Analgesia: Methods of PAIN relief that may be used with or in place of ANALGESICS.Analgesia, Epidural: The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. It is differentiated from ANESTHESIA, EPIDURAL which refers to the state of insensitivity to sensation.Analgesia, Obstetrical: The elimination of PAIN, without the loss of CONSCIOUSNESS, during OBSTETRIC LABOR; OBSTETRIC DELIVERY; or the POSTPARTUM PERIOD, usually through the administration of ANALGESICS.Analgesia, Patient-Controlled: Relief of PAIN, without loss of CONSCIOUSNESS, through ANALGESIC AGENTS administered by the patients. It has been used successfully to control POSTOPERATIVE PAIN, during OBSTETRIC LABOR, after BURNS, and in TERMINAL CARE. The choice of agent, dose, and lockout interval greatly influence effectiveness. The potential for overdose can be minimized by combining small bolus doses with a mandatory interval between successive doses (lockout interval).Analgesics, Opioid: Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.Pain, Postoperative: Pain during the period after surgery.Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle.Pain Measurement: Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.Bupivacaine: A widely used local anesthetic agent.Anesthetics, Local: Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.Acupuncture Analgesia: Analgesia produced by the insertion of ACUPUNCTURE needles at certain ACUPUNCTURE POINTS on the body. This activates small myelinated nerve fibers in the muscle which transmit impulses to the spinal cord and then activate three centers - the spinal cord, midbrain and pituitary/hypothalamus - to produce analgesia.Fentanyl: A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)Analgesics: Compounds capable of relieving pain without the loss of CONSCIOUSNESS.Anesthesia, Epidural: Procedure in which an anesthetic is injected into the epidural space.Meperidine: A narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. Prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration.Labor Pain: Pain associated with OBSTETRIC LABOR in CHILDBIRTH. It is caused primarily by UTERINE CONTRACTION as well as pressure on the CERVIX; BLADDER; and the GASTROINTESTINAL TRACT. Labor pain mostly occurs in the ABDOMEN; the GROIN; and the BACK.Sufentanil: An opioid analgesic that is used as an adjunct in anesthesia, in balanced anesthesia, and as a primary anesthetic agent.Pain: An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS.Nerve Block: Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain.Injections, Spinal: Introduction of therapeutic agents into the spinal region using a needle and syringe.Labor, Obstetric: The repetitive uterine contraction during childbirth which is associated with the progressive dilation of the uterine cervix (CERVIX UTERI). Successful labor results in the expulsion of the FETUS and PLACENTA. Obstetric labor can be spontaneous or induced (LABOR, INDUCED).Anesthesia, Obstetrical: A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth.Amides: Organic compounds containing the -CO-NH2 radical. Amides are derived from acids by replacement of -OH by -NH2 or from ammonia by the replacement of H by an acyl group. (From Grant & Hackh's Chemical Dictionary, 5th ed)Anesthesia, Spinal: Procedure in which an anesthetic is injected directly into the spinal cord.Tramadol: A narcotic analgesic proposed for severe pain. It may be habituating.Double-Blind Method: A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.Analgesics, Non-Narcotic: A subclass of analgesic agents that typically do not bind to OPIOID RECEPTORS and are not addictive. Many non-narcotic analgesics are offered as NONPRESCRIPTION DRUGS.Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors.Cesarean Section: Extraction of the FETUS by means of abdominal HYSTEROTOMY.Postoperative Nausea and Vomiting: Emesis and queasiness occurring after anesthesia.Pain Threshold: Amount of stimulation required before the sensation of pain is experienced.Interpleural Analgesia: Injection of ANALGESICS; LOCAL ANESTHETICS; or NARCOTICS into the PLEURAL CAVITY between the two pleural membranes.Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from DRUG RESISTANCE wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from MAXIMUM TOLERATED DOSE and NO-OBSERVED-ADVERSE-EFFECT LEVEL.Receptors, Opioid, mu: A class of opioid receptors recognized by its pharmacological profile. Mu opioid receptors bind, in decreasing order of affinity, endorphins, dynorphins, met-enkephalin, and leu-enkephalin. They have also been shown to be molecular receptors for morphine.Anesthesia, General: Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.Conscious Sedation: A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines)Ketorolac: A pyrrolizine carboxylic acid derivative structurally related to INDOMETHACIN. It is an NSAID and is used principally for its analgesic activity. (From Martindale The Extra Pharmacopoeia, 31st ed)Labor Stage, First: Period from the onset of true OBSTETRIC LABOR to the complete dilatation of the CERVIX UTERI.Hydromorphone: An opioid analgesic made from MORPHINE and used mainly as an analgesic. It has a shorter duration of action than morphine.Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE.Pain Management: A form of therapy that employs a coordinated and interdisciplinary approach for easing the suffering and improving the quality of life of those experiencing pain.Anesthesia, Caudal: Epidural anesthesia administered via the sacral canal.Clonidine: An imidazoline sympatholytic agent that stimulates ALPHA-2 ADRENERGIC RECEPTORS and central IMIDAZOLINE RECEPTORS. It is commonly used in the management of HYPERTENSION.Anesthesia and Analgesia: Medical methods of either relieving pain caused by a particular condition or removing the sensation of pain during a surgery or other medical procedure.Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (RECEPTORS, N-METHYL-D-ASPARTATE) and may interact with sigma receptors.Femoral Nerve: A nerve originating in the lumbar spinal cord (usually L2 to L4) and traveling through the lumbar plexus to provide motor innervation to extensors of the thigh and sensory innervation to parts of the thigh, lower leg, and foot, and to the hip and knee joints.Receptors, Opioid: Cell membrane proteins that bind opioids and trigger intracellular changes which influence the behavior of cells. The endogenous ligands for opioid receptors in mammals include three families of peptides, the enkephalins, endorphins, and dynorphins. The receptor classes include mu, delta, and kappa receptors. Sigma receptors bind several psychoactive substances, including certain opioids, but their endogenous ligands are not known.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Pirinitramide: A diphenylpropylamine with intense narcotic analgesic activity of long duration. It is a derivative of MEPERIDINE with similar activity and usage.Hypnotics and Sedatives: Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety.Butorphanol: A synthetic morphinan analgesic with narcotic antagonist action. It is used in the management of severe pain.Alfentanil: A short-acting opioid anesthetic and analgesic derivative of FENTANYL. It produces an early peak analgesic effect and fast recovery of consciousness. Alfentanil is effective as an anesthetic during surgery, for supplementation of analgesia during surgical procedures, and as an analgesic for critically ill patients.Nalbuphine: A narcotic used as a pain medication. It appears to be an agonist at kappa opioid receptors and an antagonist or partial agonist at mu opioid receptors.Narcotic Antagonists: Agents inhibiting the effect of narcotics on the central nervous system.Anesthetics, Combined: The use of two or more chemicals simultaneously or sequentially to induce anesthesia. The drugs need not be in the same dosage form.Anesthesia, Conduction: Injection of an anesthetic into the nerves to inhibit nerve transmission in a specific part of the body.Thoracotomy: Surgical incision into the chest wall.Opioid Peptides: The endogenous peptides with opiate-like activity. The three major classes currently recognized are the ENKEPHALINS, the DYNORPHINS, and the ENDORPHINS. Each of these families derives from different precursors, proenkephalin, prodynorphin, and PRO-OPIOMELANOCORTIN, respectively. There are also at least three classes of OPIOID RECEPTORS, but the peptide families do not map to the receptors in a simple way.Electroacupuncture: A form of acupuncture with electrical impulses passing through the needles to stimulate NERVE TISSUE. It can be used for ANALGESIA; ANESTHESIA; REHABILITATION; and treatment for diseases.Mepivacaine: A local anesthetic that is chemically related to BUPIVACAINE but pharmacologically related to LIDOCAINE. It is indicated for infiltration, nerve block, and epidural anesthesia. Mepivacaine is effective topically only in large doses and therefore should not be used by this route. (From AMA Drug Evaluations, 1994, p168)Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief.Ketoprofen: An IBUPROFEN-type anti-inflammatory analgesic and antipyretic. It is used in the treatment of rheumatoid arthritis and osteoarthritis.Adjuvants, Anesthesia: Agents that are administered in association with anesthetics to increase effectiveness, improve delivery, or decrease required dosage.Placebo Effect: An effect usually, but not necessarily, beneficial that is attributable to an expectation that the regimen will have an effect, i.e., the effect is due to the power of suggestion.Morphine Derivatives: Analogs or derivatives of morphine.Hyperalgesia: An increased sensation of pain or discomfort produced by mimimally noxious stimuli due to damage to soft tissue containing NOCICEPTORS or injury to a peripheral nerve.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Anesthesia, Local: A blocking of nerve conduction to a specific area by an injection of an anesthetic agent.Periaqueductal Gray: Central gray matter surrounding the CEREBRAL AQUEDUCT in the MESENCEPHALON. Physiologically it is probably involved in RAGE reactions, the LORDOSIS REFLEX; FEEDING responses, bladder tonus, and pain.Nitrous Oxide: Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream.Pentazocine: The first mixed agonist-antagonist analgesic to be marketed. It is an agonist at the kappa and sigma opioid receptors and has a weak antagonist action at the mu receptor. (From AMA Drug Evaluations Annual, 1991, p97)Postoperative Care: The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)Dexmedetomidine: A imidazole derivative that is an agonist of ADRENERGIC ALPHA-2 RECEPTORS. It is closely-related to MEDETOMIDINE, which is the racemic form of this compound.Ambulatory Surgical Procedures: Surgery performed on an outpatient basis. It may be hospital-based or performed in an office or surgicenter.Hysterectomy: Excision of the uterus.Piperidines: A family of hexahydropyridines.Dose-Response Relationship, Drug: The relationship between the dose of an administered drug and the response of the organism to the drug.Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon.Pain, Intractable: Persistent pain that is refractory to some or all forms of treatment.Oxycodone: A semisynthetic derivative of CODEINE.Pain Perception: The process by which PAIN is recognized and interpreted by the brain.Injections, Epidural: The injection of drugs, most often analgesics, into the spinal canal without puncturing the dura mater.Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak anti-inflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage.Anesthesia, Intravenous: Process of administering an anesthetic through injection directly into the bloodstream.Anesthetics, Dissociative: Intravenous anesthetics that induce a state of sedation, immobility, amnesia, and marked analgesia. Subjects may experience a strong feeling of dissociation from the environment. The condition produced is similar to NEUROLEPTANALGESIA, but is brought about by the administration of a single drug. (From Gilman et al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed)Prilocaine: A local anesthetic that is similar pharmacologically to LIDOCAINE. Currently, it is used most often for infiltration anesthesia in dentistry.Nociceptors: Peripheral AFFERENT NEURONS which are sensitive to injuries or pain, usually caused by extreme thermal exposures, mechanical forces, or other noxious stimuli. Their cell bodies reside in the DORSAL ROOT GANGLIA. Their peripheral terminals (NERVE ENDINGS) innervate target tissues and transduce noxious stimuli via axons to the CENTRAL NERVOUS SYSTEM.Delivery, Obstetric: Delivery of the FETUS and PLACENTA under the care of an obstetrician or a health worker. Obstetric deliveries may involve physical, psychological, medical, or surgical interventions.Obstetric Labor Complications: Medical problems associated with OBSTETRIC LABOR, such as BREECH PRESENTATION; PREMATURE OBSTETRIC LABOR; HEMORRHAGE; or others. These complications can affect the well-being of the mother, the FETUS, or both.Neostigmine: A cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. Neostigmine, unlike PHYSOSTIGMINE, does not cross the blood-brain barrier.Nociceptive Pain: Dull or sharp aching pain caused by stimulated NOCICEPTORS due to tissue injury, inflammation or diseases. It can be divided into somatic or tissue pain and VISCERAL PAIN.Injections, Intravenous: Injections made into a vein for therapeutic or experimental purposes.Extraction, Obstetrical: Extraction of the fetus by means of obstetrical instruments.Dipyrone: A drug that has analgesic, anti-inflammatory, and antipyretic properties. It is the sodium sulfonate of AMINOPYRINE.Anti-Inflammatory Agents, Non-Steroidal: Anti-inflammatory agents that are non-steroidal in nature. In addition to anti-inflammatory actions, they have analgesic, antipyretic, and platelet-inhibitory actions.They act by blocking the synthesis of prostaglandins by inhibiting cyclooxygenase, which converts arachidonic acid to cyclic endoperoxides, precursors of prostaglandins. Inhibition of prostaglandin synthesis accounts for their analgesic, antipyretic, and platelet-inhibitory actions; other mechanisms may contribute to their anti-inflammatory effects.Spinal Cord: A cylindrical column of tissue that lies within the vertebral canal. It is composed of WHITE MATTER and GRAY MATTER.Drug Administration Schedule: Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience.Subarachnoid Space: The space between the arachnoid membrane and PIA MATER, filled with CEREBROSPINAL FLUID. It contains large blood vessels that supply the BRAIN and SPINAL CORD.Narcotics: Agents that induce NARCOSIS. Narcotics include agents that cause somnolence or induced sleep (STUPOR); natural or synthetic derivatives of OPIUM or MORPHINE or any substance that has such effects. They are potent inducers of ANALGESIA and OPIOID-RELATED DISORDERS.Injections, Intra-Articular: Methods of delivering drugs into a joint space.Codeine: An opioid analgesic related to MORPHINE but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough.Nefopam: Non-narcotic analgesic chemically similar to ORPHENADRINE. Its mechanism of action is unclear. It is used for the relief of acute and chronic pain. (From Martindale, The Extra Pharmacopoeia, 30th ed, p26)Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Infusions, Intravenous: The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it.Buprenorphine: A derivative of the opioid alkaloid THEBAINE that is a more potent and longer lasting analgesic than MORPHINE. It appears to act as a partial agonist at mu and kappa opioid receptors and as an antagonist at delta receptors. The lack of delta-agonist activity has been suggested to account for the observation that buprenorphine tolerance may not develop with chronic use.Perioperative Care: Interventions to provide care prior to, during, and immediately after surgery.Heroin: A narcotic analgesic that may be habit-forming. It is a controlled substance (opium derivative) listed in the U.S. Code of Federal Regulations, Title 21 Parts 329.1, 1308.11 (1987). Sale is forbidden in the United States by Federal statute. (Merck Index, 11th ed)Apgar Score: A method, developed by Dr. Virginia Apgar, to evaluate a newborn's adjustment to extrauterine life. Five items - heart rate, respiratory effort, muscle tone, reflex irritability, and color - are evaluated 60 seconds after birth and again five minutes later on a scale from 0-2, 0 being the lowest, 2 being normal. The five numbers are added for the Apgar score. A score of 0-3 represents severe distress, 4-7 indicates moderate distress, and a score of 7-10 predicts an absence of difficulty in adjusting to extrauterine life.Preanesthetic Medication: Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.Administration, Rectal: The insertion of drugs into the rectum, usually for confused or incompetent patients, like children, infants, and the very old or comatose.Rats, Sprague-Dawley: A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few - MORPHINE; CODEINE; and PAPAVERINE - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic.Anesthesia Recovery Period: The period of emergence from general anesthesia, where different elements of consciousness return at different rates.Receptors, Opioid, kappa: A class of opioid receptors recognized by its pharmacological profile. Kappa opioid receptors bind dynorphins with a higher affinity than endorphins which are themselves preferred to enkephalins.Receptors, Opioid, delta: A class of opioid receptors recognized by its pharmacological profile. Delta opioid receptors bind endorphins and enkephalins with approximately equal affinity and have less affinity for dynorphins.ThiazinesInfusion Pumps: Fluid propulsion systems driven mechanically, electrically, or osmotically that are used to inject (or infuse) over time agents into a patient or experimental animal; used routinely in hospitals to maintain a patent intravenous line, to administer antineoplastic agents and other drugs in thromboembolism, heart disease, diabetes mellitus (INSULIN INFUSION SYSTEMS is also available), and other disorders.beta-Endorphin: A 31-amino acid peptide that is the C-terminal fragment of BETA-LIPOTROPIN. It acts on OPIOID RECEPTORS and is an analgesic. Its first four amino acids at the N-terminal are identical to the tetrapeptide sequence of METHIONINE ENKEPHALIN and LEUCINE ENKEPHALIN.Enkephalin, Ala(2)-MePhe(4)-Gly(5)-: An enkephalin analog that selectively binds to the MU OPIOID RECEPTOR. It is used as a model for drug permeability experiments.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Abdomen: That portion of the body that lies between the THORAX and the PELVIS.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Injections, Intramuscular: Forceful administration into a muscle of liquid medication, nutrient, or other fluid through a hollow needle piercing the muscle and any tissue covering it.Dihydromorphine: A semisynthetic analgesic used in the study of narcotic receptors.Adrenergic alpha-Agonists: Drugs that selectively bind to and activate alpha adrenergic receptors.Nociception: Sensing of noxious mechanical, thermal or chemical stimuli by NOCICEPTORS. It is the sensory component of visceral and tissue pain (NOCICEPTIVE PAIN).Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of NALOXONE. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence.Drug Combinations: Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture.Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.Enkephalins: One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla.Infusions, Parenteral: The administration of liquid medication, nutrient, or other fluid through some other route than the alimentary canal, usually over minutes or hours, either by gravity flow or often by infusion pumping.Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the PRO-OPIOMELANOCORTIN precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; OPIOID PEPTIDES is used for the broader group.Propofol: An intravenous anesthetic agent which has the advantage of a very rapid onset after infusion or bolus injection plus a very short recovery period of a couple of minutes. (From Smith and Reynard, Textbook of Pharmacology, 1992, 1st ed, p206). Propofol has been used as ANTICONVULSANTS and ANTIEMETICS.Anesthetics, Intravenous: Ultrashort-acting anesthetics that are used for induction. Loss of consciousness is rapid and induction is pleasant, but there is no muscle relaxation and reflexes frequently are not reduced adequately. Repeated administration results in accumulation and prolongs the recovery time. Since these agents have little if any analgesic activity, they are seldom used alone except in brief minor procedures. (From AMA Drug Evaluations Annual, 1994, p174)Midazolam: A short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. It is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. The short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. It is water-soluble at pH less than 4 and lipid-soluble at physiological pH.Morphinans: Compounds based on a partially saturated iminoethanophenanthrene, which can be described as ethylimino-bridged benzo-decahydronaphthalenes. They include some of the OPIOIDS found in PAPAVER that are used as ANALGESICS.Gynecologic Surgical Procedures: Surgery performed on the female genitalia.Behavior, Animal: The observable response an animal makes to any situation.Anesthesia, Dental: A range of methods used to reduce pain and anxiety during dental procedures.Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve.Doulas: Trained lay women who provide emotional and/or physical support during obstetric labor and the postpartum period for mothers and their partners.Labor Stage, Second: The period of OBSTETRIC LABOR that is from the complete dilatation of the CERVIX UTERI to the expulsion of the FETUS.Tolmetin: A non-steroidal anti-inflammatory agent (ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL) similar in mode of action to INDOMETHACIN.Piroxicam: A cyclooxygenase inhibiting, non-steroidal anti-inflammatory agent (NSAID) that is well established in treating rheumatoid arthritis and osteoarthritis and used for musculoskeletal disorders, dysmenorrhea, and postoperative pain. Its long half-life enables it to be administered once daily.Acupuncture Points: Designated locations along nerves or organ meridians for inserting acupuncture needles.Respiration: The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= OXYGEN CONSUMPTION) or cell respiration (= CELL RESPIRATION).Orthopedic Procedures: Procedures used to treat and correct deformities, diseases, and injuries to the MUSCULOSKELETAL SYSTEM, its articulations, and associated structures.Acute Pain: Intensely discomforting, distressful, or agonizing sensation associated with trauma or disease, with well-defined location, character, and timing.Injections, Intraventricular: Injections into the cerebral ventricles.Oxymorphone: An opioid analgesic with actions and uses similar to those of MORPHINE, apart from an absence of cough suppressant activity. It is used in the treatment of moderate to severe pain, including pain in obstetrics. It may also be used as an adjunct to anesthesia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1092)Hypnosis, Anesthetic: Procedure in which an individual is induced into a trance-like state to relieve pain. This procedure is frequently performed with local but not general ANESTHESIA.Epidural Space: Space between the dura mater and the walls of the vertebral canal.Postoperative Period: The period following a surgical operation.Arthroplasty, Replacement, Knee: Replacement of the knee joint.Droperidol: A butyrophenone with general properties similar to those of HALOPERIDOL. It is used in conjunction with an opioid analgesic such as FENTANYL to maintain the patient in a calm state of neuroleptanalgesia with indifference to surroundings but still able to cooperate with the surgeon. It is also used as a premedicant, as an antiemetic, and for the control of agitation in acute psychoses. (From Martindale, The Extra Pharmacopoeia, 29th ed, p593)Diclofenac: A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt.Heart Rate, Fetal: The heart rate of the FETUS. The normal range at term is between 120 and 160 beats per minute.Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug.Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Adrenergic alpha-2 Receptor Agonists: Compounds that bind to and activate ADRENERGIC ALPHA-2 RECEPTORS.Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses.Arthroscopy: Endoscopic examination, therapy and surgery of the joint.Cyclohexanecarboxylic AcidsSingle-Blind Method: A method in which either the observer(s) or the subject(s) is kept ignorant of the group to which the subjects are assigned.Hernia, Inguinal: An abdominal hernia with an external bulge in the GROIN region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the ABDOMINAL WALL (transversalis fascia) in Hesselbach's triangle. The former type is commonly seen in children and young adults; the latter in adults.Transcutaneous Electric Nerve Stimulation: The use of specifically placed small electrodes to deliver electrical impulses across the SKIN to relieve PAIN. It is used less frequently to produce ANESTHESIA.Injections, Subcutaneous: Forceful administration under the skin of liquid medication, nutrient, or other fluid through a hollow needle piercing the skin.Vomiting: The forcible expulsion of the contents of the STOMACH through the MOUTH.Antiemetics: Drugs used to prevent NAUSEA or VOMITING.Drug Therapy, Combination: Therapy with two or more separate preparations given for a combined effect.Morphine Dependence: Strong dependence, both physiological and emotional, upon morphine.Parity: The number of offspring a female has borne. It is contrasted with GRAVIDITY, which refers to the number of pregnancies, regardless of outcome.Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the TIBIAL NERVE and the PERONEAL NERVE.Epinephrine: The active sympathomimetic hormone from the ADRENAL MEDULLA. It stimulates both the alpha- and beta- adrenergic systems, causes systemic VASOCONSTRICTION and gastrointestinal relaxation, stimulates the HEART, and dilates BRONCHI and cerebral vessels. It is used in ASTHMA and CARDIAC FAILURE and to delay absorption of local ANESTHETICS.Tooth Extraction: The surgical removal of a tooth. (Dorland, 28th ed)Enkephalin, D-Penicillamine (2,5)-: A disulfide opioid pentapeptide that selectively binds to the DELTA OPIOID RECEPTOR. It possesses antinociceptive activity.Ketorolac Tromethamine: A pyrrolizine carboxylic acid derivative structurally related to INDOMETHACIN. It is a non-steroidal anti-inflammatory agent used for analgesia for postoperative pain and inhibits cyclooxygenase activity.Hot Temperature: Presence of warmth or heat or a temperature notably higher than an accustomed norm.Tonsillectomy: Surgical removal of a tonsil or tonsils. (Dorland, 28th ed)Intraoperative Care: Patient care procedures performed during the operation that are ancillary to the actual surgery. It includes monitoring, fluid therapy, medication, transfusion, anesthesia, radiography, and laboratory tests.Intraoperative Period: The period during a surgical operation.Enkephalin, Leucine: One of the endogenous pentapeptides with morphine-like activity. It differs from MET-ENKEPHALIN in the LEUCINE at position 5. Its first four amino acid sequence is identical to the tetrapeptide sequence at the N-terminal of BETA-ENDORPHIN.Receptors, Adrenergic, alpha-2: A subclass of alpha-adrenergic receptors found on both presynaptic and postsynaptic membranes where they signal through Gi-Go G-PROTEINS. While postsynaptic alpha-2 receptors play a traditional role in mediating the effects of ADRENERGIC AGONISTS, the subset of alpha-2 receptors found on presynaptic membranes signal the feedback inhibition of NEUROTRANSMITTER release.Drug Synergism: The action of a drug in promoting or enhancing the effectiveness of another drug.Catheterization, Peripheral: Insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes.Analysis of Variance: A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (ANTIBIOTIC PROPHYLAXIS) and anti-anxiety agents. It does not include PREANESTHETIC MEDICATION.Reaction Time: The time from the onset of a stimulus until a response is observed.
Maternal intrapartum temperature elevation as a risk factor for cesarean delivery and assisted vaginal delivery. (1/280)
OBJECTIVES: This study investigated the association of intrapartum temperature elevation with cesarean delivery and assisted vaginal delivery. METHODS: Participants were 1233 nulliparous women with singleton, term pregnancies in vertex presentations who had spontaneous labors and were afebrile (temperature: 99.5 degrees F [37.5 degrees C]) at admission for delivery. Rates of cesarean and assisted vaginal deliveries according to highest intrapartum temperature were examined by epidural status. RESULTS: Women with maximum intrapartum temperatures higher than 99.5 degrees F were 3 times as likely to experience cesarean (25.2% vs 7.2%) or assisted vaginal delivery (25.2% vs 8.5%). The association was present in epidural users and nonusers and persisted after birthweight, epidural use, and labor length had been controlled. In adjusted analyses, temperature elevation was associated with a doubling in the risk of cesarean delivery (odds ratio [OR] = 2.3, 95% confidence interval [CI] = 1.5, 3.4) and assisted vaginal delivery (OR = 2.1, 95% CI = 1.4, 3.1). CONCLUSIONS: Modest temperature elevation developing during labor was associated with higher rates of cesarean and assisted vaginal deliveries. More frequent temperature elevation among women with epidural analgesia may explain in part the higher rates of cesarean and assisted vaginal deliveries observed with epidural use. (+info)Neonatal outcome and mode of delivery after epidural analgesia for labour with ropivacaine and bupivacaine: a prospective meta-analysis. (2/280)
In this prospective meta-analysis, we have evaluated the effect of epidural analgesia with ropivacaine for pain in labour on neonatal outcome and mode of delivery compared with bupivacaine. In six randomized, double-blind studies, 403 labouring women, primigravidae and multiparae, received epidural analgesia with ropivacaine or bupivacaine 2.5 mg ml-1. The drugs were administered as intermittent boluses in four studies and by continuous infusion in two. Apgar scores, neurological and adaptive capacity scores (NACS), degree of motor block and mode of delivery were recorded. The studies were designed prospectively to fit meta-analysis of the pooled results. Results showed similar pain relief and consumption of the two drugs. In the vaginally delivered neonates, NACS scores were approximately equal for both groups at 2 h, but at 24 h there were fewer infants with NACS less than 35 in the ropivacaine compared with the bupivacaine group (2.8% vs 7.6%; P < 0.05). Spontaneous vaginal deliveries occurred more frequently overall with ropivacaine than with bupivacaine (58% vs 49%; P < 0.05) and instrumental deliveries (forceps and vacuum extraction) less frequently (27% vs 40%; P < 0.01), while the frequency of Caesarean section was similar between groups. The intensity of motor block was lower with ropivacaine. There were no significant differences in adverse events. (+info)Relative analgesic potencies of ropivacaine and bupivacaine for epidural analgesia in labor: implications for therapeutic indexes. (3/280)
