Cardiotocographic variations certainly attributable to epidural anaesthesia were studied over the period 1972-1980 on 716 patients in labour. Transitory side-effects due to both direct and indirect action of local anaesthetics appeared in 1.4% of the cases, without, however, subsequently creating any particular foeto-newborn problem. On the basis of the experience acquired, it seems justifiable to affirm that the correct use of continuous epidural block, affected by very small doses of bupivacaine (10-20 mg per administration) is almost risk-free. The only inconvenience therefore that may sometimes arise would only be due to the relevation of a concealed cava occlusion when the maintenance of a left lateral position is not observed.
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Eur J Anaesthesiol
January 2025
From the Department of Anaesthesiology, Wilhelmina Children's Hospital (OFCvdB, SR, LvB, WB), Pain Clinic, Department of Anaesthesiology (MR), Department of Obstetrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, the Netherlands (TPS) and Department of Anaesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA (PS).
Background: Optimising a mother's quality of recovery following caesarean delivery is of paramount importance as it facilitates maternal care of the newborn and affects physical, psychological and emotional well being. Intrathecal morphine (ITM) reduces postoperative pain and may improve quality of recovery: however its widespread use is limited.
Objective: To assess the effects of implementing ITM for caesarean delivery on postoperative quality of recovery.
J Anesth Analg Crit Care
January 2025
Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", via Sergio Pansini 5, Naples, 80100, Italy.
Labor analgesia is increasingly widespread throughout the world with a rate ranging from 10 to 60%. The benefits regarding clinical and non-clinical maternal-fetal outcomes are currently discussed in international scientific literature. Even stage of labor needs a different and appropriate approach to control the pain; however, different techniques are reported in literature.
View Article and Find Full Text PDFTurk Neurosurg
January 2025
Marmara University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Pain Management Section, Istanbul, Türkiye.
Aim: To investigate the effects of obesity on the treatment outcomes of lumbar transforaminal epidural steroid injections (TFESIs).
Material And Methods: This retrospective study included patients who underwent single-level TFESI in a pain management center between January 2021 and April 2023. Body mass index (BMI) of the patients was evaluated based on the World Health Organization guidelines.
Cureus
December 2024
Anesthesiology, Rhode Island Hospital, Brown University, Providence, USA.
Acute pain service was consulted for acute pain management in a 40-year-old male who had sustained multiple bilateral rib fractures following a fall injury. In addition to the rib fractures, the patient had also experienced injuries to his lungs and spinal column, both of which required surgeries. Considering the significant nature of pain due to his rib fractures, a multimodal pain management approach that included both pharmacological and non-pharmacological strategies was utilized.
View Article and Find Full Text PDFEur J Obstet Gynecol Reprod Biol
January 2025
Objective: To evaluate the feasibility and safety of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for performing adnexectomy and high uterosacral ligament suspension (HUSLS) after vaginal hysterectomy (VH) under epidural anesthesia.
Method: This was a retrospective case series of 42 women who underwent VH for stage II or greater apical prolapse according to pelvic organ prolapse quantification (POP-Q); however, adnexectomy could not performed and replace the vNOTES technique. The procedure continued with vNOTES adnexectomy and bilateral HUSLS under epidural anesthesia.
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