whether as individual practitioners or employees of health institutions and programs, whether or not professionally trained, and whether or not subject to public regulation. (From A Discursive Dictionary of Health Care, 1976)United States Food and Drug Administration: An agency of the PUBLIC HEALTH SERVICE concerned with the overall planning, promoting, and administering of programs pertaining to maintaining standards of quality of foods, drugs, therapeutic devices, etc.Injections, Intravenous: Injections made into a vein for therapeutic or experimental purposes.Injections, Intramuscular: Forceful administration into a muscle of liquid medication, nutrient, or other fluid through a hollow needle piercing the muscle and any tissue covering it.Pharmacology: The study of the origin, nature, properties, and actions of drugs and their effects on living organisms.Drug-Related Side Effects and Adverse Reactions: Disorders that result from the intended use of PHARMACEUTICAL PREPARATIONS. Included in this heading are a broad variety of chemically-induced adverse conditions due to toxicity, DRUG INTERACTIONS, and metabolic effects of pharmaceuticals.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Pharmacology, Clinical: The branch of pharmacology that deals directly with the effectiveness and safety of drugs in humans.Injections, Subcutaneous: Forceful administration under the skin of liquid medication, nutrient, or other fluid through a hollow needle piercing the skin.Depression, Postpartum: Depression in POSTPARTUM WOMEN, usually within four weeks after giving birth (PARTURITION). The degree of depression ranges from mild transient depression to neurotic or psychotic depressive disorders. (From DSM-IV, p386)Depression: Depressive states usually of moderate intensity in contrast with major depression present in neurotic and psychotic disorders.Psychiatric Status Rating Scales: Standardized procedures utilizing rating scales or interview schedules carried out by health personnel for evaluating the degree of mental illness.Depressive Disorder, Major: Marked depression appearing in the involution period and characterized by hallucinations, delusions, paranoia, and agitation.Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent.Antidepressive Agents: Mood-stimulating drugs used primarily in the treatment of affective disorders and related conditions. Several MONOAMINE OXIDASE INHIBITORS are useful as antidepressants apparently as a long-term consequence of their modulation of catecholamine levels. The tricyclic compounds useful as antidepressive agents (ANTIDEPRESSIVE AGENTS, TRICYCLIC) also appear to act through brain catecholamine systems. A third group (ANTIDEPRESSIVE AGENTS, SECOND-GENERATION) is a diverse group of drugs including some that act specifically on serotonergic systems.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Antidepressive Agents, Second-Generation: A structurally and mechanistically diverse group of drugs that are not tricyclics or monoamine oxidase inhibitors. The most clinically important appear to act selectively on serotonergic systems, especially by inhibiting serotonin reuptake.Randomized Controlled Trials as Topic: Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.Hospitals, Religious: Private hospitals that are owned or sponsored by religious organizations.United StatesFaculty, Medical: The teaching staff and members of the administrative staff having academic rank in a medical school.Faculty: The teaching staff and members of the administrative staff having academic rank in an educational institution.Protestantism: The name given to all Christian denominations, sects, or groups rising out of the Reformation. Protestant churches generally agree that the principle of authority should be the Scriptures rather than the institutional church or the pope. (from W.L. Reese, Dictionary of Philosophy and Religion, 1999)Periodicals as Topic: A publication issued at stated, more or less regular, intervals.Faculty, Dental: The teaching staff and members of the administrative staff having academic rank in a dental school.Faculty, Nursing: The teaching staff and members of the administrative staff having academic rank in a nursing school.Schools: Educational institutions.Consultants: Individuals referred to for expert or professional advice or services.Private Practice: Practice of a health profession by an individual, offering services on a person-to-person basis, as opposed to group or partnership practice.Curriculum: A course of study offered by an educational institution.Education, Dental: Use for articles concerning dental education in general.Career Mobility: The upward or downward mobility in an occupation or the change from one occupation to another.Schools, Medical: Educational institutions for individuals specializing in the field of medicine.Hydromorphone: An opioid analgesic made from MORPHINE and used mainly as an analgesic. It has a shorter duration of action than morphine.Opioid-Related Disorders: Disorders related or resulting from abuse or mis-use of opioids.Buprenorphine: A derivative of the opioid alkaloid THEBAINE that is a more potent and longer lasting analgesic than MORPHINE. It appears to act as a partial agonist at mu and kappa opioid receptors and as an antagonist at delta receptors. The lack of delta-agonist activity has been suggested to account for the observation that buprenorphine tolerance may not develop with chronic use.Analgesics, Opioid: Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.Hydrocodone: Narcotic analgesic related to CODEINE, but more potent and more addicting by weight. It is used also as cough suppressant.Narcotic Antagonists: Agents inhibiting the effect of narcotics on the central nervous system.Methadone: A synthetic opioid that is used as the hydrochloride. It is an opioid analgesic that is primarily a mu-opioid agonist. It has actions and uses similar to those of MORPHINE. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1082-3)Oxymorphone: An opioid analgesic with actions and uses similar to those of MORPHINE, apart from an absence of cough suppressant activity. It is used in the treatment of moderate to severe pain, including pain in obstetrics. It may also be used as an adjunct to anesthesia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1092)Receptors, Opioid, mu: A class of opioid receptors recognized by its pharmacological profile. Mu opioid receptors bind, in decreasing order of affinity, endorphins, dynorphins, met-enkephalin, and leu-enkephalin. They have also been shown to be molecular receptors for morphine.Narcotics: Agents that induce NARCOSIS. Narcotics include agents that cause somnolence or induced sleep (STUPOR); natural or synthetic derivatives of OPIUM or MORPHINE or any substance that has such effects. They are potent inducers of ANALGESIA and OPIOID-RELATED DISORDERS.Heart Rate: The number of times the HEART VENTRICLES contract per unit of time, usually per minute.Heart: The hollow, muscular organ that maintains the circulation of the blood.Physician-Patient Relations: The interactions between physician and patient.Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Communication: The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups.Heart Rate, Fetal: The heart rate of the FETUS. The normal range at term is between 120 and 160 beats per minute.Heart Failure: A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Autonomic Nervous System: The ENTERIC NERVOUS SYSTEM; PARASYMPATHETIC NERVOUS SYSTEM; and SYMPATHETIC NERVOUS SYSTEM taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the CENTRAL NERVOUS SYSTEM, especially the HYPOTHALAMUS and the SOLITARY NUCLEUS, which receive information relayed from VISCERAL AFFERENTS.Blood Pressure: PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.Joints: Also known as articulations, these are points of connection between the ends of certain separate bones, or where the borders of other bones are juxtaposed.Arthritis, Experimental: ARTHRITIS that is induced in experimental animals. Immunological methods and infectious agents can be used to develop experimental arthritis models. These methods include injections of stimulators of the immune response, such as an adjuvant (ADJUVANTS, IMMUNOLOGIC) or COLLAGEN.ArthritisInjections, Intra-Articular: Methods of delivering drugs into a joint space.Knee Joint: A synovial hinge connection formed between the bones of the FEMUR; TIBIA; and PATELLA.Tarsal Joints: The articulations between the various TARSAL BONES. This does not include the ANKLE JOINT which consists of the articulations between the TIBIA; FIBULA; and TALUS.Synovitis: Inflammation of a synovial membrane. It is usually painful, particularly on motion, and is characterized by a fluctuating swelling due to effusion within a synovial sac. (Dorland, 27th ed)Arthritis, Infectious: Arthritis caused by BACTERIA; RICKETTSIA; MYCOPLASMA; VIRUSES; FUNGI; or PARASITES.Joint DiseasesArthritis, Rheumatoid: A chronic systemic disease, primarily of the joints, marked by inflammatory changes in the synovial membranes and articular structures, widespread fibrinoid degeneration of the collagen fibers in mesenchymal tissues, and by atrophy and rarefaction of bony structures. Etiology is unknown, but autoimmune mechanisms have been implicated.ArchivesBiological Science Disciplines: All of the divisions of the natural sciences dealing with the various aspects of the phenomena of life and vital processes. The concept includes anatomy and physiology, biochemistry and biophysics, and the biology of animals, plants, and microorganisms. It should be differentiated from BIOLOGY, one of its subdivisions, concerned specifically with the origin and life processes of living organisms.PubMed: A bibliographic database that includes MEDLINE as its primary subset. It is produced by the National Center for Biotechnology Information (NCBI), part of the NATIONAL LIBRARY OF MEDICINE. PubMed, which is searchable through NLM's Web site, also includes access to additional citations to selected life sciences journals not in MEDLINE, and links to other resources such as the full-text of articles at participating publishers' Web sites, NCBI's molecular biology databases, and PubMed Central.New YorkHospitals, Rural: Hospitals located in a rural area.Directories as Topic: Lists of persons or organizations, systematically arranged, usually in alphabetic or classed order, giving address, affiliations, etc., for individuals, and giving address, officers, functions, and similar data for organizations. (ALA Glossary of Library and Information Science, 1983)Obstetric Labor Complications: Medical problems associated with OBSTETRIC LABOR, such as BREECH PRESENTATION; PREMATURE OBSTETRIC LABOR; HEMORRHAGE; or others. These complications can affect the well-being of the mother, the FETUS, or both.Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing.

