Implementation of a standardized epidural top-up algorithm for inadequate labor epidural analgesia: a single-center retrospective study.

Background: We hypothesized that implementation of a labor epidural management algorithm would increase the labor epidural catheter replacement rate at our hospital.

Methods: Our institutional review board approved this study and waived the requirement for informed consent. Patients who had labor epidural analgesia and delivered vaginally or had replacement of an epidural catheter prior to vaginal delivery from August 1, 2022 to December 31, 2022 and from August 1, 2023 to December 31, 2023 were included in the study.

Effect of programmed intermittent epidural bolus protocol on physician-administered rescue boluses of labor analgesia.

Background: Prior studies have shown that programmed intermittent epidural bolus (PIEB) techniques, with or without patient-controlled epidural analgesia (PCEA) boluses, provide better pain relief, reduced motor block, and better patient satisfaction compared to continuous epidural infusion (CEI) techniques. We hypothesized that patients who had labor epidural analgesia (LEA) maintained with PIEB and PCEA would be less likely to receive a physician-administered rescue analgesia bolus compared to patients who had CEI and PCEA.

Methods: We searched our electronic medical record for patients who had CEI and PCEA from August 1, 2021 to December 31, 2021 and for patients who had PIEB and PCEA from August 2, 2022 to December 31, 2022.

Alcohol-associated antecedent stimuli elicit alcohol seeking in non-dependent rats and may activate the insula.

Alcohol self-administration produces brain and behavior adaptations that facilitate a progressive loss of control over drinking and contribute to relapse. One possible adaptation is the ability of antecedent environmental stimuli that are consistently paired with alcohol to trigger alcohol-seeking behaviors. We previously modeled this adaptation in rats using a Pavlovian conditioning procedure in which illumination of a houselight preceded the presentation of a sipper tube that produced unsweetened alcohol when licked.