54 results match your criteria Labor and Delivery Analgesia Regional and Local


Epidural versus non-epidural or no analgesia for pain management in labour.

Cochrane Database Syst Rev 2018 05 21;5:CD000331. Epub 2018 May 21.

Tameside Hospital NHS Foundation Trust, Fountain Street, Ashton-under-Lyne, UK, OL6 9RW.

Background: Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain, and is widely used as a form of pain relief in labour. However, there are concerns about unintended adverse effects on the mother and infant. This is an update of an existing Cochrane Review (Epidural versus non-epidural or no analgesia in labour), last published in 2011. Read More

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http://dx.doi.org/10.1002/14651858.CD000331.pub4DOI Listing
May 2018
25 Reads

The effect of addition of dexamethasone to levobupivacaine in parturients receiving combined spinal-epidural for analgesia for vaginal delivery.

Indian J Anaesth 2017 Jul;61(7):556-561

Department of Obstetrics and Gynaecology, Faculty of Medicine, Cairo University, Cairo, Egypt.

Background And Aims: Regional analgesia is commonly used for the relief of labour pain, Prolongation of analgesia can be achieved by adjuvant medications. The aim of this randomised controlled trial was to evaluate the efficacy of intrathecal levobupivacaine with dexamethasone for labour analgesia.

Methods: A total of 80 females were included in this study, all were primigravidas undergoing vaginal delivery with cervical dilatation ≥4 cm and 50% or more effacement. Read More

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http://www.ijaweb.org/text.asp?2017/61/7/556/210456
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http://dx.doi.org/10.4103/ija.IJA_149_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5530740PMC
July 2017
13 Reads

The Optimal Pain Management Approach for a Laboring Patient: A Review of Current Literature.

Cureus 2017 May 10;9(5):e1240. Epub 2017 May 10.

Anesthesiology, Riverside University Health System Medical Center, Moreno Valley, California, United States.

There is a general agreement that a patient in labor should be given the option to have an epidural block for pain management. Despite this consensus, there are differences in practice patterns as to when to initiate an epidural and how to minimize its impact on the duration and outcome of a patient's labor. A review of the literature suggests epidural analgesia does prolong stages one and two of labor, but not significantly. Read More

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http://dx.doi.org/10.7759/cureus.1240DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467776PMC
May 2017
7 Reads

Continuous spinal labor analgesia for two deliveries in a parturient with severe subvalvular aortic stenosis.

J Anesth 2016 12 22;30(6):1067-1070. Epub 2016 Aug 22.

Division of Obstetric Anesthesia, Center for Perinatal Care, Child Health and Development, Kitasato University Hospital, 1-15-1 Kitasato Minami-ku, Sagamihara City, Kanagawa, 252-0375, Japan.

Various degrees of left ventricular outflow tract (LVOT) obstruction have been seen in patients with subvalvular aortic stenosis (SAS). Regional analgesia during labor for parturients with SAS is relatively contraindicated because it has a potential risk for hemodynamic instability due to sympathetic blockade as a result of vasodilation by local anesthetics. We thought continuous spinal analgesia (CSA) using an opioid and minimal doses of local anesthetic could provide more stable hemodynamic status. Read More

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http://dx.doi.org/10.1007/s00540-016-2238-6DOI Listing
December 2016
15 Reads

Ultrasound-guided epidural anesthesia for a parturient with severe malformations of the skeletal system undergoing cesarean delivery: a case report.

Local Reg Anesth 2015 6;8:7-10. Epub 2015 May 6.

Department of Anesthesiology, West China Second Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

Anesthetic management of patients with preexisting diseases is challenging and individualized approaches need to be determined based on patients' complications. We report here a case of ultrasound-guided epidural anesthesia in combination with low-dose ketamine during cesarean delivery on a parturient with severe malformations of the skeletal system and airway problems. The ultrasound-guided epidural anesthesia was performed in the L1-L2 space, followed by an intravenous administration of ketamine (0. Read More

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http://dx.doi.org/10.2147/LRA.S81696DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4427064PMC
May 2015
14 Reads

Randomized trial of anaesthetic interventions in external cephalic version for breech presentation.

Br J Anaesth 2015 Jun 10;114(6):944-50. Epub 2015 May 10.

Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China.