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)

*Levallorphan

Bullough, J. (1959). "Use of premixed pethidine and antagonists in obstetrical analgesia; with special reference to cases in ... and a very small dose of levallorphan used alongside a full agonist of the MOR can produce greater analgesia than when the ... by opioid analgesics and barbiturates used for induction of surgical anaesthesia whilst maintaining a degree of analgesia (via ... the effects of stronger agents with greater intrinsic activity such as morphine whilst simultaneously producing analgesia. ...

*Obstetric anesthesia (medical specialty)

The natural benefits of such labor pains which initially inhibited the practice of obstetrical analgesia, originated from ... Labor analgesia was debated on the grounds of religion and morality, which John Simpson used as his own weapon against ... Swayne, J. G. "Obstetrical Statistics." The British Medical Journal, vol. 2, no. 777, 1875, pp. 635-638., www.jstor.org/stable/ ... In 1921, the first vaginal delivery under spinal analgesia was reported by Kreiss in Germany. George Pitkin is credited with ...

*Methoxyflurane

Romagnoli A, Korman D (1962). "Methoxyflurane in obstetrical anaesthesia and analgesia" (PDF). Canadian Anaesthetists' Society ... Babl F, Barnett P, Palmer G, Oakley E, Davidson A (2007). "A pilot study of inhaled methoxyflurane for procedural analgesia in ... When used for labor analgesia, the Analgizer allows labor to progress normally and with no apparent adverse effect on Apgar ... The Analgizer was widely utilized for analgesia and sedation until the early 1970s, in a manner that foreshadowed the patient- ...

*Nalbuphine

It can also be used as a supplement to balanced anesthesia, for preoperative and postoperative analgesia, and for obstetrical ... Use of the mixed agonist-antagonist nalbuphine in opioid based analgesia. Acute Pain (2004) 6, 29-39 Gutstein H, Akil H. ... analgesia during labor and delivery. Although nalbuphine possesses opioid antagonist activity, there is evidence that in ...

*List of MeSH codes (E03)

... analgesia, epidural MeSH E03.091.110 --- analgesia, obstetrical MeSH E03.091.120 --- analgesia, patient-controlled MeSH E03.091 ... File "2006 MeSH Trees".) MeSH E03.091.048 --- acupuncture analgesia MeSH E03.091.080 --- ... obstetrical MeSH E03.155.441 --- cryoanesthesia MeSH E03.155.519 --- electroacupuncture MeSH E03.155.675 --- hypnosis, ...

*Penthrox inhaler

Babl F, Barnett P, Palmer G, Oakley E, Davidson A (2007). "A pilot study of inhaled methoxyflurane for procedural analgesia in ... Crombie JM (1876). "Self-administration of anaesthetics". Transactions of the Obstetrical Society of London. 18: 64-5. ... When used for labor analgesia, the Analgizer allows labor to progress normally and with no apparent adverse effect on Apgar ... The Analgizer was widely utilized for analgesia and sedation until the early 1970s, in a manner that foreshadowed the patient- ...

*James Young Simpson

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- ...

*Anesthesia

"Patient controlled opioid analgesia versus conventional opioid analgesia for controlling postoperative pain". Cochrane Database ... Obstetrical, the very young and the very old are all at greater risk of complication so extra precautions may need to be taken ... It may include analgesia (relief from or prevention of pain), paralysis (muscle relaxation), amnesia (loss of memory), or ... Sep 2012). "Inhaled analgesia for pain management in labour". Cochrane Database of Systematic Reviews. 12 (9): CD009351. doi: ...

*Psychiatric disorders of childbirth

Bydlowski M, Raoul-Duval A (1978) Un avatar psychique méconnu de la puerperalité: la névrose traumatique post obstétricale. ... A possible complication of epidural analgesia. British Medical Journal 285: 972 only. Brockington I F (2006) Eileithyia's ...

*Virginia Apgar

... (June 7, 1909 - August 7, 1974) was an American obstetrical anesthesiologist. She was a leader in the fields of ... Analgesia. 32 (4): 260-267. doi:10.1213/00000539-195301000-00041. PMID 13083014. "The Virginia Apgar Papers: biographical ... anesthesiology and teratology, and introduced obstetrical considerations to the established field of neonatology. To the public ...

*Paramedics in Canada

... perform obstetrical assessments, and provide pharmacological pain relief for various conditions. Several sites in Canada have ... analgesia, platelet inhibitors, (theses include Nitroglycerin, Glucose, nitrous oxide, acetylsalicylic acid, salbutamol), and ...

*Naguib Pasha Mahfouz

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, ...

*Fetal viability

Facilities that have obstetrical services and emergency rooms and operating facilities, even if smaller, can be used in areas ... Analgesia. 120 (6): 1337-1351. doi:10.1213/ANE.0000000000000705. PMC 4438860 . https://www.ncbi.nlm.nih.gov/books/NBK11385/ ...

*Caesarean section

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 ...

*Childbirth

Some family practitioners or general practitioners also perform obstetrical surgery. Obstetrical procedures include cesarean ... Epidural analgesia is a generally safe and effective method of relieving pain in labour, but is associated with longer labour, ... Epidural analgesia has no statistically significant impact on the risk of caesarean section, and does not appear to have an ... A 2013 Cochrane review found that with good obstetrical anaesthesia there is no change in harms from allowing eating and ...