BACKGROUND: The minimum local analgesic concentration (MLAC) has been defined as the median effective local analgesic concentration in a 20-ml volume for epidural analgesia in the first stage of labor. The aim of this study was to assess the relative analgesic potencies of epidural bupivacaine and ropivacaine by determining their respective minimum local analgesic concentrations. METHODS: Seventy-three parturients at < or = 7 cm cervical dilation who requested epidural analgesia were allocated to one of two groups in this double-blinded, randomized, prospective study. After a lumbar epidural catheter was placed, 20 ml of the test solution was given, either ropivacaine (n = 34) or bupivacaine (n = 39). The concentration of local anesthetic was determined by the response of the previous patient in that group to a higher or lower concentration using up-down sequential allocation. Analgesic efficacy was assessed using 100-mm visual analog pain scores with < or = 10 mm within 30 min defined as effective. An effective result directed a 0.01% wt/vol decrement for the next patient. An ineffective result directed a 0.01% wt/vol increment. RESULTS: The minimum local analgesic concentration of ropivacaine was 0.111% wt/vol (95% confidence interval, 0.100-0.122), and the minimum local analgesic concentration of bupivacaine was 0.067% wt/vol (95% confidence interval, 0.052-0.082). Ropivacaine was significantly less potent than bupivacaine, with a potency ratio of 0.6 (95% confidence interval, 0.49-0.74). No difference in motor effects was observed. CONCLUSION: Ropivacaine was significantly less potent than bupivacaine for epidural analgesia in the first stage of labor. (+info)Lumbar sympathetic blocks speed early and second stage induced labor in nulliparous women. (4/280)
BACKGROUND: Rapid cervical dilation reportedly accompanies lumbar sympathetic blockade, whereas epidural analgesia is associated with slow labor. The authors compared the effects of initial lumbar sympathetic block with those of epidural analgesia on labor speed and delivery mode in this pilot study. METHODS: At a hospital not practicing active labor management, full-term nulliparous patients whose labors were induced randomly received initial lumbar sympathetic block or epidural analgesia. The latter patients received 10 ml bupivacaine, 0.125%; 50 microg fentanyl; and 100 microg epinephrine epidurally and sham lumbar sympathetic blocks. Patients to have lumbar sympathetic blocks received 10 ml bupivacaine, 0.5%; 25 microg fentanyl; and 50 microg epinephrine bilaterally and epidural catheters. Subsequently, all patients received epidural analgesia. RESULTS: Cervical dilation occurred more quickly (57 vs. 120 min/cm cervical dilation; P = 0.05) during the first 2 h of analgesia in patients having lumbar sympathetic blocks (n = 17) than in patients having epidurals (n = 19). The second stage of labor was briefer in patients having lumbar sympathetic blocks than in those having epidurals (105 vs. 270 min; P < 0.05). Nine patients having lumbar sympathetic block and seven having epidurals delivered spontaneously, whereas seven patients having lumbar sympathetic block and seven having epidurals had instrument-assisted vaginal deliveries. Cesarean delivery for fetal bradycardia occurred in one patient having lumbar sympathetic block. Cesarean delivery for dystocia occurred in five patients having epidurals compared with no patient having lumbar sympathetic block (P = not significant). Visual analog pain scores differed only at 60 min after block. CONCLUSIONS: Nulliparous parturients having induced labor and receiving initial lumbar sympathetic blocks had faster cervical dilation during the first 2 h of analgesia, shorter second-stage labors, and a trend toward a lower dystocia cesarean delivery rate than did patients having epidural analgesia. The effects of lumbar sympathetic block on labor need to be determined in other patient groups. These results may help define the tocodynamic effects of regional labor analgesia. (+info)Epidural pain relief in labour: potencies of levobupivacaine and racemic bupivacaine. (5/280)
We have compared the minimum local analgesic concentrations (MLAC) of levobupivacaine relative to racemic bupivacaine in a prospective, randomized, double-blind, sequential allocation study. Women in labour were given a 20-ml bolus of epidural levobupivacaine or bupivacaine diluted to a concentration determined by up-down sequential allocation. The initial concentration was 0.07% w/v for both drugs. Efficacy was defined using a visual analogue pain score (VAPS) at 10 mm or less within 30 min. The MLAC of levobupivacaine was 0.083% w/v (95% CI 0.065-0.101) and the MLAC of bupivacaine 0.081% w/v (95% CI 0.055-0.108). In molar terms, the MLAC of levobupivacaine was 2.87 mmol litre-1 (95% CI 2.25-3.49) and the MLAC of bupivacaine 2.49 mmol litre-1 (95% CI 1.69-3.32). With regard to the commercial preparations, the potency ratio levobupivacaine: bupivacaine was 0.98 (95% CI 0.67-1.41), and this is unlikely to be of clinical relevance. In molar terms, the ratio was 0.87 (95% CI 0.60-1.25). With regard to toxicity, the evidence should be evaluated in the light of a possible 13% potency difference in molar concentration in favour of racemic bupivacaine. (+info)Epidural analgesia during labor and maternal fever. (6/280)
BACKGROUND: In recent observational studies, epidural analgesia during labor at patient request has been associated with maternal fever. The authors report a secondary analysis of fever in women who were randomized to receive either epidural or patient-controlled intravenous analgesia during labor. METHODS: Maternal tympanic temperature was measured during spontaneous labor in 715 women at term who were randomized to either epidural analgesia with bupivacaine and fentanyl or to patient-controlled intravenous analgesia with meperidine. Intent-to-treat analysis of women with fever (temperature > or = 38.0 degrees C) versus those without was performed using Student t test and Fisher exact test to determine statistical significance (P < 0.05). RESULTS: Epidural analgesia was associated with maternal fever (odds ratio = 4.0; 95% confidence interval = 2.0-7.7), as was nulliparity (odds ratio = 4.1; 95% confidence interval = 1.8-9.1) and labor longer than 12 h (odds ratio = 5.4; 95% confidence interval = 2.9-9.9). These factors were all independent variables for maternal fever when analyzed using logistic regression. CONCLUSIONS: Epidural analgesia is associated with maternal fever. However, nulliparity and dysfunctional labor are also significant cofactors in the fever attributed to epidural analgesia. (+info)Epidural analgesia in an obstetric patient with Klippel-Trenaunay syndrome. (7/280)
We describe the use of epidural analgesia for vaginal delivery of a parturient with Klippel-Trenaunay syndrome in whom the use of repeated magnetic resonance imaging during her obstetric care allowed us to see deep haemangiomata. This also allowed the safe sitting of an epidural catheter at L1-2 to provide analgesia for labour and delivery. Klippel-Trenaunay syndrome and the anaesthetic implications of the congenital vascular abnormalities and potential coagulopathy are discussed. (+info)Shivering and shivering-like tremor during labor with and without epidural analgesia. (8/280)
BACKGROUND: Effective treatment and prevention of hyperthermia and shivering-like tremor during labor is hindered by a poor understanding of their causes. The authors sought to identify the incidence of nonthermoregulatory shivering-like tremor and the factors associated with this activity. METHODS: The authors studied women in spontaneous full-term labor who chose epidural analgesia (n = 21) or opioid sedation (n = 31). Shivering-like tremor and sweating were evaluated by observation. Core temperature was recorded in the external auditory canal using a compensated infrared thermometer. Arteriovenous shunt tone was evaluated with forearm minus fingertip skin temperature gradients; gradients less than 0 were considered evidence of vasodilation. Tremor was considered nonthermoregulatory when core temperature exceeded 37 degrees C and the arms were vasodilated. Pain was evaluated using a visual analog scale. RESULTS: Shivering-like tremor was observed in 18% of 290, 30-min data-acquisition epochs before delivery. The patients were both normothermic and vasodilated during 15% of these epochs. Shivering was observed in 16% of 116 postdelivery epochs and was nonthermoregulatory in 28%. Sweating was observed in 30% of predelivery epochs, and the patients were both hypothermic and vasoconstricted during 12%. The mean core temperature in patients given epidural analgesia was approximately 0.2 degrees C greater than in those given sedation. Hyperthermia was observed during 10 epochs (38.4+/-0.3 degrees C) during epidural analgesia and during 10 epochs (38.4+/-0.3 degrees C) with sedation. The patients were vasoconstricted in more than 50% of these epochs in each group. Multivariate mixed-effects modeling identified high pain scores and vasoconstriction as significant predictors of shivering. There were no predictors for shivering epochs in patients who were simultaneously normothermic and vasodilated. Significant predictors of sweating were time before delivery, high pain scores, hypothermia with vasoconstriction, high thermal comfort, and low mean skin temperature. There were no predictors for sweating epochs in patients who were simultaneously hypothermic and vasoconstricted. CONCLUSIONS: This study confirms the clinical impression that some peripartum shivering-like tremor is nonthermoregulatory. The authors also identified nonthermoregulatory sweating. These data indicate that shivering-like tremor and sweating in the peripartum period is multifactorial. (+info)Romagnoli A, Korman D (1962). "Methoxyflurane in obstetrical anaesthesia and analgesia" (PDF). Canadian Anaesthetists' Society ... Babl F, Barnett P, Palmer G, Oakley E, Davidson A (2007). "A pilot study of inhaled methoxyflurane for procedural analgesia in ... When used for labor analgesia, the Analgizer allows labor to progress normally and with no apparent adverse effect on Apgar ... The Analgizer was widely utilized for analgesia and sedation until the early 1970s, in a manner that foreshadowed the patient- ...
