scholarly journals Labour Analgesia When Epidural Is Not a Choice: Tramadol versus Pentazocine

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Jyothi Shetty ◽  
Ashwini Vishalakshi ◽  
Deeksha Pandey
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Epidural Analgesia ◽  
Labor Pain ◽  
Resource Poor Setting ◽  
Analog Scale ◽  
The World ◽  
Resource Poor ◽  
The Given ◽  
First Stage Of Labor

Background. Parenteral opioids, thus, are still popular for pain relief in labor in many countries throughout the world. Aim. To evaluate and compare the efficacy of intramuscular tramadol and pentazocine in the first stage of labor. Method. Sixty-five patients were divided into pentazocine group and tramadol group. Subjects received either 30 mg pentazocine or 1 mg/kg tramadol intramuscularly. Pain was assessed using visual analog scale (VAS) before the administration of the drug, at 1 h, 2 h, 4 h, and at full dilatation. Maternal and neonatal side effects were determined. Results. Analgesic effect of the two drugs was not significantly different. Neither of these analgesics was effective towards the end of the first stage. However, in the tramadol group, the majority of women (55%) rated pain as severe, whereas in the pentazocine group, the majority of women (60%) rated pain as moderately severe. There were not many side effects with either of the drug in the given dosage. Mean injection to delivery interval was significantly shorter in the tramadol group as compared to the pentazocine group. Conclusion. Pentazocine or tramadol can be given for labor pain relief as an alternative to epidural analgesia in resource poor setting.

Randomized Controlled Trial Comparing Traditional with Two “Mobile” Epidural Techniques

2002 ◽  
Vol 97 (6) ◽  
pp. 1567-1575 ◽  
Author(s):  
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Visual Analog Scale ◽  
Low Dose ◽  
Labor Pain ◽  
Labor And Delivery ◽  
Analog Scale ◽  
Pain Scores ◽  
Visual Analog Scale Pain ◽  
To Receive

Background The authors recently showed that "mobile" epidural analgesia, using low-dose local anesthetic-opioid mixtures, reduces the impact of epidural analgesia on instrumental vaginal delivery, relative to a traditional technique. The main prespecified assessment of pain relief efficacy, women's postpartum estimates of labor pain after epidural insertion, did not differ. The detailed analgesic efficacy and the anesthetic characteristics of the techniques are reported here. Methods A total of 1,054 nulliparous women were randomized, in labor, to receive boluses of 10 ml 0.25% bupivacaine (traditional), combined spinal-epidural (CSE) analgesia, or low-dose infusion (LDI), the latter groups utilizing 0.1% bupivacaine with 2 microg/ml fentanyl. Visual analog scale pain assessments were collected throughout labor and delivery and 24 h later. Details of the conduct of epidural analgesia, drug utilization, and requirement for anesthesiologist reattendance were recorded. Results A total of 353 women were randomized to receive traditional epidural analgesia, 351 received CSE, and 350 received LDI. CSE was associated with a more rapid onset of analgesia, lower median visual analog scale pain scores than traditional in the first hour after epidural insertion, and a significant reduction in bupivacaine dose given during labor. Pain scores reported by women receiving LDI were similar to those in the traditional group throughout labor and delivery. Anesthesiologist reattendance was low but greater with each mobile technique. Conclusions Relative to traditional epidural analgesia, LDI is at least as effective and CSE provided better pain relief in the early stages after insertion. The proven efficacy of mobile epidurals and their beneficial impact on delivery mode make them the preferred techniques for epidural pain relief in labor.