Background: Successful external cephalic version (ECV) for breech presenting fetus reduces the need for Caesarean section (CS). We aimed to compare the success rate of ECV with either spinal anaesthesia (SA) or i.v. Read More

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http://bja.oxfordjournals.org/content/early/2015/05/10/bja.a
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http://bja.oxfordjournals.org/lookup/doi/10.1093/bja/aev107
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http://dx.doi.org/10.1093/bja/aev107DOI Listing
June 2015
7 Reads

Anesthesia for cesarean delivery in the Czech Republic: a 2011 national survey.

Anesth Analg 2015 Jun;120(6):1303-8

From the *Medical Faculty of Masaryk University and University Hospital Brno, Brno, Czech Republic; Expert Committee of Labor Anesthesia and Analgesia of the Czech Society of Anesthesiology and Intensive Care Medicine, Prague, Czech Republic; †1st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic; Expert Committee of Labor Anesthesia and Analgesia of the Czech Society of Anesthesiology and Intensive Care Medicine, Prague, Czech Republic; ‡2nd Faculty of Medicine, Charles University and Motol University Hospital in Prague, Prague, Czech Republic; Expert Committee of Labor Anesthesia and Analgesia of the Czech Society of Anesthesiology and Intensive Care Medicine, Prague, Czech Republic; §University Hospital Brno, Brno, Czech Republic; Expert Committee of Labor Anesthesia and Analgesia of the Czech Society of Anesthesiology and Intensive Care Medicine, Prague, Czech Republic; and ‖Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic.

Background: The purpose of this national survey was to determine current anesthesia practices for cesarean delivery in the Czech Republic.

Methods: In November 2011, we invited all departments of obstetric anesthesia in the Czech Republic to participate in a prospective study to monitor consecutive peripartum obstetric anesthesia procedures. Data were recorded online in the TrialDB database (Yale University, New Haven, CT). Read More

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http://dx.doi.org/10.1213/ANE.0000000000000572DOI Listing
June 2015
5 Reads

Intrapartum epidural analgesia and onset of lactation: a prospective study in an Italian birth centre.

Matern Child Health J 2015 Mar;19(3):511-8

Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via Manfredo Fanti, 6, 20122, Milan, MI, Italy,

The objective of this study is to investigate the relationship between epidural analgesia (EDA) in labor and the onset of lactation in healthy women after birth. In a Regional Perinatal Center in northern Italy, women who had had a vaginal delivery were recruited by convenience sampling. Analyses were carried out on the data of 366 women. Read More

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http://dx.doi.org/10.1007/s10995-014-1532-xDOI Listing
March 2015
7 Reads

[Anesthetic management of parturients with peripartum cardiomyopathy].

Masui 2014 Jan;63(1):31-8

Department of Obstetric Anesthesia, National Center for Child Health and Development, Tokyo 157-8535.

Peripartum cardiomyopathy (PPCM) is a rare life-threatening cardiomyopathy of unknown cause that occurs in the peripartum period in previously healthy women, and is becoming the leading cause of maternal death in U.S.A and U. Read More

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January 2014
2 Reads

The effect of neuraxial anesthesia on maternal cerebral hemodynamics.

Am J Perinatol 2014 Oct 11;31(9):787-93. Epub 2013 Dec 11.

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas.

Objective: Neuraxial anesthesia is known to reduce sympathetic tone and mean arterial pressure. Effects on cerebral hemodynamics in pregnancy are not well known. We hypothesize that cerebral hemodynamic parameters will change with respect to baseline following regional analgesia/anesthesia. Read More

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http://dx.doi.org/10.1055/s-0033-1359715DOI Listing
October 2014
2 Reads

Analgesia in Obstetrics.

Authors:
M Heesen M Veeser

Geburtshilfe Frauenheilkd 2012 Jul;72(7):596-601

Anesthesiology, Sozialstiftung Bamberg, Bamberg.

An effective relief of labour pain has become an important part of obstetric medicine. Therefore regional nerve blocks, systemic analgesic and non-pharmacologic techniques are commonly used. This review article gives a summary of pathophysiology and anatomy of labour pain as well as advantages, disadvantages, risks and adverse reactions of analgesic techniques in newborns and parturients. Read More

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http://dx.doi.org/10.1055/s-0031-1298444DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4168364PMC
July 2012
5 Reads

Labor analgesia.

Am Fam Physician 2012 Mar;85(5):447-54

University of Tennessee Health Science Center, Saint Francis Family Medicine Residency, Memphis, TN 38119, USA.

