scholarly journals An obstetric anaesthetist—A key to successful conversion of epidural analgesia to surgical anaesthesia for caesarean delivery?

2019 ◽  
Vol 64 (2) ◽  
pp. 142-144
Author(s):  
Elin eb Bjornestad ◽  
Michael F. Haney
Keyword(s):  
Epidural Analgesia ◽  
Caesarean Delivery ◽  
Obstetric Anaesthetist

The collapsed parturient

2020 ◽  
pp. 535-568
Author(s):  
Rachel Collis
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Pregnant Woman ◽  
Local Anaesthesia ◽  
Regional Anaesthesia ◽  
Caesarean Delivery ◽  
Wide Spectrum ◽  
Obstetric Patient ◽  
Labour Ward ◽  
Obstetric Anaesthetist

This chapter covers a wide spectrum of causes for collapse on the labour ward or in the emergency department, for the first steps in management. The latest guidance on the management of cardiac arrest which the obstetric anaesthetist will be required to immediately attend and initiate in a pregnant woman is described in detail, with the steps needed to progress to perimortem caesarean delivery if resuscitation is not immediately effective. The serious complications of regional anaesthesia; high blocks, total spinals, and local anaesthesia toxicity are emphasized. Anaphylaxis, magnesium toxicity, and management of trauma in the obstetric patient are also outlined.

scholarly journals Patient-Controlled Epidural Analgesia following Caesarean Delivery: A Comparison of Pethidine and Fentanyl

1996 ◽  
Vol 24 (1) ◽  
pp. 45-50 ◽  
Author(s):  
J. L. Goh ◽  
S. F. Evans ◽  
T. J. G. Pavy
Keyword(s):  
Patient Satisfaction ◽  
Side Effects ◽  
Epidural Analgesia ◽  
Epidural Morphine ◽  
Caesarean Delivery ◽  
The Other ◽  
Pain Level ◽  
Double Blind ◽  
Postoperative Epidural Analgesia

Pethidine and fentanyl have both been used to provide patient-controlled epidural analgesia (PCEA) following caesarean delivery. Both have been compared with epidural morphine but these drugs have not been compared with each other. Patient-controlled epidural analgesia was used in a prospective, randomized, double-blind, cross-over trial to compare fentanyl and pethidine for postoperative epidural analgesia in women having elective caesarean deliveries. Two groups received either PCEA fentanyl or pethidine with a cross-over to the other drug after 24 hours. Results from 45 patients showed no difference in pain level outcomes, but pethidine scored better in all side-effects except for drowsiness at 48 hours. Patients were more satisfied with pethidine (P=0.015) and overall 65% of patients preferred pethidine. We conclude that pethidine is a suitable drug for patient-controlled epidural analgesia and leads to greater patient satisfaction than does fentanyl.

Incisional and epidural analgesia after caesarean delivery: a prospective, placebo-controlled, randomised clinical study

2006 ◽  
Vol 15 (3) ◽  
pp. 189-194 ◽  
Author(s):  
P.O. Ranta ◽  
T.I. Ala-Kokko ◽  
J.E. Kukkonen ◽  
P.P. Ohtonen ◽  
T.H. Raudaskoski ◽  
...  
Keyword(s):  
Clinical Study ◽  
Epidural Analgesia ◽  
Caesarean Delivery

scholarly journals Epidural Analgesia in Labour and Risk of Caesarean Delivery

2014 ◽  
Vol 28 (5) ◽  
pp. 400-411 ◽  
Author(s):  
Melanie Bannister-Tyrrell ◽  
Jane B. Ford ◽  
Jonathan M. Morris ◽  
Christine L. Roberts
Keyword(s):  
Epidural Analgesia ◽  
Caesarean Delivery

scholarly journals Association between epidural analgesia and indications for intrapartum caesarean delivery in group 1 of the 10-group classification system at a tertiary maternity hospital, Shanghai, China: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rong Lin ◽  
Peng Shi ◽  
Haibing Li ◽  
Zhiqiang Liu ◽  
Zhendong Xu
Keyword(s):  
Cohort Study ◽  
Epidural Analgesia ◽  
Classification System ◽  
Retrospective Cohort ◽  
Caesarean Delivery ◽  
Group Classification ◽  
Maternal Request ◽  
Oxytocin Augmentation ◽  
Caesarean Delivery Rate ◽  
Group 1

Abstract Background In this study, we aimed to determine whether epidural analgesia affects the indications for intrapartum caesarean delivery, such as foetal distress, dystocia, or maternal request, in nulliparous term women with spontaneous labour (Group 1 in the 10-Group Classification System). Methods We conducted a retrospective cohort study and collected data from the electronic medical records of deliveries performed in our institution between 1 January 2017 and 30 June 2017. Women conforming to the criterion of Group 1 according to the 10-Group Classification System were enrolled. We compared labour outcomes between women with and without epidural analgesia and analysed the association between epidural analgesia and indications for caesarean by using multivariate logistic regression analysis. Results A total of 3212 women met the inclusion criteria, and 2876 were enrolled in the final analyses. Women who received epidural analgesia had a significantly lower intrapartum caesarean delivery rate (16.0% vs. 26.7%, P < 0.001), higher rates of amniotomy (53.4% vs. 42.3%, P < 0.001) and oxytocin augmentation (79.5% vs. 67.0%, P < 0.001), and a higher incidence of intrapartum fever (≥38 °C) (23.3% vs. 8.5%, P < 0.001) than those who did not receive epidural analgesia. There were no significant differences between the groups for most indications, except a lower probability of maternal request for caesarean delivery (3.9% vs. 10.5%, P < 0.001) observed in women who received epidural analgesia than in those who did not. Epidural analgesia was revealed to be associated with a decreased risk of maternal request for caesarean delivery (adjusted odds ratio [aOR], 0.30; 95% confidence interval [CI], 0.22–0.42; P < 0.001); however, oxytocin augmentation was related to an increased risk of maternal request (aOR, 2.34; 95%CI, 1.47–3.75; P < 0.001). Regarding the reasons for the maternal request for caesarean delivery, significantly fewer women complained of pain (0.5% vs. 4.6%, P < 0.001) or had no labour progress (1.3% vs. 3.6%, P < 0.001) among those who received analgesia. Conclusions Among the women in Group 1, epidural analgesia was associated with a lower intrapartum caesarean delivery rate, which may be explained by a reduction in the risk of maternal request for an intrapartum caesarean delivery.

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