Continuous epidural analgesia is considered to be the gold standard of pain relief in labour. The objective of this study was to examine the connections between epidural analgesia and the frequency of instrument-assisted deliveries. We retrospectively analysed data encompassing epidural analgesia applications during 2012 and the connections with an increased frequency of instrumental deliveries. Out of 3157 births in 2012, epidural analgesia was used in 443 (14.03 %). Epidural analgesia significantly increased the number of instrumental deliveries with vacuum extraction (χ = 35.01; df = 1; p < 0.01) and the number of emergency caesarean sections (χ = 18.01; df = 1; p < 0.01). A significantly higher percentage of dystocia leading to emergency caesarean sections was noted in deliveries with epidural analgesia (χ = 6.15; df = 1; p < 0.05). An increase in instrumental delivery incidence seems to be an acceptable risk in view of epidural analgesia-related positive effects that future mothers should be informed of.
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http://dx.doi.org/10.1007/s10354-016-0511-9 | DOI Listing |
J Clin Med
December 2024
Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland.
: Esophagectomy is a key component of esophageal cancer treatment, with minimally invasive esophagectomy (MIE) increasingly replacing open esophagectomy (OE). Effective postoperative pain management can be achieved through various analgesic modalities. This study compares the efficacy of thoracic epidural anesthesia (TEA) with non-TEA methods in managing postoperative pain following MIE.
View Article and Find Full Text PDFHealthcare (Basel)
December 2024
Department of Translational Medicine, Università del Piemonte Orientale, Gynecology and Obstetrics, "Maggiore della Carità" Hospital, 28100 Novara, Italy.
Background: Obstetric lesions of the anal sphincter (OASIS) are tears intersecting the structure of the anus after vaginal delivery. Our aim is to provide data on the incidence of OASIS and investigate potentially connected risk factors.
Methods: This is a retrospective analysis of 464 parturient patients admitted to the AOU Maggiore della Carità, Novara (Italy), in the last ten years (2013-2023), comparing 116 cases (with OASIS) versus 348 controls (with no OASIS).
Best Pract Res Clin Anaesthesiol
September 2024
Yale Medicine/Yale New Haven Health System, USA. Electronic address:
Despite advances in procedural techniques and equipment, postdural puncture headache (PDPH) remains a serious complication of labour epidural analgesia after accidental dural puncture (ADP). Often considered a temporary inconvenience, PDPH can be debilitating in the short term. It can also be associated with chronic manifestations and serious complications.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
September 2024
Department of Anesthesiology, University Hospital Basel, Basel, Switzerland.
The issue of obesity continues to reach new levels globally, affecting individuals across the age continuum. Obesity in pregnancy is associated with myriad comorbidities which may negatively impact the fetus, particularly dysfunctional labor and failure to progress ending in unplanned cesarean delivery. Neuraxial anesthesia represents the gold standard for cesarean delivery anesthesia and is increasingly beneficial for obese patients due to the risk of difficult airway.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
September 2024
Department of Anaesthesia, Ulster Hospital, Belfast, Northern Ireland.
Epidural analgesia is considered the gold standard for labour pain but may not be an option for all parturients due to patient choice or medical contraindication. Non-neuraxial alternatives for labour analgesia have been extensively studied and include both pharmacological and non-pharmacological options. Pharmacological options include the use of opioids and inhalational agents while non-pharmacological options range from non-invasive methods such as continuous labour support to techniques such as sterile water injection.
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