Bullough, J. (1959). "Use of premixed pethidine and antagonists in obstetrical analgesia; with special reference to cases in ... and a very small dose of levallorphan used alongside a full agonist of the MOR can produce greater analgesia than when the ... by opioid analgesics and barbiturates used for induction of surgical anaesthesia whilst maintaining a degree of analgesia (via ... the effects of stronger agents with greater intrinsic activity such as morphine whilst simultaneously producing analgesia. ...
The natural benefits of such labor pains which initially inhibited the practice of obstetrical analgesia, originated from ... Labor analgesia was debated on the grounds of religion and morality, which John Simpson used as his own weapon against ... Swayne, J. G. "Obstetrical Statistics." The British Medical Journal, vol. 2, no. 777, 1875, pp. 635-638., www.jstor.org/stable/ ... In 1921, the first vaginal delivery under spinal analgesia was reported by Kreiss in Germany. George Pitkin is credited with ...
It can also be used as a supplement to balanced anesthesia, for preoperative and postoperative analgesia, and for obstetrical ... Use of the mixed agonist-antagonist nalbuphine in opioid based analgesia. Acute Pain (2004) 6, 29-39 Gutstein H, Akil H. ... analgesia during labor and delivery. Although nalbuphine possesses opioid antagonist activity, there is evidence that in ...
... analgesia, epidural MeSH E03.091.110 --- analgesia, obstetrical MeSH E03.091.120 --- analgesia, patient-controlled MeSH E03.091 ... File "2006 MeSH Trees".) MeSH E03.091.048 --- acupuncture analgesia MeSH E03.091.080 --- ... obstetrical MeSH E03.155.441 --- cryoanesthesia MeSH E03.155.519 --- electroacupuncture MeSH E03.155.675 --- hypnosis, ...
Babl F, Barnett P, Palmer G, Oakley E, Davidson A (2007). "A pilot study of inhaled methoxyflurane for procedural analgesia in ... Crombie JM (1876). "Self-administration of anaesthetics". Transactions of the Obstetrical Society of London. 18: 64-5. ... When used for labor analgesia, the Analgizer allows labor to progress normally and with no apparent adverse effect on Apgar ... The Analgizer was widely utilized for analgesia and sedation until the early 1970s, in a manner that foreshadowed the patient- ...
Speert H (October 1957). "Obstetrical-gynecological eponyms: James Young Simpson and his obstetric forceps". The Journal of ... Keys TE (1973). "Sir James Young Simpson (1811-1870)". Anesthesia and Analgesia. 52 (4): 562. doi:10.1213/00000539-197307000- ...
"Patient controlled opioid analgesia versus conventional opioid analgesia for controlling postoperative pain". Cochrane Database ... Obstetrical, the very young and the very old are all at greater risk of complication so extra precautions may need to be taken ... It may include analgesia (relief from or prevention of pain), paralysis (muscle relaxation), amnesia (loss of memory), or ... Sep 2012). "Inhaled analgesia for pain management in labour". Cochrane Database of Systematic Reviews. 12 (9): CD009351. doi: ...
Bydlowski M, Raoul-Duval A (1978) Un avatar psychique méconnu de la puerperalité: la névrose traumatique post obstétricale. ... A possible complication of epidural analgesia. British Medical Journal 285: 972 only. Brockington I F (2006) Eileithyia's ...
... (June 7, 1909 - August 7, 1974) was an American obstetrical anesthesiologist. She was a leader in the fields of ... Analgesia. 32 (4): 260-267. doi:10.1213/00000539-195301000-00041. PMID 13083014. "The Virginia Apgar Papers: biographical ... anesthesiology and teratology, and introduced obstetrical considerations to the established field of neonatology. To the public ...
... perform obstetrical assessments, and provide pharmacological pain relief for various conditions. Several sites in Canada have ... analgesia, platelet inhibitors, (theses include Nitroglycerin, Glucose, nitrous oxide, acetylsalicylic acid, salbutamol), and ...
December - Robert Gwyn Macfarlane and colleagues publish the first identification of Haemophilia B. American obstetrical ... Current Research in Anesthesia and Analgesia. 32 (4): 260-267. doi:10.1213/00000539-195301000-00041. PMID 13083014. Finster, M ...
This turned out to be such a success that two whole wards were soon dedicated to obstetrical and gynaecological patients, and ... Naguib Mahfouz was a prolific author on a wide variety of subjects ranging from urinary and faecal fistulae, spinal analgesia, ...
Facilities that have obstetrical services and emergency rooms and operating facilities, even if smaller, can be used in areas ... Analgesia. 120 (6): 1337-1351. doi:10.1213/ANE.0000000000000705. PMC 4438860 . https://www.ncbi.nlm.nih.gov/books/NBK11385/ ...
Regional anaesthesia during Caesarean section is different from the analgesia (pain relief) used in labor and vaginal delivery ... Elective caesarean sections may be performed on the basis of an obstetrical or medical indication, or because of a medically ...
Some family practitioners or general practitioners also perform obstetrical surgery. Obstetrical procedures include cesarean ... Epidural analgesia is a generally safe and effective method of relieving pain in labour, but is associated with longer labour, ... Epidural analgesia has no statistically significant impact on the risk of caesarean section, and does not appear to have an ... A 2013 Cochrane review found that with good obstetrical anaesthesia there is no change in harms from allowing eating and ...
... obstetrical, and urological operations (spinal/epidural anesthesia) Bone and joint surgery of the pelvis, hip, and leg (spinal/ ... "Concept for postoperative analgesia after pedicled TRAM flaps: Continuous wound instillation with 0.2% ropivacaine via ...
04.81 Injection of anesthetic into a nerve for analgesia (05) Operations on sympathetic nerves or ganglia (05.2) Sympathectomy ... Pubiotomy to assist delivery Obstetrical symphysiotomy (73.99) Other (74) Cesarean section and removal of fetus (75) Other ...
Wang, Shu-Ming; Kain, Zeev N.; White, Paul (2008). "Acupuncture Analgesia: I. The Scientific Basis". Anesthesia & Analgesia. ... obstetrical conditions, opioid addiction, Parkinson's disease, polycystic ovary syndrome, posttraumatic stress disorder, ... Clinical Considerations". Anesthesia & Analgesia. 106 (2): 611-621. doi:10.1213/ane.0b013e318160644d. ISSN 0003-2999. PMID ... Colquhoun, D; Novella S (2013). "Acupuncture is a theatrical placebo: the end of a myth" (PDF). Anesthesia & Analgesia. 116 (6 ...
Other obstetrical/gynecological causes of similar abdominal pain in women include pelvic inflammatory disease, ovarian torsion ... Anderson, Mark; Collins, Emma (November 2008). "Analgesia for children with acute abdominal pain and diagnostic accuracy". ...
The onset of analgesia is slower with epidural analgesia or anaesthesia than with spinal analgesia or anaesthesia. ... Epidural analgesia during childbirth[edit]. Epidural analgesia provides rapid pain relief in most cases. It is more effective ... Epidural analgesia after surgery[edit]. Epidural analgesia has been demonstrated to have several benefits after surgery, ... Epidural analgesia may be used:. *For analgesia alone, where surgery is not contemplated. An epidural injection or infusion for ...
Obstetrical surgery and other procedures (ICD-9-CM V3 72-75, ICD-10-PCS 1) ... Regional anaesthesia during Caesarean section is different from the analgesia (pain relief) used in labor and vaginal delivery ... Elective caesarean sections may be performed on the basis of an obstetrical or medical indication, or because of a medically ...
Other obstetrical/gynecological causes of similar abdominal pain in women include pelvic inflammatory disease, ovarian torsion ... "Analgesia for children with acute abdominal pain and diagnostic accuracy". Archives of Disease in Childhood. 93 (11): 995-7. ...
Obstetrical and Gynecological Survey (página oficial). *Obstetrics and gynaecology ([3]). *Obstetrics and Gynecology Clinics of ... Anesthesia and Analgesia (página oficial). *Anesthesiology (página oficial). *Annals of Emergency Medicine ...
Obstetrical surgery and other procedures (ICD-9-CM V3 72-75, ICD-10-PCS 1) ... Analgesia. 112 (1): 207-12. doi:10.1213/ANE.0b013e31820034f0. PMID 21081771.. ...
Geburtshilfiche Anasthesie und Analgesie.(Obstetrical Anesthesia and Analgesia.). Anesthesiology 1 1970, Vol.32, 91. doi: ... Geburtshilfiche Anasthesie und Analgesie.(Obstetrical Anesthesia and Analgesia.) You will receive an email whenever this ... L. BECK, BRUNO J. URBAN; Geburtshilfiche Anasthesie und Analgesie.(Obstetrical Anesthesia and Analgesia.). Anesthesiology 1970; ...
Lumbar Sympathetic Nerve Block for Obstetrical Analgesia; Preliminary Report of Over 1,200 Cases. Anesthesiology 1 1958, Vol.19 ... MARY LOU BYRD, EDWARD Y. POSTMA, GLENN M. VAN DOMMELEN; Lumbar Sympathetic Nerve Block for Obstetrical Analgesia; Preliminary ... Lumbar Sympathetic Nerve Block for Obstetrical Analgesia; Preliminary Report of Over 1,200 Cases ... Lumbar Sympathetic Nerve Block for Obstetrical Analgesia; Preliminary Report of Over 1,200 Cases ...
