Anesthesia for Obstetrics

Birnbach, David J.; Browne, I.

doi:10.1016/b978-0-443-06959-8.00069-8

Cited by 64 publications

(91 citation statements)

References 254 publications

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“…However, EA is temporarily able to cause a greater pain score decrement, which was not found for the rPCA group [the maximum pain score decrement from the baseline during the analgesia administration was 5.25 (3)(4)(5)(6) in the EA group and only 3.75 (1-5) in the rPCA group]. Pain may increase with the progression of labour as a result of sensitization 11 .…”

Section: Discussionmentioning

confidence: 89%

“…While there are a large number of relative contraindications, there are a few absolute contraindications to neuroaxial analgesia. These include patient refusal, overt maternal coagulopathy, infection at the needle site, and maternal hemodynamic instability 5 . Therefore, there is a need find an effective alternative to epidural analgesia, which would have an easier and lower-risk administration procedure, fast effect onset and minimal side effects on the parturient and foetus.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of parturient - controlled remifentanil with epidural bupivacain and sufentanil for labour analgesia: Randomised controlled trial

Štourač¹,

Suchomelová²,

Stodůlková³

et al. 2014

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Introduction. Epidural analgesia (EA) has significant contraindications including coagulation disorders and parturient refusal. One alternative is intravenous self-administered analgesia using the ultra short-acting opioid remifentanil (rPCA). We compared the efficiency and safety of standard epidural analgesia with parturient-controlled intravenous analgesia using remifentanil as well as personal satisfaction. Materials and Methods. We enrolled twelve ASA I classified women with singleton pregnancy who delivered vaginally in the period 3/2010-5/2010 and who received rPCA (n=12) in standard analgesic protocol: 20 μg boluses using PCA pump with a lockout interval of 3 min. The control group consisted of 12 pregnant women who received EA (n=12): 0.125% bupivacaine with sufentanil 0.5 μg/mL in top-up boluses every hour until delivery. Data were acquired from standard Acute Pain Service (APS) form and patient medical records (demographic, labour course parameters), Visual Analogue Scale (VAS), Bromage Scale (BS) and adverse effects of analgesia.Results. There were no demographic or labour course parameter differences between groups (P>0.05). The differences in VAS decrease (P=0.056) and parturient satisfaction (P=0.24) during the whole analgesia administration were statistically insignificant. The main limitation of the study was small sample and enrolment of healthy singleton pregnant women only. Conclusion. Remifentanil use in obstetric analgesia is a viable alternative to EA, especially in cases of EA contraindications and parturient disapproval.

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Comparison of parturient - controlled remifentanil with epidural bupivacain and sufentanil for labour analgesia: Randomised controlled trial

Štourač¹,

Suchomelová²,

Stodůlková³

et al. 2014

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…In the breech presentation, an external version can be performed to alter the presentation of the fetus. If an external version does not work, then elective cesarean delivery may be performed [5]. Complications can occur in cesarean section such as infection (surgical wound, uterus, puerperium), wound hematoma or disruption, laceration of urinary vesica, ureteral trauma, extension of hospitalization, anesthesia complication, hysterectomy, hypovolemic shock, heart failure, venous thromboembolism and death [6].…”

Section: Discussionmentioning

confidence: 99%

Acupuncture as adjuvant general anesthesia on cesarean section

Kurniawan¹,

Tarawan²,

Djuantono³

et al. 2018

J Anesthesiol Clin Sci

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Acupuncture has been widely used to induce analgesia. Acupuncture can be used as pain therapy, allergy, inflammation, metabolic disorder, poststroke and adjuvant anesthesia. This case report aims to describe the benefits of acupuncture as an adjuvant of general anesthesia in cesarean section. A 20 years woman G1P0A0 parturien aterm with fetal breech position presented to undergo cesarean section in general anesthesia with an adjuvant acupuncture at Dr. Dustira Hospital Cimahi Indonesia in June 20th, 2017. Patient was treated electroacupuncture by inserting needles at the points of incision, Hegu (LI-4), Neikuan (P-6), Sanyinjiao (SP-6) and Zusanli (S-36) bilaterally 10 mA at a frequency of 40 Hz began 30 minutes before induction of anesthesia until surgery was completed. Induction of anesthesia was initiated by injection of fentanyl 50 µg and propofol 50 mg until negative eyelids reflex followed by ventilation support with isofluran, N2O:O2, atracurium 25 mg and then performed intubation. Maintenance of anesthesia used isofluran to achieve adequate anesthesia level with BIS monitor on 40-60 scale, N2O:O2 = 2 L/min: 2 L/min. During operation the hemodynamic condition was stable with an average of end tidal isofluran 0.5 vol%. The baby was born with APGAR score of 5-8-10. After surgery the acupuncture needle at the left Hegu point is maintained for 24 hours. Patient was not given either analgesic or antiemetic postoperatively. The patient was admitted to the recovery room for 30 minutes without any complaint of bleeding, pain, nausea or vomiting, then moved to the nursing ward. In this case, acupuncture as adjuvant general anesthesia decreased the dose of anesthetic drugs and did not interfere with the fetus. Acupuncture was also useful to prevent postoperative pain and nausea vomiting.