Regional analgesia has become the most common method of pain relief used during labor in the United States. Epidural and spinal analgesia are two types of regional analgesia. With epidural analgesia, an indwelling catheter is directed into the epidural space, and the patient receives a continuous infusion or multiple injections of local anesthetic. Read More

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March 2012
4 Reads

Epidural technique for postoperative pain: gold standard no more?

Authors:
Narinder Rawal

Reg Anesth Pain Med 2012 May-Jun;37(3):310-7

From the Department of Anaesthesiology and Intensive Care, University Hospital, Örebro, Sweden.

Epidural analgesia is a well-established technique that has commonly been regarded as the gold standard in postoperative pain management. However, newer, evidence-based outcome data show that the benefits of epidural analgesia are not as significant as previously believed. There are some benefits in a decrease in the incidence of cardiovascular and pulmonary complications, but these benefits are probably limited to high-risk patients undergoing major abdominal or thoracic surgery who receive thoracic epidural analgesia with local anaesthetic drugs only. Read More

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http://dx.doi.org/10.1097/AAP.0b013e31825735c6DOI Listing
August 2012
16 Reads

Epidural versus non-epidural or no analgesia in labour.

Cochrane Database Syst Rev 2011 Dec 7(12):CD000331. Epub 2011 Dec 7.

Tameside Hospital NHS Foundation Trust, Fountain Street, Ashton-under-Lyne, UK, OL6 9RW.

Background: Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain and is widely used as a form of pain relief in labour. However, there are concerns regarding unintended adverse effects on the mother and infant.

Objectives: To assess the effects of all modalities of epidural analgesia (including combined-spinal-epidural) on the mother and the baby, when compared with non-epidural or no pain relief during labour. Read More

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http://dx.doi.org/10.1002/14651858.CD000331.pub3DOI Listing
December 2011
20 Reads

Maternal ambulation during labor.

Curr Opin Anaesthesiol 2011 Jun;24(3):268-73

University College London Hospital, London, UK.

Purpose Of Review: To describe the recent advances in labor epidural analgesia, which may have an impact on maternal ambulation during labor.

Recent Findings: With the advent of new epidural adjuvant drugs and new epidural delivery systems, we are now able to use very low concentration local anesthetic solutions with a reduction in the total doses of local anesthetic administered. This allows a much greater preservation of lower limb motor function in the parturient, with a subsequent positive effect on maternal ambulation. Read More

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http://dx.doi.org/10.1097/ACO.0b013e328345d8d0DOI Listing
June 2011
2 Reads

Anesthetic management of spinal muscle atrophy type II in a parturient.

Local Reg Anesth 2011 6;4:15-20. Epub 2011 Apr 6.

Department of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, WA, USA.

We report the peripartum management of a 30-year-old wheelchair-bound nullipara woman with spinal muscular atrophy (SMA) type II, including severe restrictive lung disease and Harrington rods. At 38 weeks gestation, she was admitted for an induction of labor with neuraxial analgesia, but she subsequently had to be delivered via cesarean section under general anesthesia. We describe the anesthetic implications of SMA on labor and delivery management and review the available literature. Read More

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http://dx.doi.org/10.2147/LRA.S17089DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3417967PMC
October 2012
2 Reads

Advances in labor analgesia.

Authors:
Cynthia A Wong

Int J Womens Health 2010 Aug 9;1:139-54. Epub 2010 Aug 9.

Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

The pain of childbirth is arguably the most severe pain most women will endure in their lifetimes. The pain of the early first stage of labor arises from dilation of the lower uterine segment and cervix. Pain from the late first stage and second stage of labor arises from descent of the fetus in the birth canal, resulting in distension and tearing of tissues in the vagina and perineum. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971706PMC
August 2010
6 Reads

[Quality indicator survey of anaesthesia records in hospitals of Aquitaine].

Ann Fr Anesth Reanim 2008 Mar 14;27(3):216-21. Epub 2008 Feb 14.

CCECQA, hôpital Xavier-Arnozan, 33604 Pessac cedex, France.

Objectives: Assessing the quality of anaesthesia records according to the criteria of the reference frame of professional practices evaluation proposed by the French Anaesthetists College (Cfar) in 2005.

Study Design: Retrospective, multicentric study.