2. 5 For Obstetrical Analgesia. The usual dosage is 50 mg to 100 mg intramuscularly or subcutaneously when pain becomes ... Demerol Injection is indicated for preoperative medication, support of anesthesia, and obstetrical analgesia. ... Have not provided adequate analgesia, or are not expected to provide adequate analgesia ... The principal actions of therapeutic value are analgesia and sedation.. Pharmacodynamics. Effects on the Central Nervous System ...
Use in Postoperative or Obstetrical Analgesia. Duraclon (epidural clonidine) is not recommended for obstetrical, post-partum, ... Epidurally administered clonidine produces dose-dependent analgesia not antagonized by opiate antagonists. The analgesia is ... Successful analgesia, defined as a decrease in either morphine use or Visual Analog Score (VAS) pain, was significantly more ... NOTE: Duraclon® (epidural clonidine) is not recommended for obstetrical, post-partum, or peri-operative pain management. The ...
"Obstetrical Analgesia and Anesthesia." Williams Obstetrics, 25e Cunningham F, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey ... Obstetrical Analgesia and Anesthesia. In: Cunningham F, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, Spong CY. ... We are indebted to Sir James Y. Simpson, the discoverer of chloroform, for the introduction of anaesthesia into obstetrical ... That said, obstetrical anesthesia presents unique challenges. Labor begins without warning, and anesthesia may be required ...
2. 5 For Obstetrical Analgesia 2.6 Dosage Modifications with Concomitant Phenothiazines 2. 7 Instructions for Use of the ... Obstetrical Analgesia:. 50 mg to 100 mg intramuscularly or subcutaneously; may be repeated at 1 to 3 hour intervals. (2.4) ... 2. 5 For Obstetrical Analgesia. The usual dosage is 50 mg to 100 mg intramuscularly or subcutaneously when pain becomes regular ... DEMEROL Injection is indicated for preoperative medication, support of anesthesia, for obstetrical analgesia, and for the ...
Use in Postoperative or Obstetrical Analgesia. Epidural clonidine hydrochloride is not recommended for obstetrical, post-partum ... Epidurally administered clonidine produces dose-dependent analgesia not antagonized by opiate antagonists. The analgesia is ... Successful analgesia, defined as a decrease in either morphine use or Visual Analog Score (VAS) pain, was significantly more ... However, in a rare obstetrical, post-partum or peri-operative patient, potential benefits may outweigh the possible risks. ...
AN EVALUATION OF ACUPUNCTURE ANALGESIA IN OBSTETRICS. WALLIS, LINDSAY; SHNIDER, SOL M.; PALAHNIUK, RICHARD J.; More ... Thought you might appreciate this item(s) I saw at Obstetrical & Gynecological Survey.. ...
Analgesia. Obstetrical. Anesthesia. Epidural. Newborn. Anesthetics, local. Clonidine. Pregnant women. Infant, newborn. ... Labor Analgesia With Ropivacaine and Clonidine (LA). The safety and scientific validity of this study is the responsibility of ... Labor analgesia with ropivacaine added to clonidine: a randomized clinical trial. Sao Paulo Med J. 2008 Mar 6;126(2):102-6. ...
Obstetrical Analgesia and Anaesthesia. Infections in Pregnancy. Recent Advances in Medical and Surgical Management. Normal ... Primary care in women is to give exhaustive care, quality obstetrical care, gynecological care and advancing physical ...
Obstetrical analgesia. Suppository. *Increased intracranial pressure resulting from intracranial lesion; conditions resulting ... Patient-controlled analgesia. Usual concentration, 0.2 mg/mL; demand dose, 0.1-0.2 mg; dose range is 0.05-0.4 mg Lockout ... Controlled-release formulation should only be used when continuous analgesia is required over an extended period of time; not ...
Analgesia, Obstetrical. *Anesthesia, Obstetrical. *Device: Epidural delivery system. *Drug: Entonox. *Drug: Meperidine ...
Romagnoli A, Korman D (1962). "Methoxyflurane in obstetrical anaesthesia and analgesia". Canadian Anaesthetists Society ... A method of sedation analgesia in routine dentistry". Journal of the Dental Association of South Africa. 29 (2): 77-80. PMID ... Lewis LA (1984). "Methoxyflurane analgesia for office surgery: surgical gem". Journal of Dermatologic Surgery and Oncology. 10 ... Babl F, Barnett P, Palmer G, Oakley E, Davidson A (2007). "A pilot study of inhaled methoxyflurane for procedural analgesia in ...
Patient-Controlled Analgesia: Does a Concurrent Opioid Infusion Improve Pain Management After Surgery?. PARKER, ROBERT K.; ... Thought you might appreciate this item(s) I saw at Obstetrical & Gynecological Survey.. ...
The obstetrical anesthesia database will be queried for all forceps deliveries between the dates of January 2004 - January 2005 ... Patients who require a decrease in their basal labor analgesia epidural infusion rate will have an increased incidence of ... The database will be queried for the following; maternal age, parity, gestational age, type of analgesia, changes in epidural ... Home » Topics » Anesthesiology » Research » The Association Between Decreasing Labor Analgesia Epidural Infusion and Forceps ...
Patient attitudes and ethnic preferences towards obstetric analgesia. Other projects have been performed in conjunction with ... Obstetrical Anesthesia*Pain Management*Pediatric Anesthesia*Management of Perioperative Services*Regional Anesthesia. ... Optimization of neuraxial techniques for labor and cesarean analgesia. *Predicting individual labor and cesarean pain and ... Management of maternal cardiac arrest and other obstetrical emergencies. * ...
Experience with spinal analgesia in a British obstetric unit. Br J Anaesth 1979; 51: 531-4.PubMedCrossRefGoogle Scholar ... The quality of PDPH literature in obstetrical anesthesia: results from an obstetrical PDPH bibliographic database. ... Obstetrical epidural anaesthesia in a rural Canadian hospital. Can J Anaesth 1992; 39: 390-3.PubMedGoogle Scholar ... The effect of intrathecal analgesia on the success of external cephalic version. Anesth Analg 2001; 93: 410-3.PubMedCrossRef ...
Embolism, Amniotic Fluid; Cesarean Section; Analgesia, Obstetrical; Pregnancy; Anesthesia, Spinal Academic: 336-718-8278. ...
The Effects of Regional Analgesia on the Progress and Outcome of Labor. Marissa Lazor, M.D. In 1847, the Scottish obstetrician ... Obstetrical practice styles. *Small sample size in Thorps study - only one more c-section in the control group would have ... Debate on Labor Analgesia -Debate on labor analgesia. chan wei-hung md department of anesthesiology ntuh. labor analgesia. ... labor analgesia: an update -Labor analgesia: an update . is there an advantage ofcse over epidural?. dr. fatma al dammas ...
Obstetrical anesthesia requires balancing these considerations; however, the life and well-being of the mother should come ... analgesia. The benefits of the combined technique are more rapid onset of analgesia within 5 minutes, better sacral analgesia, ... Patient-controlled epidural analgesia for labor. (A review of PCEA regimens for labor analgesia.) Anesthesiology. vol. 111. ... Epidural analgesia for labor and delivery. (An evidence-based review of the risks and benefits of epidural analgesia for labor ...
Anesthesia, Obstetric, Anesthesia, Obstetrical, Obstetric Anesthesia, Obstetrical Anesthesia, anesthesia for obstetrics, ... Consider Patient Controlled Analgesia with Fentanyl, alfenta, or remifentanil. III. Preparations: Spinal Anesthesia (3-6 hours ... Ontology: Anesthesia, Obstetrical. (C0002922) Definition (CSP) state characterized by loss of feeling or sensation caused by ... anesthesia obstetrics, obstetrics anesthesia, anesthesia in obstetrics, anesthesia obstetric, obstetric anesthesia, obstetrical ...
Bullough, J. (1959). "Use of premixed pethidine and antagonists in obstetrical analgesia; with special reference to cases in ... and a very small dose of levallorphan used alongside a full agonist of the MOR can produce greater analgesia than when the ... by opioid analgesics and barbiturates used for induction of surgical anaesthesia whilst maintaining a degree of analgesia (via ... the effects of stronger agents with greater intrinsic activity such as morphine whilst simultaneously producing analgesia. ...
What is obstetrical anesthesia? Meaning of obstetrical anesthesia medical term. What does obstetrical anesthesia mean? ... Looking for online definition of obstetrical anesthesia in the Medical Dictionary? obstetrical anesthesia explanation free. ... See: interpleural analgesia. intrathecal anesthesia. Intrathecal analgesia.. intratracheal anesthesia. Anesthesia administered ... We focus on obstetrical care and obstetrical anesthesia.. Anesthesia provider model, hospital resources, and maternal outcomes ...
Analgesia, Obstetrical; Cesarean Section. Interventions: Drug: Morphine; Drug: Hydromorphone. Outcome Measures: Visual analog ... Epidural Analgesia Versus IV Analgesia in Lumbar Spine Fusions Conditions: Lumbar Spine Fusion; Pain; Back Pain. ... True Functional Restoration and Analgesia in Non-Radicular Low Back Pain Condition: Low Back Pain. ... Patient satisfaction with perioperative analgesia; Number of participants with adverse events. ...
Use in Postoperative or Obstetrical Analgesia. Epidural clonidine is not recommended for obstetrical, postpartum, or ... Obstetrical, postpartum, or perioperative pain management: Clonidine hydrochloride injection (epidural clonidine) is not ... Obstetrical, postpartum, or perioperative pain management: Clonidine hydrochloride injection (epidural clonidine) is not ... Successful analgesia, defined as a decrease in either morphine use or Visual Analog Score (VAS) pain, was significantly more ...