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“…ezaryen ameliyatlarında rejyonal teknikler, gerek annede gerekse yenidoğanda sağladıkları avantajlar nedeniyle popüler olmakla birlikte, koagülopati, rejyonal anestezinin uygulanacağı bölgede enfeksiyon, hipovolemi, ağır fötal distres ve hastanın rejyonal anesteziyi kabul etmemesi durumlarında genel anestezi uygulamaları önemli yer tutmaktadır (1).…”

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Comparison of the Effects of Thiopental Sodium and Propofol on Haemodynamics, Awareness and Newborns During Caesarean Section Under General Anaesthesia

Cakirtekin¹,

Yıldırım²,

Bakan³

et al. 2015

Turk J Anesth Reanim

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Objective:To compare the effects of propofol and thiopental on haemodynamics, awareness and newborns in pregnant women undergoing elective caesarean section.Methods: Seventy pregnant women were assigned into two equal groups. For anaesthesia induction, 2 mg kg -1 propofol (Group P) and 5 mg kg -1 thiopental (Group T) were administered. Maternal haemodynamic parameters and bispectral index (BIS) values were recorded before induction, in 1-minute intervals within the first 10 minutes after induction and in 5-minute intervals thereafter, during skin incision, uterine incision, removal of infant, uterine sutures, skin sutures, eye opening and extubation in all cases. Cord blood gas analysis and 1-and 5-minute APGAR scores were recorded. In all cases, a keyword was spelled to ear during removal of the infant, and at the first postoperative hour, patients were questioned. Important time periods of surgery and anaesthesia and also the first postoperative hour haemodynamic values, pain scores, nausea and vomiting were noted. Results:The demographic data were similar among cases. In Group T, systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and mean arterial pressure (MAP) at the first 2 minutes after induction and heart rate (HR) at almost all time points were significantly higher. BIS values from induction to the eighth minute and skin incision, uterine incision and removal of the infant were lower in Group P. No patient remembered the keyword spelled, while 4 patients reported dreaming during general anaesthesia. The effects of propofol and thiopental sodium on 1-and 5-minute APGAR scores, cord blood gas values and postoperative visual analogue scale (VAS) scores were similar. Conclusion:Propofol is a more appropriate anaesthetic agent than thiopental in anaesthesia for caesareans, since it provides better anaesthestic depth and more rapid recovery.Keywords: Caesarean section, propofol, thiopental sodium, bispectral index, intraoperative awareness Amaç: Elektif sezaryen ameliyatlarında; propofol ve tiyopentalin hemodinami, intraoperatif farkındalık ve yenidoğan üzerine etkilerinin karşılaştırılması amaçlandı.Yöntemler: Yetmiş gebe iki eşit gruba ayrılarak; indüksiyonda 2 mg kg -1 propofol (Grup P) ve 5 mg kg -1 tiyopental (Grup T) uygulandı. Tüm olguların indüksiyon öncesi, indüksiyon sonrası ilk 10 dakika (dk) birer dakika aralıklarla, sonrasında beşer dakika aralarla ve cilt insizyonu, uterus insizyonu, bebek çıkımı, uterus dikişi, cilt dikişi, göz açma ve ekstübasyon sırasındaki hemodinamik parametreler ve bispektral indeks (BİS) değerleri kaydedildi. Yenidoğan 1 ve 5. dak APGAR skorları ve kordon kan gazı değer-leri kaydedildi. Tüm olguların kulaklarına bebek çıkımı sırasında anahtar bir kelime söylenerek, postoperatif birinci saatte sorgulandı. Cerrahi ve anesteziye ait önemli süreler ile postoperatif birinci saat hemodinamik değerler, ağrı düzeyleri ve bulantı-kusma sıklığı kaydedildi. Bulgular:Olguların demografik verileri benzerdi. Grup T'de, indüksiyondan sonraki 1 ve 2. dakikalarda sistolik...

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Anesthesia for Obstetrics

Cited by 64 publications

References 254 publications

Comparison of parturient - controlled remifentanil with epidural bupivacain and sufentanil for labour analgesia: Randomised controlled trial

Comparison of parturient - controlled remifentanil with epidural bupivacain and sufentanil for labour analgesia: Randomised controlled trial

Acupuncture as adjuvant general anesthesia on cesarean section

Comparison of the Effects of Thiopental Sodium and Propofol on Haemodynamics, Awareness and Newborns During Caesarean Section Under General Anaesthesia

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