Materials And Methods: Fifty anaesthesia records were randomly selected from each of the 64 health care settings in Aquitaine with an inpatient surgery activity. Read More

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http://dx.doi.org/10.1016/j.annfar.2007.12.008DOI Listing
March 2008
3 Reads

[Anaesthesia, a cause of fetal distress?].

Ann Fr Anesth Reanim 2007 Jul-Aug;26(7-8):694-8. Epub 2007 Jun 14.

Département d'anesthésie-réanimation, hôpital Antoine-Béclère, APHP, Clamart cedex, France.

Objective: To describe the effects of anaesthetic techniques and agents on the risk of fetal distress during labour pain relief and anaesthesia for caesarean section.

Study Design: Data on obstetric anaesthesia- and analgesia-induced fetal distress were searched in Medline database using MESH terms: fetal distress, anaesthesia, analgesia, labour, caesarean section, and umbilical artery pH. Trials published in English or French language were selected. Read More

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http://linkinghub.elsevier.com/retrieve/pii/S075076580700195
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http://dx.doi.org/10.1016/j.annfar.2007.05.004DOI Listing
October 2007
3 Reads

Case report: Successful labour epidural analgesia in a patient with spinocerebellar ataxia.

Can J Anaesth 2007 Jun;54(6):467-70

Department of Anesthesia and Pain Management, Mount Sinai Hospital, 600 University Avenue, Room 781, Toronto, Ontario M5G 1X5, Canada.

Purpose: To report the favourable outcome associated with epidural analgesia in a parturient with spinocerebellar ataxia (SCA).

Clinical Features: A 34-yr-old patient, G2 P0, presented at term with a history of SCA since the age of 22 characterized by slurred speech, balance and gait disturbances, diplopia and nystagmus. A magnetic resonance imaging of the brain at the age of 27 showed cerebellar degeneration. Read More

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http://link.springer.com/10.1007/BF03022033
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http://dx.doi.org/10.1007/BF03022033DOI Listing
June 2007
3 Reads

[Combined spinal-epidural anaesthesia for pain relief in obstetric patients].

Authors:
Thomas Standl

Anasthesiol Intensivmed Notfallmed Schmerzther 2007 May;42(5):342-9

Klinik für Anästhesie und operative Intensivmedizin, Städtischen Klinikums Solingen, Akademisches Lehrkrankenhaus, Universität Köln, Germany.

Besides epidural analgesia combined spinal-epidural anaesthesia (CSE) is one of the favourite techniques of regional anaesthesia for pain relief in obstetric patients. CSE combines the advantage of spinal anaesthesia, e.g. Read More

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http://dx.doi.org/10.1055/s-2007-981689DOI Listing
May 2007
5 Reads

Efficacy of patient-controlled epidural analgesia after initiation with epidural or combined spinal-epidural analgesia.

Int J Obstet Anesth 2007 Jul 16;16(3):226-30. Epub 2007 May 16.

Department of Anesthesiology and Reanimation, Gazi University Faculty of Medicine, Besveler, Ankara, Turkey.

Background: The aim of the present study was to compare the efficacy of patient-controlled epidural analgesia after initiation with either epidural or combined spinal-epidural analgesia.

Methods: Forty ASA I parturients at 37-42 weeks' gestation and cervical dilatation <6 cm were randomly allocated to receive either epidural analgesia (group EA) or combined spinal-epidural analgesia (group CSEA). Analgesia was initiated with a 7-mL epidural bolus 0. Read More

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http://linkinghub.elsevier.com/retrieve/pii/S0959289X0700046
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http://dx.doi.org/10.1016/j.ijoa.2007.02.007DOI Listing
July 2007
3 Reads

Cesarean section in a patient with familial cardiomyopathy and a cardioverter-defibrillator.

Can J Anaesth 2006 May;53(5):478-81

Department of General Anesthesiology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, E-31, Cleveland, Ohio 44195, USA.

Purpose: To describe the impact of maternal automatic implantable cardioverter-defibrillator (AICD) therapy on pregnancy outcome, and discuss the clinical rationale for regional anesthesia in parturients with AICDs.

Clinical Features: A 20-yr-old primigravida with a history of familial cardiomyopathy and AICD placement presented at 39 weeks gestational age for elective labour induction. Ultimately, the patient underwent a Cesarean section for a failed induction. Read More

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http://link.springer.com/10.1007/BF03022620
Publisher Site
http://dx.doi.org/10.1007/BF03022620DOI Listing
May 2006
4 Reads

Obstetric regional blocks for women with multiple sclerosis: a survey of UK experience.