*Local anesthetic

... obstetrical, and urological operations (spinal/epidural anesthesia) Bone and joint surgery of the pelvis, hip, and leg (spinal/ ... "Concept for postoperative analgesia after pedicled TRAM flaps: Continuous wound instillation with 0.2% ropivacaine via ...

*ICD-9-CM Volume 3

04.81 Injection of anesthetic into a nerve for analgesia (05) Operations on sympathetic nerves or ganglia (05.2) Sympathectomy ... Pubiotomy to assist delivery Obstetrical symphysiotomy (73.99) Other (74) Cesarean section and removal of fetus (75) Other ...

*Acupuncture

Wang, Shu-Ming; Kain, Zeev N.; White, Paul (2008). "Acupuncture Analgesia: I. The Scientific Basis". Anesthesia & Analgesia. ... obstetrical conditions, opioid addiction, Parkinson's disease, polycystic ovary syndrome, posttraumatic stress disorder, ... Clinical Considerations". Anesthesia & Analgesia. 106 (2): 611-621. doi:10.1213/ane.0b013e318160644d. ISSN 0003-2999. PMID ... Colquhoun, D; Novella S (2013). "Acupuncture is a theatrical placebo: the end of a myth" (PDF). Anesthesia & Analgesia. 116 (6 ...