Paravertebral Block versus Thoracic Epidural Analgesia for Postthoracotomy Pain Relief: A Meta-Analysis of Randomized Trials

2021 ◽  
Author(s):  
Mu Xu ◽  
Jiajia Hu ◽  
Jianqin Yan ◽  
Hong Yan ◽  
Chengliang Zhang
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Epidural Analgesia ◽  
Meta Analysis ◽  
Thoracic Epidural Analgesia ◽  
Paravertebral Block ◽  
Cochrane Library ◽  
Thoracic Epidural ◽  
Analgesic Consumption ◽  
Postthoracotomy Pain

Abstract Objective Paravertebral block (PVB) and thoracic epidural analgesia (TEA) are commonly used for postthoracotomy pain management. The purpose of this research is to evaluate the effects of TEA versus PVB for postthoracotomy pain relief. Methods A systematic literature search was conducted in PubMed, EMBASE, Web of Science, and the Cochrane Library (last performed on August 2020) to identify randomized controlled trials comparing PVB and TEA for thoracotomy. The rest and dynamic visual analog scale (VAS) scores, rescue analgesic consumption, the incidences of side effects were pooled. Results Sixteen trials involving 1,000 patients were included in this meta-analysis. The pooled results showed that the rest and dynamic VAS at 12, 24, and rest VAS at 48 hours were similar between PVB and TEA groups. The rescue analgesic consumption (weighted mean differences: 3.81; 95% confidence interval [CI]: 0.982–6.638, p < 0.01) and the incidence of rescue analgesia (relative risk [RR]: 1.963; 95% CI: 1.336–2.884, p < 0.01) were less in TEA group. However, the incidence of hypotension (RR: 0.228; 95% CI: 0.137–0.380, p < 0.001), urinary retention (RR: 0.392; 95% CI: 0.198–0.776, p < 0.01), and vomiting (RR: 0.665; 95% CI: 0.451–0.981, p < 0.05) was less in PVB group. Conclusion For thoracotomy, PVB may provide no superior analgesia compared with TEA but PVB can reduce side effects. Thus, individualized treatment is recommended. Further study is still necessary to determine which concentration of local anesthetics can be used for PVB and can provide equal analgesic efficiency to TEA.

Baricity, Needle Direction, and Intrathecal Sufentanil Labor Analgesia

1997 ◽  
Vol 86 (3) ◽  
pp. 592-598 ◽  
Author(s):  
Fazeela Ferouz ◽  
Mark C. Norris ◽  
Valerie A. Arkoosh ◽  
Barbara L. Leighton ◽  
Louis M. Boxer ◽  
...  
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Normal Saline ◽  
Analgesic Efficacy ◽  
Study Drug ◽  
Labor Analgesia ◽  
Labor Pain ◽  
Double Blind Study ◽  
Drug Injection ◽  
Double Blind

Background Intrathecal sufentanil relieves labor pain but centrally mediated side effects are common. Preventing rostral spread of intrathecal sufentanil should limit these side effects. Both direction of the lateral opening of a pencil-point needle and drug baricity modify the spread of intrathecal local anesthetics. This randomized, prospective, double-blind study examines the effects of these variables on intrathecal sufentanil labor analgesia. Methods Forty laboring, full-term parturients, whose cervixes were dilated less than 5 cm and who requested analgesia for labor were enrolled. Combined spinal epidural analgesia was induced in patients in the sitting position. They were allocated to receive 10 micrograms intrathecal sufentanil diluted with either normal saline or dextrose with the aperture of the pencil-point needle directed cephalad or caudad during drug injection. Thus there were four groups of ten patients: dextrose up, dextrose down, saline up, and saline down. Sufentanil was diluted with normal saline to a concentration of 10 micrograms/ml. The study drug was made by mixing 1 ml sufentanil solution with either 1 ml 10% dextrose or 1 ml normal saline. Visual analog scores for pain, pruritus, nausea, and pain relief were recorded before and 5, 10, 15, and 30 min after drug injection. Results Baricity, but not needle orientation, influenced pain relief and pruritus. Sufentanil in dextrose produced less itching but also less analgesia. Nine of 20 women in the dextrose groups compared with 1 of 20 in the saline groups requested additional analgesia by 30 min. Conclusions Little or no labor analgesia developed for patients receiving sufentanil with dextrose. A supraspinal action may contribute to intrathecal sufentanil's analgesic efficacy.

scholarly journals Development of the Labor Pain Relief Attitude Questionnaire for Pregnant Women (LPRAQ-p)