Int J Obstet Anesth 2006 Apr 20;15(2):115-23. Epub 2006 Feb 20.

Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, UK.

Background: There has been a reluctance to use regional blocks for women with multiple sclerosis as effects on the course of the disease are unclear. We assessed the views of UK consultant obstetric anaesthetists regarding management of women with multiple sclerosis.

Methods: Following Obstetric Anaesthetists' Association approval a questionnaire was sent to UK consultant members. Read More

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http://dx.doi.org/10.1016/j.ijoa.2005.10.010DOI Listing
April 2006
1 Read

Similar onset time of 2-chloroprocaine and lidocaine + epinephrine for epidural anesthesia for elective Cesarean section.

Acta Anaesthesiol Scand 2006 Mar;50(3):358-63

Department of Anesthesiology and Intensive Care, Haukeland University Hospital, Bergen, Norway.

Background: The use of regional anesthesia for elective Cesarean section has been demonstrated to be safe for both the mother and new-born. In parturients with an epidural catheter placed previously for labor analgesia, extension of the epidural block may be the preferred option, provided that adequate speed of onset and adequate surgical anesthesia are obtained. We therefore performed a prospective, randomized, double-blind trial to examine the speed of onset and anesthetic quality of 2-chloroprocaine vs. Read More

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http://dx.doi.org/10.1111/j.1399-6576.2006.00937.xDOI Listing
March 2006
2 Reads

The effects of continuous epidural analgesia on Doppler velocimetry of uterine arteries during different periods of labour analgesia.

Br J Anaesth 2006 Feb 23;96(2):226-30. Epub 2005 Dec 23.

Department of Anesthesiology, National Taiwan University Hospital, College of Medicine, Taipei, Taiwan.

Background: The transient effects of epidural bupivacaine 0.25-0.5% on the Doppler velocimetry of umbilical and uterine arteries had been reported, but the effects of continuous lower dose epidural bupivacaine (0. Read More

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http://dx.doi.org/10.1093/bja/aei311DOI Listing
February 2006
2 Reads

Epidural versus non-epidural or no analgesia in labour.

Cochrane Database Syst Rev 2005 Oct 19(4):CD000331. Epub 2005 Oct 19.

Liverpool Women's Hospital NHS Trust, Division of Perinatal and Reproductive Medicine, Crown Street, Liverpool, UK L8 7SS.

Background: Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain and is widely used as a form of pain relief in labour. However, there are concerns regarding unintended adverse effects on the mother and infant.

Objectives: To assess the effects of all modalities of epidural analgesia (including combined -spinal-epidural) on the mother and the baby, when compared with non-epidural or no pain relief during labour. Read More

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http://dx.doi.org/10.1002/14651858.CD000331.pub2DOI Listing
October 2005
17 Reads

A primigravida allegedly allergic to local anaesthetics.

Authors:
S Brown J R Jenkins

Int J Obstet Anesth 2003 Apr;12(2):113-5

Department of Anaesthesia, James Paget Hospital, Great Yarmouth, Norfolk, UK.

Pregnant patients may give a history of allergy to local anaesthetics, but many of these supposed allergies have not been investigated. There is cross-reactivity between the amide local anaesthetics, which are the only group available in the UK for regional analgesia. We report the management of a primigravida who gave a history of allergy to two local anaesthetics, lidocaine and prilocaine. Read More

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http://dx.doi.org/10.1016/S0959-289X(02)00188-7DOI Listing
April 2003
1 Read

[Myasthenia gravis, pregnancy and delivery: a series of ten cases].

Ann Fr Anesth Reanim 2004 May;23(5):459-64

Département d'anesthésie-réanimation, assistance publique-hôpitaux de Paris, hôpital Antoine- Béclère, 157, rue de la Porte-de-Trivaux, BP 405, 92141 Clamart cedex, France.

Objective: To study the reciprocal interferences between pregnancy and myasthenia gravis (MG) and to describe obstetric and anaesthetic management during labour and the post-partum period.

Study Design: Retrospective, single centre study.

Methods: The files of 10 patients with MG, who delivered between October 1994 and May 2002, were examined. Read More

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http://dx.doi.org/10.1016/j.annfar.2004.01.014DOI Listing
May 2004
21 Reads

[Anesthesia and analgesia in obstetrics].