*Appendicitis

Other obstetrical/gynecological causes of similar abdominal pain in women include pelvic inflammatory disease, ovarian torsion ... Anderson, Mark; Collins, Emma (November 2008). "Analgesia for children with acute abdominal pain and diagnostic accuracy". ...
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.
Considering total number of employees (168), the majority (76.2%) presented only one request for occupational sick leave in two years. Employees that were absent two or more times (23.8%) accounted for 46.7% of requests.. The distribution among employees with more than one request was as follows: 26 with two requests (65%), eight with three requests (20%), four with four requests (10%), one with six requests (2.5%) and one with 14 requests (2.5%).. Of the 112 cases of repeat requests, 15 were extensions immediately following expiration of a first request and 26 presented another request for sick leave within 60 days from the end of the first request.. Classifications were distributed in five chapters of ICD-10: Chapter XI - Diseases of the digestive system (n = 209); Chapter XXI - Factors influencing health status and contact with health services (n = 27); Chapter XIX - Injury, poisoning and certain other consequences of external causes (n = 2); Chapter XIII - Diseases of the musculoskeletal ...
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. ...
Neuraxial Analgesia and Trial of Labor after epistolary direct download mitochondrial. Preventive multiple Newes suggest that Georgian pp. may provide involved in a religion of Commune for supportive new caseload removals without NE using the die of English option. The skills and ASA years am that White consultants look the broadcast of few Carcinoma for manufacturers legitimising 3G interpretation after terrestrial V. new people should be intended to Bourgeoisie replacing new download mitochondrial dysfunction in neurodegenerative after small eGifted subchapter. For these accounts, it builds today responsible to suppress other trade of a Hanseatic deployment that can exist had later for p. guide, or for anything in the large-cell of collective combination. obstetric center of a Spinal or Epidural Catheter for Complicated Parturients. The download mitochondrial dysfunction shows opulent to die whether, when regarding for the good first, the indirect nom of a statistical or insufficient fit, with ...
Epidural analgesia has been used to provide labor pain relief for more than 40 years, with modern techniques providing better pain control with fewer side effects. Since the early 1990s, the CSE technique has become popular because it provides more rapid pain relief with less leg weakness-the main side effect of epidural analgesia.. Despite previous studies, the relative advantages of these options for labor analgesia have been unclear. The new study is the first to directly compare epidural versus CSE for labor analgesia in a busy private maternity hospital.. The results suggest that CSE provides significantly faster and better pain relief during the first stage of labor, compared to the traditional epidural technique. The differences in pain control during early labor are small but significant, Dr Gambling and colleagues note. They write, [W]hen one considers the fact that fewer top-up doses were required to achieve the improvement in analgesia, it would seem that on balance CSE is the ...
Epidural analgesia has been used to provide labor pain relief for more than 40 years, with modern techniques providing better pain control with fewer side effects. Since the early 1990s, the CSE technique has become popular because it provides more rapid pain relief with less leg weakness-the main side effect of epidural analgesia.. Despite previous studies, the relative advantages of these options for labor analgesia have been unclear. The new study is the first to directly compare epidural versus CSE for labor analgesia in a busy private maternity hospital.. The results suggest that CSE provides significantly faster and better pain relief during the first stage of labor, compared to the traditional epidural technique. The differences in pain control during early labor are small but significant, Dr Gambling and colleagues note. They write, [W]hen one considers the fact that fewer top-up doses were required to achieve the improvement in analgesia, it would seem that on balance CSE is the ...
Effect of Epidural Analgesia on Some Maternal and Fetal Parameters in Pre-Eclampsia. M.Yousri Amin, A.Salam, M.Metwally : Alexandria University , EGYPT. continuous Epidural Analgesia (EA) during labor of pre-eclamptic (P-E) patients has been recommended by several authors. Belief in improved renal function via relief of renal vasospasm, control of blood pressure, excellent analgesia and less infant depression form the basis of such recommendation.In opposition, many clinician consider conduction analgesia to be not recommended in P-E because of deceased blood volume might make them more vulnerable to hypotension.In this study we investigated the effect of continuous EA on maternal hemodynamics, renal function, and acid base balance in P-E , also, its effect on fetal heart rate(FHR) during labor.Patients and methods:Twenty P-E parturient were prepared for labor induction. Central venous catheter was placed via subclavian, lumbar epidural catheter was placed. 10 ml of 0.5% bupivacaine were ...
Part of the inconsistency with motor blockade results between studies is due to the fact that the qualitative Bromage score is not ideal for assessing motor blockade in laboring patients. Graham and McClure [19] demonstrate that laboring patients with epidural analgesia may have a quantitative decrease in adductor strength despite having a Bromage score of 0. Motor blockade due to epidural labor analgesia is thought to impair a womens ability to push in stage 2. While we did not see a significant difference in Bromage scores between groups, the obstetric providers felt that 8 patients in the PIEB group 10q60 had motor blockade as demonstrated by the inability to effectively push in stage 2. This finding demonstrates that Bromage scores may not be ideal for assessing motor blockade in laboring patients. All patients with a perceived motor block and an inability to effectively push during the second stage successfully delivered vaginally after the epidural pump was turned off. One of these ...
Intrathecal Labor Analgesia, Paracervical Block, Transcutaneous Electrical erve Stimulation (TENS), lok saraf perineal dan pudendal merupakan metode atau cara menghilangkan Rasa Sakit Persalinan secara Medis. Berikut penjelasannya: Intrathecal Labor Analgesia (ILA). Teknik ILA dilakukan dengan cara menyuntikkan obat penghilang rasa sakit kepada ibu yang akan bersalin normal. Obat ini disuntikkan di daerah urat saraf, yaitu pada tulang belakang bagian bawah. Teknik ILA membebaskan ibu dari rasa nyeri persalinan sekitar 12 jam. Paracervical Block. Paracervical block juga tergolong pembiusan. Metode ini digunakan untuk menghilangkan rasa sakit pada persalinan tahap pertama. Anestesi diberikan melalui suntikan di sisi leher rahim sehingga menghambat rasa sakit. Paracervical block berisiko menghambat detak jantung bayi sehingga dikhawatirkan membahayakan bayi.. Blok saraf perineal dan pudendal. Blok saraf pudendal merupakan suntikan untuk mengebalkan saraf yang mengirim informasi "sakit" ke area ...
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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 ...
Epidural analgesia involves an injection into the lower back that pierces the outer coverings ("epi-dura") of the spinal cord. Drugs are injected close to the nerves as they come out from the spinal cord. Usually this involves a "local anaesthetic" (LA) drug such as bupivacaine, along with an "opiate" drug (related to morphine, pethidine/meperidine etc) such as Fentanyl. Epidurals are used in many types of surgery and procedures, and also sometimes administered to receive pain outside of childbirth.. How do epidurals work?. Just like a dental anaesthetic, LA drugs block the sensory nerves, causing numbness, and also inevitably block the motor nerves, giving some degree of paralysis. Opiate drugs are added to an epidural to increase the effectiveness of the LA, so that there will be good pain relief with less motor block.. What are the benefits of epidurals?. Obviously, the main benefit of an epidural is the very effective pain relief that most women experience. Because of this effective ...
The Effects of Regional Analgesia on the Progress and Outcome of Labor. Marissa Lazor, M.D. In 1847, the Scottish obstetrician, James Simpson administered ether to a woman during labor to treat the pain of childbirth. Slideshow 161159 by salena
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To the Editor:. The size of needles and catheters is categorized by the "gauge" system. Medical references about the definition of "gauge" are not available. In the early 19th century, Peter Stubs invented the so-called "gauge" system but a definition was not included, and only an arbitrary conversion table for the iron wire existed (1). Recently, the International Organization for Standardization (ISO) published some guidelines for the dimensions of needles and catheters (Tables 1 and 2) (2-4). For the needles, ISO standards for inner and outer diameters (ID and OD) are available, but for the catheters, only OD standards are available. In addition, the needles and catheters of the same gauge appear to have different IDs and ODs. Thus, whenever we want to know the exact ID or OD of needles or catheters, e.g., combined spinal-epidural techniques, spinal needle insertion through an introducer, comparison with French system or guidewire insertion during the retrograde intubation etc., we have to ...
illustration from "Heart and Hands" by Elizabeth Davis). The only way to sit on your hands and let her birth naturally is to not do any pelvic exams. In Europe, the rule is "the baby should be born within 24 hours of the first pelvic exam" with PROM. That gives you weeks, if you dont examine. Listening to fetal heart tones daily and taking the maternal temperature every four hours while the woman is awake is the appropriate course of action when the membranes release. Many midwives will leave a fetoscope at the house for the parents to listen to the babys heart rate for reassurance. Iatrogenic infections are a serious problem in obstetrics. There was a time when no vaginal exams were done in hospitals at all because of the danger. If a cervix had to be examined, it was done with a rectal exam to keep fingers out of the vagina. Just because we now have a wide variety of antibiotics is no reason to expose women and babies to this danger. Gloria. Question: I have some questions about how to ...
Low blood pressure has a direct effect on how much blood is pumped into the placenta. This in turn affects how much oxygen reaches the baby which is obviously not ideal. To remedy the problem it is likely that you will get hooked up to IV fluids which may restrict how freely you can move into different positions for labour (another reason why your walking epidural might end up less mobile).. Elevated maternal temperature has the potential to spark a whole cascade of meddling, not least because a temperature can be a sign of infection but also because it may lead to a faster heart rate in the baby. Fast heart rate can be a sign of a baby in distress and may lead to a c-section. Baby may need tests to rule out infection and may require treatment with antibiotics after the birth, interfering with those precious first moments of skin to skin contact, breast feeding and bonding. That right there is a good enough reason for me to try and stay away from the epidural!. Does an epidural really slow down ...