2020 ◽  
Author(s):  
Lianne P Hulsbosch ◽  
Ivan Nyklíček ◽  
Eva S Potharst ◽  
Myrthe GBM Boekhorst ◽  
Victor JM Pop
Keyword(s):  
Factor Analysis ◽  
Pain Relief ◽  
Confirmatory Factor Analysis ◽  
Epidural Analgesia ◽  
Pregnant Women ◽  
Labor Pain ◽  
Attitude Questionnaire ◽  
Distress Symptoms ◽  
Confirmatory Factor ◽  
Explorative Factor Analysis

Abstract Background: Receiving epidural analgesia during labor can possibly have negative consequences for mother and child. Yet, the use of epidural analgesia rapidly increased in the Netherlands over the last decade. Since antenatal plans for labor pain relief have been related to epidural analgesia use during labor, the aim of the current study was to develop a Labor Pain Relief Attitude Questionnaire for pregnant women (LPRAQ-p).Methods: Three focus group interviews were conducted with pregnant women, new mothers and caregivers and 13 candidate items were derived. Psychometric properties were tested with explorative factor analysis in sample I (N = 429) and a subsequent confirmatory factor analysis in a different sample II (N = 432).Results: The explorative factor analysis suggested a two-factor seven-item solution: a ‘women’s perception’ and ‘social environment’ subscale. The confirmatory factor analysis confirmed an excellent six-item model fit with appropriate internal consistency. Higher scores on the six-item LPRAQ-p indicate greater willingness for request of pain relief medication during labor. Two-tailed t-tests showed that women with elevated levels of depression and pregnancy-specific distress symptoms, nulliparous women and multiparous women with complications during previous delivery had greater willingness for request of pain relief medication during labor. Linear regression showed that the most important association with higher scores on the LPRAQ-p were high pregnancy-specific distress symptoms.Conclusions: This study showed the LPRAQ-p to be a valid instrument to evaluate attitude towards labor pain relief in pregnant women. High scores on this questionnaire are associated with high levels of pregnancy-specific distress symptoms.

scholarly journals A pilot study comparing dural puncture epidural with 27G Whitacre needle and conventional lumbar epidural labor analgesia

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Ashok Jadon ◽  
Surabhi Srivastawa ◽  
Neelam Sinha ◽  
Swastika Chakraborty ◽  
Apoorva Bakshi ◽  
...  
Keyword(s):  
Side Effects ◽  
Epidural Analgesia ◽  
Dural Puncture ◽  
Mode Of Delivery ◽  
Labor Analgesia ◽  
Labor Pain ◽  
Spinal Needle ◽  
Lumbar Epidural Analgesia ◽  
A New Technique ◽  
Dural Puncture Epidural

Abstract Background The dural puncture epidural (DPE) technique is relatively a new technique of labor analgesia and has been advocated with the advantage of faster onset of pain relief. However, there are differences of opinion regarding the efficacy of the DPE technique and the size of the spinal needle to be used for the DPE. Various studies have suggested that DPE can only be done with a larger gauge of a spinal needle; however, recent studies have variable observations. We have compared the conventional lumbar epidural analgesia and DPE using a 27G pencil-point needle to assess the efficacy of DPE and its possible side effects. Results The time to achieve a 50% reduction in VAS was 7.06 ± 0.79 min in group CLE (n = 15) and 5.0 ± 1.06 min in group DPE (n = 15) (difference of two means was 2.06, 95% CI [1.36, 2.75], t = 5.99, p < 0.0001). The time to achieve VAS < 3 in group CLE was 14.93 ± 1.98 min, and in the group DPE, it was 10.13 ± 1.45 min (difference of two means was 4.8, 95% CI [3.52, 6.09], t = 7.55, p < 0.0001). The mode of delivery, APGAR scores, and side effects were comparable (p > 0.05). Conclusions DPE provided faster relief of labor pain than the conventional labor epidural analgesia. There were no added side effects by DPE in conventional lumbar epidural analgesia for labor. A 27G Whitacre pencil-point needle can be used for DPE. Trial registration CTRI, CTRI/2020/08/027060. Registered on 10/08/2020. Trial registered prospectively. CTRI website URL: http://ctri.nic.in

scholarly journals Conhecimento das gestantes acerca das medidas de alívio da dor durante o parto

