Remifentanil target-controlled infusion during second stage labour in high-risk parturients: a case series.

Background: Providing adequate analgesia and appropriate sedation to high-risk parturients during late second stage labour without compromising foetal safety remains a major challenge, especially in situations when neuraxial block is not applicable. Remifentanil emerged as an option for labour analgesia during the last decade but may be suitable for the facilitation of complicated vaginal deliveries as well.

Methods: A retrospective chart review of nine labouring women with significant medical and/or obstetrical risk factors was conducted.

Alternatives to neuraxial analgesia for labor.

Purpose Of Review: Although millions of parturients profit from neuraxial analgesia for labor, there are far more of those who do not have this choice for one reason or another. They need alternative ways to relieve labor pain.

Recent Findings: Paracervical block gives less efficient analgesia compared with single-shot spinal in a sample of multiparae at active labor but is associated with better umbilical artery pH.

Timing of intravenous patient-controlled remifentanil bolus during early labour.

Background: Remifentanil labour analgesia is superior to nitrous oxide but less potent than epidural analgesia. The short onset and offset times of effect suggest that the timing of the bolus in the contraction cycle could have importance. We hypothesised that administering a remifentanil bolus during contraction pause would improve analgesia in early labour.

Intravenous remifentanil vs. epidural levobupivacaine with fentanyl for pain relief in early labour: a randomised, controlled, double-blinded study.

Background: We hypothesised that intravenous patient-controlled analgesia (IV PCA) with remifentanil could provide as satisfactory pain relief for labour as epidural analgesia.

Methods: Fifty-two parturients with singleton uncomplicated pregnancies were randomised to receive either IV PCA with remifentanil or epidural analgesia with 20 ml levobupivacaine 0.625 mg/ml and fentanyl 2 microg/ml in saline.

Comparison of remifentanil and nitrous oxide in labour analgesia.

Background: We compared the efficacy and side-effects of remifentanil with those of nitrous oxide during the first stage of labour.

Methods: Twenty parturients participated in a randomized, double-blind, cross-over study. Intravenous remifentanil in 0.

Influence of the injection site (L2/3 or L3/4) and the posture of the vertebral column on selective spinal anesthesia for ambulatory knee arthroscopy.

Background: We tested the hypothesis that selective spinal anesthesia for ambulatory knee arthroscopy can be accomplished with a small dose of bupivacaine at the L3/4 interspace with or without a head-down tilt of 5 degrees when the patients were in the lateral decubitus position.

Methods: In this double-blind study, 123 patients were randomly allocated to receive spinal anesthesia with 4 mg of hyperbaric bupivacaine inserted at either the L2/3 interspace, while the vertebral column was kept horizontal (L2/3 group), or the L3/4 level, with the vertebral column horizontal (L3/4H) or tilted 5 degrees head-down (L3/4T). At 7 min, an additional head down tilt was used in all groups if the sensory block was inadequate.

Breast-feeding problems after epidural analgesia for labour: a retrospective cohort study of pain, obstetrical procedures and breast-feeding practices.

Various clinical practices have been found to be associated with breast-feeding problems. However, little is known about the effect of pain, obstetrical procedures and analgesia on breast-feeding behaviour. We designed a retrospective study with a questionnaire concerning pain, obstetrical procedures and breast-feeding practices mailed to 164 primiparae in Lapland.

Remifentanil in obstetric analgesia: a dose-finding study.

Unlabelled: IV patient-controlled analgesia (PCA) with remifentanil is a new approach in systemic opioid analgesia during labor. We determined the minimum effective dose of IV remifentanil by increasing the PCA bolus from 0.2 microg/kg with 0.

Food and nutrition policy development.

It has been estimated that over 700 million people still do not have enough food to eat on a daily basis and that more than 2 billion are subsisting on diets that lack the essential vitamins and minerals required for normal growth and development and to prevent premature death and disabilites such as blindness and mental retardation. At the same time, millions more suffer from chronic diseases caused by excessive and unbalanced diets. At the International Conference on Nutrition (ICN), held in Rome in 1992 and sponsored by the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) of the United Nations system, 159 nations endorsed a World Declaration that included recognition of the need for national plans of action for nutrition/national food and nutrition policies.

The baby-friendly hospital initiative.

A new global 'baby-friendly hospital initiative' has been launched by UNICEF and WHO. Its central elements are hospital practices that are known to protect, promote and support breast-feeding. The health benefits of breast-feeding have been shown to be more extensive than previously believed.

Clinical nutrition in East Asia and the Pacific.

Identifying the nutrition problems of Asia and the Pacific is made difficult by the enormous geographic, socioeconomic and cultural diversity that exists in these areas. With increasing longevity and reduced infant mortality, the more chronic diseases are becoming increasingly important. For almost 90% of the countries that keep such data in the Western Pacific Region of WHO, at least three of the five leading causes of death are noncommunicable diseases.