Anesthesia and AnalgesiaAnesthesiologyNeuraxialCombined spinal-epidural analgesia for painObstetricsPostsurgical analgesiaSupport of anesthesiaOpioidAvailability of epidural analgesiaSpinalRoutine Epidural AnalgesiaProviding analgesia for laborRegional anesthesiaGynecological SurveyInadequate AnalgesiaPostpartumComplicationsIntravenousInclude epiduralAnestheticParturientCatheterAnaesthesiaIncidenceSedationVaginal deliveryNulliparous womenFetalEXPARELEpiduralsSurgeryPregnancyNeurosurgicalContractionsLumbarLabor and deliBupivacaineDurationPainPatientInterventionsElectiveCitation
- Obstetrical Anesthesia and Analgesia. (asahq.org)
- There have been various studies on the complications of obstetric anesthesia and analgesia. (pubmedcentralcanada.ca)
- Anesthesia and Analgesia Practice Pathway Options for Total Knee Arthroplasty: An Evidence-Based Review by the American and European Societies of Regional Anesthesia and Pain Medicine. (amedeo.com)
- Three months prior to that study's release, researchers from Sunnybrook and Women's College Health Sciences Centre in Toronto reported in the November issue of Anesthesia and Analgesia that patient-controlled epidural analgesia did not result in an increased incidence of obstetrical intervention. (medpagetoday.com)
- The purpose of this review is to summarize the proper guidelines for the management of patients undergoing joint replacement surgery in the context of pharmacologic DVT prophylaxis and neuraxial anesthesia and analgesia. (ispub.com)
- The anesthesiology team provides clinical anesthesia for obstetrical cases, including high-risk deliveries, vaginal deliveries and Cesarean sections (C-sections). (gwhospital.com)
- The Department of Anesthesiology at Newton-Wellesley Hospital provides a full range of anesthetic and pain management services to patients in the operating rooms, Preoperative Evaluation Center, obstetrical suite and other areas of the hospital. (nwh.org)
- Neuraxial analgesia is the preferred method of providing analgesia for labor and vaginal delivery. (renalandurologynews.com)
- The obstetrician can usually tell the anesthesiologist if there are medical issues that might complicate or preclude provision of neuraxial analgesia for labor. (renalandurologynews.com)
- Neuraxial analgesia for labor is always elective, although the discomfort and anxiety of the parturient will give a sense of urgency, especially late in labor. (renalandurologynews.com)
- The ASA Task Force on Guidelines for Obstetrical Anesthesia has suggested that in healthy women, obtaining a routine platelet count does not reduce complications of neuraxial anesthesia. (renalandurologynews.com)
- In addition, neuraxial blockade techniques such as the combined spinal-epidural, continuous spinal anesthetic techniques, or patient-controlled intravenous analgesia for labor are available. (edu.lb)
- Options for post-cesarean analgesia include neuraxial opioids or catheters, patient-controlled intravenous analgesia, and transversus abdominal plain blockade. (edu.lb)
- Subsequently, the American Society of Regional Anesthesia (ASRA) produced guidelines with respect to the safe use of anticoagulants in patients receiving neuraxial anesthesia/analgesia based upon the available case reports and evidence. (ispub.com)
- Thus the use of neuraxial anesthesia and post-operative analgesia combined with early pharmacologic prophylaxis would appear to be the most efficacious approach toward preventing thromboembolic complications. (ispub.com)
- Ramos JA, Shettar SS, James CF . [Neuraxial analgesia in a parturient with the Vacterl association undergoing labor and vaginal delivery]. (mayo.edu)
- Approximately 60 percent of women, or 2.4 million each year, choose epidural or combined spinal-epidural analgesia for pain relief during labor. (slideserve.com)
- Levallorphan was also used in combination with opioid analgesics to reduce their side effects, mainly in obstetrics, and a very small dose of levallorphan used alongside a full agonist of the MOR can produce greater analgesia than when the latter is used by itself. (wikipedia.org)
- Enflurane analgesia in obstetrics. (springer.com)
- Comparison between particular methods of obstetrics analgesia, their analgetic efects and influence on progress of delivery and postpartum adaptation of fetus. (readbyqxmd.com)
- In 2011, a liposomal formulation of bupivacaine, EXPAREL, was approved by the FDA for single-dose infiltration in surgical site to produce postsurgical analgesia. (clinicaltrials.gov)
- TAP infiltration is being increasingly utilized for postsurgical analgesia in abdominal procedures as clinicians aim to maintain pain control while reducing reliance on opioid analgesics. (businesswire.com)
- EXPAREL is indicated for single-dose administration into the surgical site to produce postsurgical analgesia. (businesswire.com)
- In May, Pacira announced the completion of the end-of-review process with the U.S. Food and Drug Administration (FDA) Division of Anesthesia, Analgesia and Addiction Products (DAAAP) of the Center for Drug Evaluation and Research regarding the supplemental New Drug Application (sNDA) for the use of EXPAREL for administration as a nerve block to provide postsurgical analgesia. (thestreet.com)
- A pivotal study in third molar extraction will evaluate the use of EXPAREL administered as an infiltration to provide postsurgical analgesia in oral surgery. (thestreet.com)
- Demerol Injection is indicated for preoperative medication, support of anesthesia, and obstetrical analgesia. (drugs.com)
- Demerol is used to relieve moderate to severe pain, as a preoperative medication, and the support of anesthesia and for obstetrical analgesia. (fsu.edu)
- It acts as an antagonist of the μ-opioid receptor (MOR) and as an agonist of the κ-opioid receptor (KOR), and as a result, blocks the effects of stronger agents with greater intrinsic activity such as morphine whilst simultaneously producing analgesia. (wikipedia.org)
- Levallorphan was formerly widely used in general anesthesia, mainly to reverse the respiratory depression produced by opioid analgesics and barbiturates used for induction of surgical anaesthesia whilst maintaining a degree of analgesia (via KOR agonism). (wikipedia.org)
- These events should be anticipated and managed as part of opioid analgesia therapy. (flashcardmachine.com)
- Opioid tolerance and opioid-induced hyperalgesia as a result of postoperative analgesia are important topics requiring attention. (frontiersin.org)
- Epidurals provided "superior analgesia and less maternal and neonatal sedation compared with patient-controlled intravenous opioid analgesia," the randomized, controlled trial found. (medpagetoday.com)
- The safety of this drug product has only been established in a highly selected group of cancer patients, and only after an adequate trial of opioid analgesia. (drugstip.com)
- Subgroup analyses included policy regarding the presence of companion, availability of epidural analgesia, policy on routine electronic fetal monitoring and variations in provider characteristics. (who.int)
- 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)
- A variety of regional analgesia services are available for women in labor including epidural, spinal, combined spinal epidural and patient-controlled epidural. (gwhospital.com)
- Possible regional anesthesia techniques include epidural analgesia, spinal analgesia (sometimes referred to as the intrathecal or subarachnoid space), or a combination of epidural and spinal analgesia. (medscape.com)
- In obstetric patients, regional analgesia refers to partial or complete loss of pain sensation below the T8 to T10 spinal level. (medscape.com)
- Effect of maternal ambulation on labour with low-dose combined spinal-epidural analgesia. (biomedsearch.com)
- Two hundred and twenty-nine nulliparous women who requested regional analgesia during labour were given a combined spinal-epidural block. (biomedsearch.com)
- The staff serves more than 13,000 patients of all ages each year, and provides many of the hospital's obstetrical patients with analgesia, using the most current epidural and spinal techniques for labor and delivery. (nwh.org)
- Besides a synopsis of a German translation of the current "Practice Guidelines for Obstetric Anaesthesia 2016" , written by the American Society of Anesthesiologists, the authors provide personal information regarding major topics of obstetric anaesthesia including pre-anaesthesia patient evaluation, equipment and staff at the delivery room, use of general anaesthesia, peridural analgesia, spinal anaesthesia, combined spinal-epidural anaesthesia, single shot spinal anaesthesia, and programmed intermittent epidural bolus. (readbyqxmd.com)
- In all cases 'usual care' did not involve continuous intrapartum support, but it could have involved other measures, such as routine epidural analgesia for pain relief in labour. (who.int)
- 1. What specific issues are involved in providing analgesia for labor in an uncomplicated pre-eclamptic patient? (anaesthesiauk.com)
- Bupivacaine is indicated for the production of local or regional anesthesia or analgesia for surgery, dental and oral surgery procedures, diagnostic and therapeutic procedures, and for obstetrical procedures. (asahq.org)
- Thought you might appreciate this item(s) I saw at Obstetrical & Gynecological Survey. (lww.com)
- Obstetrical and Gynecological Survey 13.6 (1958): 820-21. (spinningbabies.com)
- Failed procedures result in the loss of diagnostic information, 4 inability to deliver treatment, or inadequate analgesia. (bmj.com)
- NOTE: Cloniodine hydrochloride injection is not recommended for obstetrical, postpartum, or peri-operative pain management. (nih.gov)
- Clonidine hydrochloride injection (epidural clonidine) is not recommended for obstetrical, postpartum, or perioperative pain management. (wikidoc.org)
- However, in a rare obstetrical, postpartum or perioperative patient, potential benefits may outweigh the possible risks. (wikidoc.org)
- The secondary outcomes included labour events (regional analgesia/anaesthesia, duration of labour, severe labour pain), caesarean birth, instrumental vaginal birth, perineal trauma (episiotomy or laceration requiring suturing), low 5-minute Apgar score and prolonged newborn hospital stay, difficulty mothering, and low self-esteem in the postpartum period. (who.int)