Ther Umsch 2002 Dec;59(12):667-76

Klinik für Anaesthesiologie, Technischen Universität München, Klinikum rechts der Isar, München.

Anesthesia in obstetrics includes the medical attendance of women in the delivery room as well as giving anesthesia for cesarean sections in the operating room. Over the last years the treatment of labor pain with epidural anesthesia has been modified. Whereas a couple of years ago local anesthetics were used almost exclusively, the recent trend goes toward a combination of local anesthetics with opioids. Read More

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http://dx.doi.org/10.1024/0040-5930.59.12.667DOI Listing
December 2002
2 Reads

[Analgesia during labour: from taboo to evidence-based medicine].

Authors:
M C Schneider

Anaesthesist 2002 Dec;51(12):959-72

Anästhesie, Universitätsfrauenklinik Basel, Switzerland.

Peripartum care of parturients has contributed a great deal to the development of modern anaesthesia during the past 150 years. The introduction of general and regional anaesthesia provided new options of relieving pain during delivery and preventing suffering. However,provision of effective labor analgesia gave and still gives rise to controversy as to whether interfering with natural events such as delivery was justifiable on a religious,moral or ideological level. Read More

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http://dx.doi.org/10.1007/s00101-002-0414-6DOI Listing
December 2002
2 Reads

[Amniotic fluid embolism: successful evolution course after uterine arteries embolization].

Ann Fr Anesth Reanim 2002 May;21(5):431-5

Département de réanimation et de soins intensifs cardiologiques, centre hospitalier Saint-Joseph et Saint-Luc, 9, rue du Pr Grignard, 69365 Lyon, France.

A 28-year-old woman, G3P3, who was otherwise healthy and had taken no medication and had no known allergy, was admitted to our hospital for delivery after a normal pregnancy. An epidural catheter was inserted for analgesia and labour was induced with oxytocin. Two hours later, she suffered a sudden cardiac arrest. Read More

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May 2002
3 Reads

Continuous spinal analgesia for labor and delivery in a parturient with hypertrophic obstructive cardiomyopathy.

Acta Anaesthesiol Scand 2002 Mar;46(3):329-31

Department of Anesthesiology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.

Induction of labor under analgesia was planned for a 30-year-old-primiparous patient with hypertrophic obstructive cardiomyopathy (HOCM), as her fetal evaluation revealed intrauterine growth restriction at 38 weeks' gestation. However, regional analgesia during labor may present a potential risk for hemodynamic instability in patients with HOCM due to the possibility of a sympathetic block, as a result of vasodilation associated with the administration of local anesthesia. This case report demonstrates the successful management of the patient with analgesia provided by a continuous spinal catheter dosed with a continuous infusion of fentanyl and supplemental meperidine. Read More

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March 2002
2 Reads

Anaesthetic management of emergency caesarean section in a patient with Noonan's syndrome--case report and literature review.

Authors:
M M Magboul

Middle East J Anaesthesiol 2000 Oct;15(6):611-7

Department of Anaesthesia, King Saud University, P.O. Box 7805, Riyadh 11472, Kingdom of Saudi Arabia.

Patients with Noonan's syndrome present a multiplicity of challenges to the anaesthetist, particularly with regard to cardiovascular, spinal, and airway abnormalities. Anaesthetist may have to deal with an increasing number of these patients presenting to anaesthesia departments requesting analgesia and anaesthesia for surgery of labour. Early detection and planing between obstetricians, midwives and anaesthetists will help successful management of these patients. Read More

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October 2000
1 Read

[Pain relief for vaginal delivery--an overview].

Authors:
G Fiedler

Anasthesiol Intensivmed Notfallmed Schmerzther 2001 Jan;36(1):49-53

Frauenklinik, Hegau-Klinikum Singen.

The multimodal aspects of labour pain, it's origin and effects, as well as the possibilities of it's treatment will be described from the obstetrician's point of view. This will include a comparison of methods in current common use during delivery including psychosomatic methods, physical methods, acupuncture, homeopathy, use of water, drug therapy as well as the use of local and regional anaesthesia. For particular discussion is the use of epidural catheter in delivery, with respect to availability, optimal timing and obtaining informed consent and it's documentation, as well as teamwork and clear interdisciplinary decisions concerning frequency and parameters of monitoring for epidural catheter anaesthesia following the motto: "how much is necessary, how little is possible?" Read More

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http://dx.doi.org/10.1055/s-2001-10239-6DOI Listing
January 2001
2 Reads

The combined spinal-epidural technique.