2019 ◽  
Vol 87 (25) ◽  
Author(s):  
Alessa Sousa da Silva ◽  
Carla Cristina Chaves de Oliveira ◽  
Emmanuel Calisto da Costa Brito ◽  
Tiago Barreto Castro e Silva ◽  
Danielle Rosa Evangelista
Keyword(s):  
Pain Relief ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Labor Pain ◽  
Sectional Study ◽  
Average Income ◽  
Cross Sectional ◽  
Pain Knowledge ◽  
Statistical Program ◽  
First Stage Of Labor

Objetivou-se analisar o conhecimento das gestantes primíparas acerca de métodos de alivio da dor no primeiro estágiodo parto. Trata-se de estudo exploratório e transversal. Foram entrevistadas 49 gestantes cadastradas na rede municipal dePalmas, Tocantins. Os dados foram processados no programa estatístico Epi Info, versão 3.3 de 2004. A análise foi atravésde estatística descritiva simples. Os resultados mostram gestantes com 25,04 ±5,71 anos de idade, com parceiro fixo, ensino médio completo, renda média de 1473,14 ±936,18 e 7,02 ±2,03 consultas pré-natal, encontravam-se com 34,8±3,42semanas de gestação. 100% afirmaram que o tema não foi abordado no acompanhamento pré-natal. 75,5% das gestantesforam classificadas com nenhum conhecimento. Concluiu-se que as gestantes apresentam necessidades de ter conhecimento sobre os métodos de alivio a dor, para o exercício do processo de parir de forma humanizada.Palavras-chave: Primeira fase do Trabalho de Parto; Dor do Parto; Conhecimento. ABSTRACTThe objective of this study was to analyze the knowledge of primiparous pregnant women about methods of pain relief inthe first stage of labor. This is an exploratory and cross-sectional study. Forty-nine pregnant women registered in the municipal network of Palmas, Tocantins were interviewed. The data was processed in the statistical program Epi Info, version 3.3of 2004. The analysis was through simple descriptive statistics. The results show pregnant women who were 25.04 ± 5.71years old, with a fixed partner, complete high school, average income of 1473.14 ± 936.18 and 7.02 ± 2.03 prenatal consultations, were with 34.8 ± 3.42 weeks of gestation. 110% stated that the topic was not addressed in prenatal care. 75.5%of the pregnant women were classified with having no knowledge. It was concluded that the pregnant women present theneed to be aware of the methods of pain relief, to exercise the process of giving birth in a humanized way.Keywords: Labor Stage, First; Labor Pain; Knowledge.

scholarly journals Labor pain relief and postpartum depression. Is there a correlation?

2017 ◽  
Vol 66 (5) ◽  
pp. 11-20 ◽  
Author(s):  
Oksana V. Riazanova ◽  
Yury S. Aleksandrovich ◽  
Vitaly A. Reznik ◽  
Irina A. Gorkovaya ◽  
Maria A. Korgozha ◽  
...  
Keyword(s):  
Pain Relief ◽  
Postpartum Depression ◽  
Epidural Analgesia ◽  
Vaginal Delivery ◽  
Local Anesthetic ◽  
Pain Syndrome ◽  
Vaginal Birth ◽  
Labor Pain ◽  
Gestation Period ◽  
Ropivacaine Hydrochloride

The article is dedicated to the evaluation of the effect of labor pain relief by using epidural analgesia during vaginal delivery on the frequency of postpartum depression. Materials and methods. 159 women were included in the study. The average age of the patients was 29 years, the average gestation period was 39.7 weeks. In the first group, in order to relief the pain while vaginal birth, an epidural analgesia was administered. A continuous patient-controlled infusion was used along with 0.08% solution of ropivacaine hydrochloride in the capacity of a local anesthetic. Patients of the second group gave birth without any anesthesia. Evaluation of the depression progress was carried out several times: before birth, 6 hours after delivery, 3 days and 6 weeks after delivery. Results of the study. Usage of epidural analgesia during vaginal delivery leads to a significant pain syndrome relief, but does not reduce the probably of postpartum depression.