- Logically, with increased use of regional analgesia, there are now reports of complications with these techniques. (mhmedical.com)
- 2 For example, investigators found that the incidence of serious complications of obstetric epidural analgesia did not change over a 17-yr study period. (pubmedcentralcanada.ca)
- Immediate and delayed complications of epidural analgesia in labour and delivery. (biomedsearch.com)
- A prospective controlled, longitudinal study investigated the immediate and delayed complications of epidural analgesia in labour. (biomedsearch.com)
- Epidural analgesia managed by the obstetrician doesn't result in more complications by the method itself, the increase of operative deliveries is found even in clinics where the PDA is carried out by the anesthetist. (afar.info)
- Obstetric analgesia and anesthesia have some specific aspects, which in particular are directly related to pathophysiological alterations during pregnancy and also to the circumstance that two or even more individuals are always affected by complications or therapeutic measures. (readbyqxmd.com)
- A prospective study of 644 patients who received intravenous increments of nalbuphine (196 women) or epidural analgesia (217 women) or pethidin (231 women). (readbyqxmd.com)
- Services include epidural, patient-controlled analgesia for postoperative pain, medication management, therapeutic/diagnostic blocks and implanted devices. (gwhospital.com)
- Despite the potential for renal impairment when used at anesthetic doses, no significant adverse effects have been reported in the literature when it is used at the lower doses (up to 6 milliliters) used for producing analgesia and sedation. (wikipedia.org)
- PARSIPPANY, N.J., Nov. 14, 2017 (GLOBE NEWSWIRE) -- Pacira Pharmaceuticals, Inc. (NASDAQ:PCRX) today announced that the U.S. Food and Drug Administration (FDA) has notified the company that its supplemental New Drug Application (sNDA) for EXPAREL ® (bupivacaine liposome injectable suspension) as a nerve block for regional analgesia will be discussed at a meeting of the Anesthetic and Analgesic Drug Products Advisory Committee (AADPAC). (businessinsider.com)
- It has also been used in obstetrical practice as a low-risk and low-cost anesthetic technique during repair of obstetrical lacerations. (clinicaltrials.gov)
- The editorial provides evidenced-based guidance regarding alternative analgesic and anesthetic management strategies for the obstetrical patient to address both bupivacaine and other drug shortages that may occur. (aana.com)
- While the laboring parturient has a sense of urgency secondary to pain, it is essential to understand that labor analgesia is considered elective. (oncologynurseadvisor.com)
- Obstetrical anesthesia for a parturient with a ventriculoperitoneal shunt and third ventriculostomy. (biomedsearch.com)
- Vet J. Postoperative analgesia with transversus abdominis plane catheter infusions of levobupivacaine after major gynecological and obstetrical surgery. (musicmarkup.info)
- We are indebted to Sir James Y. Simpson, the discoverer of chloroform, for the introduction of anaesthesia into obstetrical practice. (mhmedical.com)
- 1 Epidural catheterisations provide regional anaesthesia and analgesia during childbirth or surgical procedures. (bmj.com)
- Patients who require a decrease in their basal labor analgesia epidural infusion rate will have an increased incidence of forceps delivery. (bioportfolio.com)
- Compared with usual care, the provision of continuous support to women during labour increases the likelihood of spontaneous vaginal birth, reduces the duration of labour and use of analgesia and lowers the incidence of caesarean section and instrumental delivery. (who.int)
- The general therapeutic effects of this drug are analgesia and sedation. (fsu.edu)
- Besides providing analgesia in labor, regional analgesia may facilitate atraumatic vaginal delivery of twins, preterm neonates, and neonates with breech presentation. (medscape.com)
- Earlier this year, in the Feb. 17 issue of The New England Journal of Medicine, Northwestern researchers found Cesarean rates did not significantly differ among 750 nulliparous women who either received epidural analgesia during early labor (less than four centimeters dilation) or during later labor (4 cm dilation or more). (medpagetoday.com)
- Obstetric and neonatal conditions such as acute bleeding or hemorrhage, severe preeclampsia and ongoing fetal compromise warrant further assessment, workup, consultation, and stabilization prior to initiating any method of labor analgesia. (oncologynurseadvisor.com)
- 225 women were recruited (69 in Group-A and 156 in Group-B). We found significant differences between the groups in terms of labour length, Numeric Rating Scale score and analgesia request rate, type of delivery, need of episiotomy, and fetal occiput rotation. (hindawi.com)
- Epidural analgesia was routinely available in 14 trials and electronic fetal monitoring was used routinely in nine of them. (who.int)
- EXPAREL is contraindicated in obstetrical paracervical block anesthesia. (businessinsider.com)
- PARSIPPANY, N.J., July 25, 2017 (GLOBE NEWSWIRE) -- Pacira Pharmaceuticals, Inc. (NASDAQ:PCRX) today announced the completion of two Phase 3 placebo-controlled studies evaluating the efficacy, safety and pharmacokinetics of EXPAREL ® (bupivacaine liposome injectable suspension) as a single-dose nerve block for prolonged regional analgesia. (globenewswire.com)
- Because a single-dose nerve block of EXPAREL offers prolonged regional analgesia, it has the potential to replace cumbersome devices like pumps and catheters. (globenewswire.com)
- One hundred and twenty-two parturients were studied: 81 had epidurals in labour and 41 had other forms of analgesia. (biomedsearch.com)
- A study comparing pudendal block with placebo after transvaginal reconstructive surgery did not produce any differences in post-operative pain intensity or the consumption of narcotic analgesia. (clinicaltrials.gov)
- Peridural analgesia may prevent pain, but some physicians prefer to administrate this until labor has progressed in order to avoid blocking labor so a cesarean surgery would be required. (readbyqxmd.com)
- Disorders of pregnancy such as preeclampsia, placental abruption, or sepsis further compound provision of obstetrical anesthesia. (mhmedical.com)
- These tests evaluate inhibitory and excitatory mechanisms of pain processing and are here utilized to evaluate endogenous analgesia at different time-points during pregnancy and the peripartum period to help reveal individual s risk for persistent pain. (jove.com)
- It is important to determine the main indications and limitations for their application in various groups of surgical patients (neurosurgical, pediatric, obstetrical patients, etc. (frontiersin.org)
- The team provides a wide range of anesthesia services from basic inpatient and outpatient services to the subspecialties of cardiac, obstetrical, ambulatory and neurosurgical anesthesia. (gwhospital.com)
- Unless the cessation of contractions is indicated for obstetrical reasons, patients who present in labor will be delivered, and their care must be optimized using information already obtained or readily gathered. (clinicaladvisor.com)
- Nalbuphine hydrochloride can also be used as a supplement to balanced anesthesia, for preoperative and postoperative analgesia, and for obstetrical analgesia during labor and delivery. (rxlist.com)
- Multiple modalities exist for nonpharmacologic analgesia for labor and delivery. (oncologynurseadvisor.com)
- As previously mentioned, analgesia for labor and delivery is elective. (oncologynurseadvisor.com)
- Obstetric Epidural Analgesia (OEA) is presently considered to be one of the most effective and commonly utilized techniques for providing pain relief during labor and delivery. (clinmedjournals.org)
- Healthcare facilities across North America are experiencing a shortage of several bupivacaine formulations affecting analgesia and anesthesia care, particularly for obstetric services. (aana.com)
- Demographic data, obstetrical interventions, duration from rupture of membrane to delivery, and durations of labor stages were recorded. (soap.org)
- NOTE: Duraclon ® (epidural clonidine) is not recommended for obstetrical, post-partum, or peri-operative pain management. (drugs.com)
- Labor analgesia is elective, although ethically and in the interest of good customer service, parturients expect their request for pain medication to be responded to in an expeditious way. (renalandurologynews.com)
- In the early 20th century, women used laughing gas to ease the pain of labor, but its use declined in favor of more potent analgesia. (wyso.org)
- Approximately 60% of laboring women (2.4 million each year) choose regional analgesia for pain relief during labor. (medscape.com)
- The American College of Obstetricians and Gynecologists and the American Society of Anesthesiologists stand by the safety of epidural analgesia and say they support epidural pain relief "on demand. (medpagetoday.com)
- In this case, the mother suffers pain until labor has progressed enough to apply analgesia. (readbyqxmd.com)
- However, in a rare obstetrical, post-partum or peri-operative patient, potential benefits may outweigh the possible risks. (drugs.com)
- It was utilized in self-administration devices for obstetric analgesia, in a manner that foreshadowed the patient-controlled analgesia infusion pumps of today. (wikipedia.org)
- Regional analgesia is also contraindicated in cases of patient refusal or inadequate practitioner training and experience. (medscape.com)
- This high rate of operative interventions is not unexpected due to the indication that led to epidural analgesia. (afar.info)
- Analgesia for labor is always elective and the provider should not proceed if further evaluation is deemed necessary. (renalandurologynews.com)
- Labor analgesia is elective. (oncologynurseadvisor.com)
- Citations on PDPH in the obstetrical population were identified by computerized searches, citation review, and hand searches of abstracts and conference proceedings. (springer.com)