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Third Stage Of Labor
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Alyssa R. Hersh, Jorge E. Tolosa
An epidural is commonly used during labor for pain control. Spinal, epidural, paracervical block, nitrous oxide, or general anesthesia may be used if complications arise in the management of retained placenta, intractable PPH, uterine inversion, or assisted vaginal deliveries (see Chap. 12).
Critical Care and Anaesthesia
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Rajkumar Rajendram, Alex Joseph, John Davidson, Avinash Gobindram, Prit Anand Singh, Animesh JK Patel
What are the benefits of an epidural?Better analgesia − decreased oral opioid requirementsReduced respiratory problems postopBetter GIT function (due to SNS blockade)Reduced DVT/PE risk − better blood flow and vasodilatation and a reduction in thrombogenic factorsDecreased surgical stress response
Anesthesia and analgesia and the curse of Eve
Published in Michael J. O’Dowd, The History of Medications for Women, 2020
The headache which followed inadvertent dural puncture was a disagreeable and disabling event which occurred in at least 0.5% of epidural patients. A partial solution was offered by Rice and Dobbs (1950 p. 17) who first described epidural injection of saline to combat the problem. The technique was enhanced by Gormley (1960 p. 565) who injected autologous non-anticoagulated blood by epidural injection to seal the rent in the dura and thus stop leakage of cerebrospinal fluid which led to the low tension dural tap headache. Improvements in epidural needles and catheters also helped.
The Use of Hypnosis during the Perinatal Period: A Systematic Review
Published in International Journal of Clinical and Experimental Hypnosis, 2023
Émilie Dumont, David Ogez, Sabine Nahas, Ghassan El-Baalbaki
Current scientific literature highlights symptoms of anxiety and depression experienced by many women during pregnancy (Dunkel Schetter, 2011; Schetter & Tanner, 2012). There is also growing evidence that these psychological symptoms contribute to the pain experienced during the delivery process (Dencker et al., 2019; Dick-Read, 2013; Semple & Newburn, 2011). On the other hand, the use of analgesics and epidural anesthesia to manage pain during childbirth can lead to adverse effects (e.g., lower Apgar index, higher NICU admission, delayed breastfeeding, Herrera-Gómez et al., 2015; Komatsu et al., 2018), which raises concern regarding the potential short-term and long-term impact on the mother and her newborn’s health. According to the World Health Organization (2018), epidural analgesia and other forms of medicalization of the birthing process can also deprive the mother of a positive birth experience, affect her ability to give birth, and adversely impact her postnatal life. As a result, the biomedical model advocated in industrialized societies can compromise women’s natural ability to give birth and lead to a loss of a sense of control.
Effect of encouraging a combined spinal epidural technique for cesarean delivery anesthesia
Published in Baylor University Medical Center Proceedings, 2022
Alexa Borja, Jessica Ehrig, Kristen Vanderhoef, Kendall Hammonds, Michael P. Hofkamp
The Baylor Scott & White Research Institute institutional research board waived informed consent for this study. We searched our electronic medical record (Epic, Verona, Wisconsin) for subjects who had cesarean deliveries from May 15, 2019, through April 15, 2021, which corresponded to when we encouraged a combined spinal anesthetic technique for cesarean delivery. Subjects who received a spinal anesthetic without subsequent placement of a labor epidural were defined as having single-shot spinal anesthesia. Subjects who received a spinal anesthetic followed by placement of an epidural catheter were defined as having combined spinal epidural anesthesia. We excluded subjects for receiving neuraxial labor analgesia, puncture of the dura by a Touhy epidural needle, hysterectomy at the time of cesarean delivery, conversion to general anesthesia for reasons other than failure of the neuraxial anesthetic, and use of a lower dose of intrathecal hyperbaric bupivacaine due to maternal comorbidities. A study investigator entered data from the electronic medical record into Research Electronic Data Capture (REDCap) housed at the Baylor Scott & White Research Institute. At our institution, regional anesthesia for cesarean deliveries is performed exclusively by anesthesiology residents and attending anesthesiologists. Data were analyzed using SAS version 9.4 (SAS, Cary, NC).
Combination of Epidural Blockade and Parecoxib in Enhanced Recovery After Gastrointestinal Surgery
Published in Journal of Investigative Surgery, 2021
Xuerong Zhang, Jun Zhu, Bingqian Ye, Ayibuta Yashengaili, Lei Xu, Xuebin Li
The epidural blockade is a kind of anesthesia method to block patients’ pain during the surgery. Its application has been reported in many researches. Ding et al. showed in a meta-analysis that in thoracotomy, the epidural blockade could reduce the pain condition, the rates of pulmonary complications and the incidence of urinary retention [23]. Shi et al. demonstrated the epidural blockade could decrease chronic hypoxia-induced pulmonary hypertension and vascular remodeling in rats [24]. In a recent trial, Hashemi et al. reported epidural anesthesia with parasagittal interlaminar approach was better than midline interlaminar method, with deeper motor block, higher sensory level block, and hemodynamic stability in fracture surgery [25]. It was also found the epidural blockade was effective in emergency cesarean section [26]. In the present study, we found epidural blockade could also enhance the patients’ recovery, reduce the pain condition and enhance the recovery of postoperative sedation and cognitive function.