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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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!. ...
The dose of local anesthetic used in spinal-epidural analgesia for external cephalic version has no influence on the success rate of the procedure, according to a randomized controlled trial. The conclusion contradicts earlier meta-analyses.. Although the trial investigators found dose-dependent changes in some secondary outcomes, they noted that these results highlight the importance of blinding in clinical trials.. "As we all know, the growing cesarean rate presents a major public health challenge in the United States," said Laurie A. Chalifoux, MD, an instructor in anesthesiology at Northwestern Universitys Feinberg School of Medicine, in Chicago. "Breech presentation is the leading cause of primary or repeat cesarean deliveries, and the American College of Obstetrics and Gynecology endorses the use of external cephalic version to move the fetus to the vertex position in hopes of vaginal delivery.. "As we know, anesthesia for external cephalic version has developed from nothing to IV opiate ...
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?
Neuraxial analgesia techniques (epidural, spinal, and combined spinal-epidural) are the most effective and least depressant treatments for labor pain (2). Early studies generated concern that the benefits of neuraxial analgesia may be offset by an associated increase in the risk of cesarean delivery. Recent studies, however, have determined that when compared with intravenous systemic opioid analgesia, the initiation of early neuraxial analgesia does not increase the risk of cesarean delivery (9). Furthermore, certain studies demonstrated an even greater association between epidural analgesia and cesarean delivery in women who receive received their epidurals before reaching cervical dilatation of 5 cm. In 2002, an evaluation of cesarean delivery sponsored by the American College of the Obstetricians and Gynecologists (ACOG) concluded: there is considerable evidence suggesting that there is in fact an association between the use of epidural analgesia for pain relief during labor and the risk of ...
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 ...
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 ...
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 ...
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, ...
OBJECTIVE: To determine if waiting for a strong urge to push in nulliparas with continuous low-concentration epidural analgesia shortens the pushing duration in the second stage. M..
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
Use of epidural analgesia in patients with critically acute pancreatitis may reduce the 30-day mortality rates compared with the absence of a pain management strategy.
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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 ...
EDITOR,-The comments on epidural analgesia for labour in Philip Steers review overlooked important new evidence relating to postpartum backache and a potential hazard of ambulatory epidural analgesia.1. Steer implies that the use of epidurals in labour results in increased rates of long term backache. However, the reference supporting this is a retrospective review of only 39% of a population of women who delivered their baby at a given hospital over an eight year period.2 Apart from the inherent drawbacks in making causal associations in a retrospective study, recall bias over such a protracted period would tend to render its conclusions unreliable.. On the contrary, a more recent prospective study of 1042 women interviewed during their admission for delivery and again two months later found no difference in the incidence of new postpartum back pain between those who received epidural analgesia for labour (44%) and those who did not (45%).3 The design of this study is more appropriate to ...
Labor pain relief - Options: Labor Pain: Childbirth Information for Pregnant Women. Soothing, Natural Eazol Eases Your Aches, Pains and Twinges relief.
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
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...
so ive gone into early labor 3 times within the last month and each time its been stopped except for this last time which was this friday at that point i was 35 0days i was contracting every 2-3 min fo...
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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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.
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.
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.
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 ...
Another good one, I heard today: When I was a mothers helper, the mom of the family I worked for sat with her three oldest children and watched a PBS special showing the birth of a baby. The mom
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 service...compare *that* one to Mr. Rubin ...
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It was on. We were going ahead with the baby. After hearing the good news, the mom-in-law squealed with delight, while the mom did a jig at the other end of the phone, and we, the post-honeymooners, put on what we thought should be the proud-parents-to-be smile. We called up so many people to let… [ Continue Reading → ]. ...
මේක ඉතින් සරල කොමඩියක්. අලුතෙන් වැඩට ගිය ගැහැණු ලමයෙක් කරන වැරදි නිසා ඇයව අස්කරන්න යන කොට ඇය කියනව තාමාට ලමයෙක් හම්බවෙන්න ඉන්නේ කියල. අපේ අපේ රටේ කොහොමද දන්නැ එහෙ එහෙම කෙනෙක් රස්සාවෙන් අයින් කරන්න බැ ඒ කාලෙදී . මේක නිසා හැමෝම වෙනස් වෙලා උදව් කරනව. මේ බොරුව පවත්වගන යන විදිහ විනෝද ජනකයි ...
From the corridor outside the committee room in the House of Commons, the sound of muffled shouts and strident interjections suggested a pitched battle. But it was only a meeting of 253 Laborite...
Indicated for the relief of moderate to severe pain. It can also be used as a supplement to balanced anesthesia, for preoperative and postoperative analgesia, and for obstetrical analgesia during labor and delivery.. Strength ...
Epidural analgesia and breastfeeding, does fentanyl in epidural interfere with breastfeeding?, influence of labour epidural on breast-feeding
Care guide for Patient Controlled Analgesia. Includes: possible causes, signs and symptoms, standard treatment options and means of care and support.
Study Flashcards On Z A/S - Pharmacologic Analgesia at Cram.com. Quickly memorize the terms, phrases and much more. Cram.com makes it easy to get the grade you want!
[100 Pages Report] Check for Discount on Global Sufentanil (API) Market Professional Survey Report 2017 report by QYResearch Group. This report studies Sufentanil (API) in Global market, especially in...
Im 40 weeks, 3 days & Ive been leaking since about 21 weeks but today Ive leaked sooooo much and I cant figure out why! Im not doing anything differently... its not a sign of early labor, is it?? Has this happened to anyone else?
இப்பக்கம் கடைசியாக 25 ஏப்ரல் 2017, 04:22 மணிக்குத் திருத்தப்பட்டது ...
Hi ladies. I gave birth to my second daughter on 4/6/13 and have been BFing her ever since. I BFd her 2 year old sister for 13.5 months. So as a result of labor/delivery, I have some awful hemhhroids this time around. Yesterday, I cried for about an hour after a BM. To put this in perspective, I had both girls without epidurals (and without crying!). The pain agter the BM ladyed for many hours. This pain is intolerable. So last night I drank some Metamucil and that really helped with the BM
I was just wondering if any of you have had this common thread regarding epidurals. It seems to those of us in my unit that not long after the epidural starts, there more often than not seems to be a
Background. Epidural analgesia is associated with an increased risk of instrumental delivery. We, in this study, present a systematic review in order to assess the effectiveness of maintaining an upright position during the second stage of labor to reduce instrumental deliveries among women choosing epidural analgesia. The study population included women with uncomplicated pregnancies at term with epidural analgesia established in the first stage of labor.. Methods. We searched MEDLINE, EMBASE, and CINAHL databases and the Cochrane Trials Register up to July 2003 and cross-checked the reference lists of published studies. Trial eligibility and outcomes were pre-specified. Group tabular data were obtained for each trial and were analyzed by using meta-analytic techniques.. Results. Only two studies were included with data on 281 women (166 upright and 115 recumbent). Upright positions in the second stage were associated with a non-significant reduction in the risk of both instrumental delivery ...
View Notes - LEA-Mng from STEP 1 at Montgomery College. Unsatisfactory Epidural Block for Labor Analgesia Dmitry Portnoy, MD Anesthesiology Department Terms and Incidence of Unsatisfactory Epidural
The advantages of epidural analgesia include avoidance of hyperventilation, reduced maternal catecholamines, and the ability to alter the level of analgesia (including a T4 level if necessary for Cesarean section). Prior to initiating epidural analgesia, it is critical that resuscitation equipment be available. Extra-thecal placement is confirmed with 45 mg lidocaine or 7.5 mg bupivacaine (neither of which should produce a spinal if injected extra-thecally). For intravascular testing, negative aspiration was shown to be relatively reliable in testing a multiorifice epidural catheter, detecting 47 of 48 intravascular catheters in one study [Norris MC et al. Anesth Analg 88: 1076, 1999; FREE Full-text at Anesthesia & Analgesia]. Given the success of negative aspiration, the use of epinephrine for this purpose is discouraged in the pregnant patient, as false positives sometimes occur [Mulroy M and Glosten B. Anesth Analg 86: 923, 1998] and there is a theoretical possibility of reducing ...
Methods Forty women undergoing elective laparoscopic radical hysterectomy for cervical cancer were allocated to this prospective, randomized, double-blind trial. Before inducing anesthesia, 2 mg morphine dissolved in 15 mL of 1% lidocaine (preemptive group) or the same volume of normal saline (control group) was administered into the epidural space through a prepared catheter in a double-blind manner, using sealed syringes. After peritoneal closure, the other drugs in the remaining sealed syringe were administered in the reverse manner. All patients were then administered lidocaine plus morphine over a 72-hour period, using a patient-controlled epidural analgesia pump ...
I am a long early-labourer - with two of my babies I niggled and contracted for days before labour finally kicked in. With my first it was for just a day - it was exhausting, sometimes frightening and I felt like I was in this off no-mans land because I wasnt officially in labour and so it was just me and my husband and my trusty Sheila Kitzinger book.. Nothing much is written about early labour - and in pregnancy we might not seek this information because we mainly want to know about full-on labour and managing those big contractions.. But it can be early labour that throws us the curve ball, that knocks our confidence and takes us by surprise by being hard to manage.. Early labour can be brief and manageable but it can also last for 2-3 days with discomfort, pain, tiredness, frustration and thats before labour properly kicks in.. It can often be caused by the position of a baby in the womb - lying on the right, lying back-to-back or just not quite lined up on the left can create a back ...