Anesthesiol Clin North America 2000 Jun;18(2):267-95

Department of Anesthesiology and Intensive Care, Orebro Medical Center Hospital, Sweden.

Epidural and spinal blocks are well-accepted regional techniques, but they have several disadvantages. The CSE technique can reduce or eliminate the risks of these disadvantages. CSE block combines the rapidity, density, and reliability of the subarachnoid block with the flexibility of continuous epidural block to extend duration of analgesia. Read More

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June 2000
2 Reads

[Anesthesia and delivery].

Rev Prat 1999 Jan;49(2):167-71

Département d'anesthésie réanimation, Groupe hospitalier La Pitié-La Salpêtrière, Paris.

Close collaboration of an informed anaesthetist with the obstetrician, and respect of the security protocols in every anaesthesia must guarantee the well-being of pregnant women. The development of loco-regional anaesthesia for use in labour analgesia and caesarean section has reduced the indications and the mortality related to general anaesthesia. In the last 30 years, analgesia and control of loco-regional anaesthesia effects have been greatly improved. Read More

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January 1999
6 Reads

[Current practices in obstetrical analgesia in German university clinics. Results of a 1996 survey. Part 2].

Authors:
H Wulf U Stamer

Anaesthesist 1998 Sep;47(9):757-64

Klinik für Anästhesiologie und Operative Intensivmedizin, Christian-Albrechts-Universität zu Kiel.

Unlabelled: Obviously there is a world-wide trend towards regional analgesia for pain relief during delivery. Data on the current practice in Germany are lacking.

Methods: In 1996 questionnaires on obstetric anaesthesia and analgesia were mailed to all university departments of anaesthesia. Read More

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http://dx.doi.org/10.1007/s001010050623DOI Listing
September 1998

[Obstetric analgesia in Norwegian hospitals].

Tidsskr Nor Laegeforen 1998 Apr;118(11):1693-6

Anestesiavdelingen Ullevål sykehus, Oslo.

We report the results of a questionnaire sent to anaesthetists and midwives on the use of obstetric analgesia and anaesthesia in Norwegian hospitals in 1996. 95% of the 49 hospitals involved responded to the questionnaire, representing a total of 56,884 births. The use of epidural analgesia in labour varied from 0 to 25% in the different hospitals with a mean value of 15%. Read More

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April 1998
4 Reads

Dorsal column function after epidural and spinal blockade: implications for the safety of walking following low-dose regional analgesia for labour.

Anaesthesia 1998 Apr;53(4):382-7

Department of Anaesthesia, Royal Free Hospital, London, UK.

Walking after regional blockade for labour using low-dose combinations of bupivacaine and fentanyl is possible due to the maintenance of lower limb motor power. In order to investigate concerns that dorsal column function, important in maintaining balance, is impaired after such techniques, clinical assessment of lower limb proprioception and vibration sense was evaluated in parturients after either low-dose epidural (n = 30) or spinal blockade (n = 30) for labour analgesia and compared with spinal anaesthesia (n = 30) for elective Caesarean section using a larger total dose of local anaesthetic. Of the patients receiving low-dose regional labour analgesia 7% (n = 4) had abnormal dorsal column function compared with 97% (n = 29) receiving spinal anaesthesia for Caesarean section (p < 0. Read More

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April 1998
6 Reads

Safe epidural analgesia in thirty parturients with platelet counts between 69,000 and 98,000 mm(-3).

Anesth Analg 1997 Aug;85(2):385-8

Department of Anesthesiology, Mount Sinai School of Medicine, New York, New York, USA.

Regional anesthesia is a popular form of pain relief for the management of labor and delivery. Thrombocytopenia is considered a relative contraindication to the administration of regional anesthesia. Some authorities have recommended that an epidural anesthetic be withheld if the platelet count is <100,000 mm(-3). Read More

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August 1997
1 Read

Neonatal welfare and placental transfer of fentanyl and bupivacaine during ambulatory combined spinal epidural analgesia for labour.

Anaesthesia 1997 Jun;52(6):517-24

Department of Anaesthesia, Queen Charlotte's Hospital, London, UK.