PATIENT CONTROLLED EPIDURAL ANALGESIA versus CONTINUOUS INFUSION FOR LABOR PAIN RELIEF

1998 ◽  
Vol 86 (Supplement) ◽  
pp. 371S
Author(s):  
Susan Harke ◽  
Gordon Mandell ◽  
Sivam Ramanathan
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Continuous Infusion ◽  
Labor Pain

Đánh giá hiệu quả giảm đau bằng gây tê ngoài màng cứng trong phẫu thuật nội soi cắt đại, trực tràng

2022 ◽  
Author(s):  
Thanh Xuan Nguyen
Keyword(s):  
Colorectal Cancer ◽  
Side Effects ◽  
Pain Relief ◽  
Visual Analog Scale ◽  
Epidural Anesthesia ◽  
Postoperative Mortality ◽  
Cancer Surgery ◽  
Major Surgery ◽  
Analog Scale ◽  
Colorectal Cancer Surgery

TÓM TẮT Đặt vấn đề: Gây tê ngoài màng cứng để giảm đau trong và sau mổ được áp dụng rộng rãi trên thế giới từ nhiều thập niên qua. Kết quả của nhiều công trình nghiên cứu cho thấy phương pháp này làm giảm những biến chứng trong và sau mổ, giảm tỉ lệ tử vong sau mổ của các phẫu thuật nặng. Nghiên cứu nhằm đánh giá hiệu quả và các tác dụng phụ của gây tê ngoài màng cứng trong phẫu thuật ung thư đại, trực tràng. Phương pháp: Nghiên cứu mô tả cắt ngang trên 28 bệnh nhân được gây tê ngoài màng cứng trong mổ ung thư đại, trực tràng có phối hợp gây mê nội khí quản. Sinh hiệu và tình trạng sức khỏe của bệnh nhân được theo dõi trước và sau khi tiêm thuốc giảm đau. Ghi nhận mức độ giảm đau theo Visual Analog Scale (VAS), mức độ liệt vận động theo Bromage và các tác dụng phụ sau mổ. Kết quả: Hiệu quả giảm đau sau mổ tốt, tại các thời điểm sau mổ VAS đều ≤ 1,5. Tỉ lệ các biến chứng: tụt huyết áp: 7,14%, đau đầu: 7,14%, lạnh run: 10,71%, buồn nôn, nôn: 17,86%. Kết luận: Kỹ thuật gây tê ngoài màng cứng phối hợp với gây mê toàn thân là kỹ thuật giảm đau hiệu quả và an toàn cho phẫu thuật vùng bụng trong mổ và 24 giờ sau mổ. ABSTRACT THE EFFICIENCY OF SPINAL EPIDURAL ANESTHESIA FOR LAPAROSCOPIC COLORECTAL CANCER SURGERY Background: Epidural anesthesia for pain relief during and after surgery has been widely applied in the world for decades. The results of many studies show that this method reduces intra - and postoperative complications and reduces the postoperative mortality rate of major surgery. The study aimed to evaluate epidural anesthesia’s effectiveness and side effects in colorectal cancer surgery. Methods: A cross - sectional descriptive study on 28 patients receiving epidural anesthesia in surgery for colorectal cancer in combination with endotracheal anesthesia. The patient’s vital signs and health status were monitored before and after the injection of pain medication. Record the level of pain relief according to the Visual Analog Scale (VAS), the degree of motor paralysis according to Bromage, and the side effects after surgery. Results: Good postoperative pain relief effect, at all times after surgery, VAS was ≤ 1.5. Rate of complications: hypotension: 7.14%, headache: 7.14%, shiver: 10.71%, nausea, vomiting: 17.86%. Conclusion: The epidural anesthesia combined with general anesthesia is an effective and safe analgesia technique for abdominal surgery during surgery and 24 hours after surgery. Keywords: Epidural anesthesia, colorectal cancersurgery

Sign in / Sign up

Export Citation Format

Share Document