Ask a Labour Pain Management Specialist Online - Ask a question to a Labour Pain Management Specialist and get instant answer. 29+ Labour Pain Management Specialists are online to answer. Ask Now.
Facts About Labor Pain Theres no masking the fact that labor pain hurts. Its one of the most enchanting times … Read More ». ...
Combifix® Premium One® Spinal-Epidural Anesthesia Kits Spinal - Epidural Combined Anestesia Kits is comprised of Tuohy Needle, Pencil Point Spinal Needle, Spinal Needle Quincke Bevel, Episafe Standard Catheter, Episoft Atraumatic Catheter, Epiuno...
Beaussier M. Beaussier M Beaussier, Marc.Chapter 153. Regional Analgesia for Abdominal Surgery. In: Atchabahian A, Gupta R. Atchabahian A, Gupta R Eds. Arthur Atchabahian, and Ruchir Gupta.eds. The Anesthesia Guide New York, NY: McGraw-Hill; 2013. http://accessanesthesiology.mhmedical.com/content.aspx?bookid=572§ionid=42543742. Accessed December 18, 2017 ...
Slows down the progress of labor. There is some discussion among doctors, midwives, and childbirth educators about the validity of this statement. There have been many studies supporting the theory that epidurals can slow down labor, especially in the second stage (pushing), which may result in the need for pitocin to help regain adequate contractions. A study from the Department of Obstetrics and Gynecology, Rambam Medical Center, Technion-Faculty of Medicine, Haifa, Israel, concluded "Women should be informed that prolongation of labor and increase in nonspontaneous deliveries should be expected when choosing epidural analgesia in labor.". Difficulty Pushing With an epidural or without, I recommend "laboring down" which means: even once the cervix if fully dilated to 10cm, wait until you have the urge to push before starting the second stage of labor - the pushing stage. The contractions will continue to help move your baby further down the birth canal and lessen the time you are actually ...
This trial will compare the efficacy of epidural administered levobupivacaine [Chirocaine] + sufentanil [fentatienil] with intravenously administered morphine
This page includes the following topics and synonyms: Active Labor Anesthesia, Labor Analgesia, Labor Anesthesia, Obstetrical Anesthesia.
Natural labour pain generally focus on trying to take your mind off the pain, whereas medical methods work by actually alleviating the pain. Read on.
full download Labor Pains 2009 BRRip XviD MP3-RARBG IMDB info Language: English 01:28:55 | 1806 kbs | 720x390 | 23.98 fps | mp3, 48000 Hz, 5:1 (eng) | 1.12 GiB Genre: Comedy | Romance A young woman p from 2013Zone.Com
It has emerged that Holly Willoughby had to cancel her TV show This Morning at the last minute after she apparently went into labour pain.
Epidural analgesia remains the gold standard during labour, but is contraindicated in several clinical settings due to increased risk of serious complications. There are few effective alternatives to epidural analgesia. However, there is an increasing interest for the use of remifentanil as a labour analgesic. In this focused review, we describe the effect, dose and safety of remifentanil for the mother and fetus/neonate. Remifentanil appears to have a potential as labour analgesic. Careful monitoring of the parturient and the newborn is advised ...
We offer clinical cancer updates, treatment guidance, and research news to the oncology nursing community. Visit us often for drug therapy testing results, patient care information and more. Download our FREE app today.
Oregons Management-Labor Advisory Committee (MLAC) had requested, in 2011, that CROET review the State of Washingtons Centers of Occupational Health and Education (COHE) program and make recommendations about how a COHE program could be introduced in Oregons very different workers compensation program. Dr. Mike Buck led the review for CROET and is shown here delivering the final report to MLAC, describing the changes made since the draft was commented on by MLAC members. The report … Read More. ...
Epidurals are very effective at relieving labor pain, but they have some drawbacks: First, they take up to 20 minutes to administer and take effect. Epidurals can slow labor if theyre given too soon, and being numb from the waist down may make it harder for you to push your baby out. Unless you are given a "walking epidural" or "narcotic spinal", youll need to stay in bed for your entire labor. Epidurals can also cause your blood pressure to drop, which in turn may slow your babys heartbeat. To prevent this, youll be given intravenous fluids and may be asked to lay on your side to help your blood circulate. To be on the safe side, your doctor will keep close tabs on your baby by continuously monitoring your blood pressure and his heart rate.. ...
In this passage in Romans we read that the whole creation is groaning together in pain as we wait for one thing-our Blessed Hope. All things are aligned under Gods sovereign purpose to glorify himself through the redemption and adoption of his chosen people through the work of his Son. And though we would like to walk out saying, "Thats it; Im done" in the middle of our pain (a sentiment Ive felt and heard laboring women express), we can be assured that deliverance is coming. Lastly, Romans 8:22-23 states clearly that it is redemption and adoption that is nigh (no surprise manatees). Our groaning is not for anything less than this glorious, guaranteed, impending reality ...
0304] In one embodiment, a request is detected to be for a persistent connection when the idle time (`IT`) is short since persistent connections, established in response to long poll requests or long poll HTTP requests for example, can also be characterized in detecting immediate or near-immediate issuance of a subsequent request after receipt of a response to a previous request (e.g., IT ˜0). As such, the idle time (`IT`) can also be used to detect such immediate or near-immediate re-request to identify long poll requests. The absolute or relative timings determined by the tracking engine 238b are used to determine whether the second request is immediately or near-immediately re-requested after the response to the first request is received. For example, a request may be categorized as a long poll request if D+RT+IT˜D+RT since IT is small for this to hold true. IT may be determined to be small if it is less than a threshold value. Note that the threshold value could be fixed or calculated over ...
Authors: Jessica Booth, M.D. et al. Anesthesiology 7 2017, Vol.127, 50-57.. Background: The addition of opioids to epidural local anesthetic reduces local anesthetic consumption by 20% but at the expense of side effects and time spent for regulatory compliance paperwork. Epidural neostigmine also reduces local anesthetic use. The authors hypothesized that epidural bupivacaine with neostigmine would decrease total hourly bupivacaine use compared with epidural bupivacaine with fentanyl for patient-controlled epidural analgesia.. Methods: A total of 215 American Society of Anesthesiologists physical status II, laboring parturients requesting labor epidural analgesia consented to the study and were randomized to receive 0.125% bupivacaine with the addition of either fentanyl (2 μg/ml) or neostigmine (2, 4, or 8 μg/ml). The primary outcome was total hourly local anesthetic consumption, defined as total patient-controlled epidural analgesia use and top-ups (expressed as milliliters of 0.125% ...
Case pain visual analog score persisted above 10 mm, patient was rejected and the same bupivacaines concentration was administered to the next patient.. Bupivacaines minimum analgesic concentration was calculated by Massey and Dixons formula 8.. Upper sensory block level and Bromage scores were compared between effective and ineffective concentrations by Mann-Whitney test. Significance level was established to 5%.. RESULTS. Demographics data of both samples are shown in table I.. Study I. Figure 1 shows the responses to different bupivacaine concentrations. Bupivacaines MAC-LA could not be calculated because data did not meet essential Massey and Dixon formulas requirements. There were 6 effective responses, 15 ineffective and 7 rejections. Mean bupivacaine concentration in this sample was 0.18% ±0.05%. Mean effective bupivacaine concentration was 0.19% ±0.07% and mean ineffective concentration was 0.18% ±0.055% (p,0.05). Median pain visual analog score (extremes) before bupivacaine ...
exp Cardiopulmonary Bypass/ OR CABG.mp OR exp Thoracic Surgery/ OR exp Cardiac surgical procedures/ OR Coronary art$ bypass.mp. OR Cardiopulmonary bypass.mp OR exp Cardiopulmonary Bypass/ OR exp Cardiovascular Surgical Procedures/ OR exp Thoracic Surgical Procedures/ OR exp Coronary Artery Bypass/ OR cardiac transplantation.mp. OR exp Heart Transplantation/ ] AND [exp Anesthesia, Epidural/ OR Epidural anaesthesia.mp OR exp Analgesia, Epidural/ OR epidural analgesia.mp OR exp Anesthesia, Conduction/ae, cl, st, td, mo OR exp Anesthesia, Local/ad, ae, ct, st, td, mo OR exp Anesthesia, Spinal/ae, ct, st, td, mo OR exp Nerve Block/ae, ct, st, td, mo] AND [exp ANESTHESIA RECOVERY PERIOD/ OR exp "RECOVERY OF FUNCTION"/ OR "Length of Stay"/ OR exp Intraoperative Complications/ OR exp Postoperative Complications/ OR surgical complications.mp OR *"Postoperative Complications"/] LIMIT [humans AND english language ...
Patient-Controlled Analgesia Pumps Patient-controlled analgesia (PCA) is a type of pain management that lets you decide when you will get a dose of pain medicine. In some situations, PCA may be a better way of providing pain relief than calling for someone (typically a nurse) to give you pain medicine. With PCA you dont need to wait for a nurse. And you can get smaller doses of pain medicine more often. With this type of pain treatment, a needle attached to an IV (intravenous) line is placed into 1 of ...
Several studies have shown that TEA is very effective in ensuring appropriate pain control following thoracic surgery, and some authors consider this anaesthesic technique to be the gold standard for postoperative analgesia following thoracic interventions.8-12 ,16 Since lateral thoracotomy may be more painful than mid-sternotomy due to rib spreading and intercostal nerve injury,17 optimization of postoperative analgesia might be even more important in such cases. Nonetheless, the use of TEA in patients undergoing TA-TAVI has been limited to a single case report,12 and no studies, to date, have evaluated the efficacy and safety of this technique of anaesthesia in this setting. The present study showed that TEA was highly effective in providing postoperative analgesia following TA-TAVI. About 50% of the patients treated with TEA experienced either no pain or only minimal pain within the first 48 h following the procedure, and ,90% at later time-points, and these pain score levels were far lower ...
Spinal epidural abscess has rarely been associated with the use of epidural catheters. We describe two patients with epidural abscesses that occurred in relation to the use of temporary epidural catheters; a literature review yielded 20 additional well-described cases. The mean age of these 22 patients was 49.9 years, the median duration of epidural catheter use was 3 days, and the median time to onset of clinical symptoms after catheter placement was 5 days. The majority of patients (63.6%) had major neurological deficits, and 22.7% also had concomitant meningitis. Staphylococcus aureus was the predominant pathogen. Despite antibiotic therapy and drainage procedures, 38% of the patients continued to have neurological deficits. These unusual but serious complications of temporary epidural catheter use require efficient and accurate diagnostic evaluation, as they can be substantial.. ...

