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Postdural puncture headache: Beyond the evidence.
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 PDFMorbid obesity: Optimizing neuraxial analgesia and cesarean delivery outcomes.
Best 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 PDFNon-neuraxial labour analgesia.
Best 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.
View Article and Find Full Text PDFInitiation and maintenance of neuraxial labour analgesia: A narrative review.
Best Pract Res Clin Anaesthesiol
September 2024
Department of Anaesthesiology, GZA Hospitals, Antwerp, Belgium.
Labour analgesia is a crucial aspect of obstetric anaesthesia, aiming to alleviate pain during childbirth while ensuring maternal and foetal safety. Over the past decade, advancements in labour analgesia techniques have evolved, impacting initiation, maintenance, and outcomes. We emphasize the longstanding importance of epidural analgesia while recognizing the growing significance of combined spinal-epidural and dural puncture epidural techniques for labour initiation.
View Article and Find Full Text PDFAvailability of, Barriers to Performing, and Educational Practices of Interventional Procedures for Refractory Pain in Cancer Patients: A Nationwide Survey of Designated Cancer Hospitals in Japan.
Palliat Med Rep
December 2024
Department of Palliative Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Background: Because of the limitations of pharmacological therapy, nonpharmacological therapies including intervention procedures are also important for quality of cancer pain management.
Objective: To clarify the availability of, number performed, barriers to performing, and educational practices of four interventional procedures (celiac plexus neurolysis/splanchnic nerve neurolysis, phenol saddle block, epidural analgesia, and intrathecal analgesia) in designated cancer hospitals.
Design: Cross-sectional survey.
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