To investigate current concerns that potent opioid drugs, such as fentanyl, used for labour regional analgesia may affect neonatal status, maternal and umbilical plasma concentrations of fentanyl and bupivacaine at delivery were measured in 40 nulliparous patients receiving low-dose combined spinal epidural analgesia. Neonatal assessments included Apgar scores, umbilical blood gases and neurobehavioural tests. All maternal and umbilical venous plasma concentrations were low. Read More

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June 1997
3 Reads

Pharmacologic alternatives to classic regional anesthesia in obstetrics.

Acta Anaesthesiol Scand Suppl 1997 ;111:167-71

University of Vienna Medical School, Department of Anesthesiology, Austria, Europe.

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February 1998
4 Reads

Anaesthetic management of labour and delivery in the parturient with mitochondrial myopathy.

Can J Anaesth 1996 Apr;43(4):403-7

Department of Anaesthesia, Ottawa Civic Hospital, Ontario, Canada.

Purpose: We describe the anaesthetic management for Caesarean section in a parturient with a defect in complex III of the respiratory chain who had increased lactate concentrations at rest and with exercise.

Clinical Features: We administered effective epidural anaesthesia with lidocaine for Caesarean delivery. The serum lactate concentration was less than the preoperative value both during and after surgery. Read More

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http://dx.doi.org/10.1007/BF03011722DOI Listing
April 1996
1 Read

[Maternal-fetal cardiovascular effect of spinal anesthesia].

Authors:
D Edouard

Cah Anesthesiol 1994 ;42(2):235-40

Service d'Anesthésiologie, Université de Paris-Sud, Hôpital Antoine-Béclère, Clamart, France.

Despite of a chronic volume overload the left ventricle function of pregnant women is preserved by both afterload reduction (arterial vasodilatation) and a facilitation of heart filling through an increase in peripheral venous tone. Fetal oxygenation results from an equilibrium between placental and umbilical blood flows. During regional anaesthesia the sympathetic blockade leads to a peripheral vasodilatation (mainly in the capacitive territories) which is the cause of arterial hypotension through a decrease in cardiac output. Read More

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October 1994
13 Reads

Epidural anaesthesia for caesarean section in a patient with a cerebral artery aneurysm.

Int J Obstet Anesth 1993 ;2(1):49-52

Department of Anaesthesiology, University Hospital, S-581 85 Linköping, Sweden.

A case is described of a 30-year-old insulin-dependent diabetic woman who presented at 25 weeks gestation with frontal headache. Contrast tomography revealed an aneurysm of the middle cerebral artery with no evidence of subarachnoid bleeding. Although elective caesarean section at term was planned, it was performed at gestational week 38 due to the onset of vaginal bleeding and premature labour. Read More

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January 2006
3 Reads

[The use of opioids by the regional route in obstetrics].

Cah Anesthesiol 1991 ;39(2):97-103

Département d'Anesthésie-Réanimation, Centre Hospitalier Universitaire, Nîmes.

Epidural and spinal administration of opioids in obstetrics can be used during labour and for cesarean section. Although these routes of administration are of limited use when opiates are employed as sole agents, the association with local anesthetics may improve the characteristics of analgesia. The administration of a local anesthetic-opiate mixture allows a reduction of the total amount of local anesthetics, thus reducing the incidence of maternal hypotension and the percentage of instrumental extraction. Read More

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September 1991
3 Reads

[Maternal and neonatal plasma concentrations of bupivacaine during peridural anesthesia for cesarean section].

Reg Anaesth 1990 Aug;13(6):133-7

Abteilung Anaesthesiologie und Operative Intensivmedizin, Justus-Liebig-Universität Giessen.

Many anesthesiologists prefer epidural anesthesia for cesarean section because of the potential risks of general anesthesia such as Mendelson's syndrome. For this indication, the local anesthetic of first choice is the long-acting substance bupivacaine. The aim of the following study was to determine maternal and neonatal plasma concentrations of bupivacaine 0. Read More

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August 1990
3 Reads

Regional anaesthesia and uterine blood flow.

Ann Chir Gynaecol 1984 ;73(3):149-52

Sufficient placental blood flow is mandatory for the well-being of the fetus. The delicate balance between uterine perfusion pressure and uterine vascular resistance can be critically disturbed during epidural anaesthesia. Maternal hypotension is common when extensive block for Caesarean Section is used. Read More

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December 1984
2 Reads

Obstetric anesthesia, why?

Authors:
B B Gutsche

Clin Perinatol 1982 Feb;9(1):215-24

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February 1982
1 Read