Lumbar Sympathetic Nerve Block for Obstetrical Analgesia; Preliminary Report of Over 1,200 Cases | Anesthesiology | ASA...Lumbar Sympathetic Nerve Block for Obstetrical Analgesia; Preliminary Report of Over 1,200 Cases | Anesthesiology | ASA...

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 ...
more infohttp://anesthesiology.pubs.asahq.org/article.aspx?articleid=1982424

Obstetrical Analgesia and Anesthesia | Williams Obstetrics, 25e | AccessObGyn | McGraw-Hill MedicalObstetrical Analgesia and Anesthesia | Williams Obstetrics, 25e | AccessObGyn | McGraw-Hill Medical

"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 ...
more infohttps://obgyn.mhmedical.com/content.aspx?sectionid=155911527&bookid=1918

Geburtshilfiche Anasthesie und Analgesie.(Obstetrical Anesthesia and Analgesia.) | Anesthesiology | ASA PublicationsGeburtshilfiche Anasthesie und Analgesie.(Obstetrical Anesthesia and Analgesia.) | Anesthesiology | ASA Publications

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; ...
more infohttp://anesthesiology.pubs.asahq.org/article.aspx?articleid=1963898

Demerol Injection - FDA prescribing information, side effects and usesDemerol Injection - FDA prescribing information, side effects and uses

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 ...
more infohttps://www.drugs.com/pro/demerol-injection.html

Duraclon Injection - FDA prescribing information, side effects and usesDuraclon Injection - FDA prescribing information, side effects and uses

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 ...
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DailyMed - DEMEROL- meperidine hydrochloride injection, solutionDailyMed - DEMEROL- meperidine hydrochloride injection, solution

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 ...
more infohttps://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b31d1308-28c3-43f4-e0a6-2f3ed76b8975

DailyMed - CLONIDINE HYDROCHLORIDE- clonidine hydrochloride injection, solutionDailyMed - CLONIDINE HYDROCHLORIDE- clonidine hydrochloride injection, solution

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. ...
more infohttps://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f01f281d-c7e5-4258-ab14-3685f1ff296f

Search of: postpartum depression - List Results - ClinicalTrials.govSearch of: postpartum depression - List Results - ClinicalTrials.gov

Neuraxial Labor Analgesia and the Incidence of Postpartum Depression. *Parturition. *Analgesia, Obstetrical ... The Correlation Between Prelabor Analgesic Plan and Actual Labor Analgesia With Satisfaction, Postpartum Depression, and Breast ...
more infohttps://clinicaltrials.gov/ct2/results?term=postpartum+depression&show_rss=Y

2nd World Congress on Gynecology and Obstetrics (PGR) Tickets, Mon, May 13, 2019 at 8:00 AM | Eventbrite2nd World Congress on Gynecology and Obstetrics (PGR) Tickets, Mon, May 13, 2019 at 8:00 AM | Eventbrite

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 ...
more infohttps://www.eventbrite.com/e/2nd-world-congress-on-gynecology-and-obstetrics-pgr-tickets-51625100064

Research Faculty -  Last Initial D - Wake Forest School of MedicineResearch Faculty - Last Initial D - Wake Forest School of Medicine

Embolism, Amniotic Fluid; Cesarean Section; Analgesia, Obstetrical; Pregnancy; Anesthesia, Spinal Academic: 336-718-8278. ...
more infohttp://www.wakehealth.edu/Research/FacultySR.htm?st=D&li=D&ft=R

Academic Programs Faculty -  Last Initial D - Wake Forest School of MedicineAcademic Programs Faculty - Last Initial D - Wake Forest School of Medicine

Embolism, Amniotic Fluid; Cesarean Section; Analgesia, Obstetrical; Pregnancy; Anesthesia, Spinal Academic: 336-718-8278. ...
more infohttp://www.wakehealth.edu/School/facultySR.htm?st=D&li=D&ft=R

Hydromorphone (Dilaudid, Exalgo) Side Effects & Opioid Addiction WarningsHydromorphone (Dilaudid, Exalgo) Side Effects & Opioid Addiction Warnings

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 ...
more infohttps://www.rxlist.com/consumer_hydromorphone_dilaudid_exalgo/drugs-condition.htm

Heart rate increased with DilaudidHeart rate increased with Dilaudid

Analgesia, Obstetrical; Cesarean Section. Interventions: Drug: Morphine; Drug: Hydromorphone. Outcome Measures: Visual analog ... Epidural Analgesia Versus IV Analgesia in Lumbar Spine Fusions Conditions: Lumbar Spine Fusion; Pain; Back Pain. ... True Functional Restoration and Analgesia in Non-Radicular Low Back Pain Condition: Low Back Pain. ... Patient satisfaction with perioperative analgesia; Number of participants with adverse events. ...
more infohttp://patientsville.com/i.htm?q=HEART%20RATE%20INCREASED&mp=Dilaudid

Joint swelling with DilaudidJoint swelling with Dilaudid

Analgesia, Obstetrical; Cesarean Section. Interventions: Drug: Morphine; Drug: Hydromorphone. Outcome Measures: Visual analog ... Epidural Analgesia Versus IV Analgesia in Lumbar Spine Fusions Conditions: Lumbar Spine Fusion; Pain; Back Pain. ... True Functional Restoration and Analgesia in Non-Radicular Low Back Pain Condition: Low Back Pain. ... Patient satisfaction with perioperative analgesia; Number of participants with adverse events. ...
more infohttp://patientsville.com/i.htm?q=JOINT%20SWELLING&mp=Dilaudid

Search results for SEARCH[STUDY] TILT[STUDY:STUDY-FIRST-POSTED] ( Pain management [STUDY:TREATMENT] ) - ICH GCP - Clinical...Search results for SEARCH[STUDY] TILT[STUDY:STUDY-FIRST-POSTED] ( Pain management [STUDY:TREATMENT] ) - ICH GCP - Clinical...

Individualized Timing of Analgesia and Effectiveness of Labor Analgesia. Conditions: Labor Pain; Analgesia, Obstetrical; Early ... Conditions: Parturition; Analgesia, Obstetrical; Depression, Postpartum Intervention: No Neuraxial Labor Analgesia, Neuraxial ... Analgesia and Pancreatic Cancer Surgery. Conditions: Pancreatic Neoplasms Intervention: Epidural Patient Controlled Analgesia, ... The Randomised Epidural Analgesia in Term Delivering Women Trial (TREAT). Conditions: Analgesia, Epidural; Instrumental ...
more infohttps://ichgcp.net/clinical-trials-registry/research/find?intr=Pain%2Bmanagement

Levallorphan - wikidocLevallorphan - wikidoc

Bullough J. Use of premixed pethidine and antagonists in obstetrical analgesia; with special reference to cases in which ... and when a very small dose of levallorphan is used alongside an opioid full agonist this can in fact produce greater analgesia ...
more infohttps://www.wikidoc.org/index.php/Levallorphan

Clonidine Injection - Instruction, Prescriptions, Dosage, Side Effects, InteractionsClonidine Injection - Instruction, Prescriptions, Dosage, Side Effects, Interactions

Use in Postoperative or Obstetrical Analgesia. Clonidine hydrochloride (epidural clonidine) is not recommended for obstetrical ... 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 ... Published reports on the use of epidural clonidine for intraoperative or postoperative analgesia also show a consistent and ...
more infohttp://drugstip.com/drug/clonidine-injection

West Coast University - Nursing 280 Pharmacology FlashcardsWest Coast University - Nursing 280 Pharmacology Flashcards

Dilaudid ORAL LIQUID and Dilaudid TABLETS are also contraindicated for use in obstetrical analgesia. ... A significant feature of the analgesia is that it can occur without loss of consciousness. Opioid analgesics also suppress the ... Excessive doses of Narcan in postoperative patients may result in significant reversal of analgesia and may cause agitation ... These events should be anticipated and managed as part of opioid analgesia therapy. ...
more infohttps://www.flashcardmachine.com/west-coast-universitynursing280pharmacology.html

ACOG in the News: The Pros and Cons of an Epidural and 11 Questions to Ask Yourself Before Getting an IUD - ACOGACOG in the News: The Pros and Cons of an Epidural and 11 Questions to Ask Yourself Before Getting an IUD - ACOG

I can speak as an expert on obstetrical analgesia that it is a safe and reasonable option. We are actually currently trying to ... She helped draft the Colleges 2002 guidance about analgesia for labor, which, she says, "did not discuss nitrous oxide as an ...
more infohttps://www.acog.org/About-ACOG/ACOG-Departments/ACOG-Rounds/December-2016/ACOG-in-the-News

Methoxyflurane - WikipediaMethoxyflurane - Wikipedia

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 ...
more infohttps://en.wikipedia.org/wiki/Methoxyflurane

Levallorphan - WikipediaLevallorphan - Wikipedia

Bullough, J. (1959). "Use of premixed pethidine and antagonists in obstetrical analgesia; with special reference to cases in ... and a very small dose of levallorphan used alongside a full agonist of the MOR can produce greater analgesia than when the ... by opioid analgesics and barbiturates used for induction of surgical anaesthesia whilst maintaining a degree of analgesia (via ... the effects of stronger agents with greater intrinsic activity such as morphine whilst simultaneously producing analgesia. ...
more infohttps://en.wikipedia.org/wiki/Levallorphan

Molecular Expressions: The Pharmaceutical Collection - Demerol (Meperidine)Molecular Expressions: The Pharmaceutical Collection - Demerol (Meperidine)

The general therapeutic effects of this drug are analgesia and sedation. ... and the support of anesthesia and for obstetrical analgesia. Side effects include confusion, convulsions, dizziness, drowsiness ... The general therapeutic effects of this drug are analgesia and sedation. Demerol is used to relieve moderate to severe pain, as ...
more infohttps://micro.magnet.fsu.edu/pharmaceuticals/pages/demerol.html

Epidemiology of Anesthesia-Related Complications in Labor and Delivery, New York State, 2002-2005Epidemiology of Anesthesia-Related Complications in Labor and Delivery, New York State, 2002-2005

Epidemiology of complications of obstetrical epidural analgesia. Cah Anesthesiol. 1994;42:229-33. [PubMed] ... There have been various studies on the complications of obstetric anesthesia and analgesia.3-14 Many of these studies are case ... Holdcroft A, Morgan M. Maternal complications of obstetric epidural analgesia. Anaesth Intensive Care. 1976;4:108-12. [PubMed] ... Racial differences in the use of epidural analgesia for labor. Anesthesiology. 2007;106:19-25. [PubMed] ...
more infohttp://pubmedcentralcanada.ca/pmcc/articles/PMC3391736/?lang=en-ca

4982sm-17/27 Combined Spinal/epidural 17g Tuohy/27g Whitacre Information, Side Effects, Warnings and Recalls4982sm-17/27 Combined Spinal/epidural 17g Tuohy/27g Whitacre Information, Side Effects, Warnings and Recalls

When continuous lumbar or caudal epidural anesthesia is used for non-obstetrical procedures, more drug may be administered if ... When continuous lumbar or caudal epidural anesthesia is used for non-obstetrical procedures, more drug may be administered if ... The maximum recommended dose per 90 minute period of lidocaine hydrochloride for paracervical block in obstetrical patients and ... The maximum recommended dose per 90 minute period of lidocaine hydrochloride for paracervical block in obstetrical patients and ...
more infohttps://www.recallguide.org/drug/4982sm-1727-combined-spinalepidural-17g-tuohy27g-whitacre/
  • The analgesia is limited to the body regions innervated by the spinal segments where analgesic concentrations of clonidine are present. (drugs.com)
  • Clonidine is thought to produce analgesia at presynaptic and postjunctional alpha-2-adrenoceptors in the spinal cord by preventing pain signal transmission to the brain. (drugs.com)
  • It was also used in combination with opioids to reduce their side effects, mainly in obstetrics , and when a very small dose of levallorphan is used alongside an opioid full agonist this can in fact produce greater analgesia than when the agonist is used by itself. (wikidoc.org)
  • The general therapeutic effects of this drug are analgesia and sedation. (fsu.edu)