A retrospective case-controlled study of the association between request to discontinue second stage labor epidural analgesia and risk of instrumental vaginal delivery.

Abstract:

BACKGROUND:Epidural dose is often reduced in the second stage of labor with the intention of improving maternal expulsive efforts and decreasing the need for instrumental vaginal delivery (IVD). We conjectured that parturients requiring IVD would have had more analgesic interventions and requests to decrease analgesic density in the second stage. METHODS:This retrospective, case-controlled study evaluated parturients with combined spinal-epidural analgesia and IVD over a 22-month period. Data recorded and compared between IVD and spontaneous delivery groups included requests to decrease the density of second stage analgesia and treatment of breakthrough pain. A model was developed from patient characteristics and analgesia interventions to predict the likelihood of IVD. RESULTS:Records from 2072 parturients were analyzed. The number of parturients in whom basal epidural infusion rate was decreased during the second stage of labor was greater in the IVD group (146/1021 (14.3%) vs. 51/1051 (4.9%), P<0.001), as was the number of parturients requiring treatment of breakthrough pain in the first stage of labor. Logistic regression analysis found that treatment for breakthrough pain was the strongest predictor of IVD. CONCLUSION:These results support an association between a request to reduce epidural dose in the second stage of labor, as well as supplemental analgesia for treatment of breakthrough pain, with IVD. It is unclear whether administration of more local anesthetic to treat breakthrough pain results in more dense motor blockade, and hence increases risk of IVD, or whether the decrease in infusion rate reflects obstetricians' dissatisfaction with the progress of obstructed labor.

journal_name

Int J Obstet Anesth

authors

Toledo P,McCarthy RJ,Ebarvia MJ,Wong CA

doi

10.1016/j.ijoa.2007.10.007

subject

Has Abstract

pub_date

2008-10-01 00:00:00

pages

304-8

issue

4

eissn

0959-289X

issn

1532-3374

pii

S0959-289X(08)00058-7

journal_volume

17

pub_type

杂志文章
  • Haemodynamic effects of the position chosen for the insertion of an epidural catheter.

    abstract::An epidural catheter may be inserted with the patient either in the flexed left lateral or the sitting position. We have studied, non-invasively, the haemodynamic changes associated with these positions, using the thoracic bio-impedance method (BOMED NCCOM3 Monitor). Maternal arterial pressure and fetal heart rate wer...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/0959-289x(93)90046-k

    authors: Chadwick IS,Eddleston JM,Chandelier CK,Pollard BJ

    更新日期:1993-01-01 00:00:00

  • Effect of fluid preload on maternal haemodynamics for low-dose epidural analgesia in labour.

    abstract::We prospectively studied 30 women in labour who requested epidural analgesia. They were randomly allocated into two groups; one received a preload of 7 mL/kg normal saline and the other no preload. All patients had a standard epidural solution consisting of 0.1% bupivacaine 20 mL containing fentanyl 2 microg/mL. Mean ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1054/ijoa.2001.0904

    authors: Hawthorne L,Slaymaker A,Bamber J,Dresner M

    更新日期:2001-10-01 00:00:00

  • Acute starvation in pregnancy: a cause of severe metabolic acidosis.

    abstract::We report a case of starvation-induced metabolic ketoacidosis in a previously healthy 29-year-old, nulliparous woman at 32 weeks of gestation. She was admitted to hospital with mild preeclampsia associated with persistent nausea and vomiting that progressed to severe preeclampsia requiring urgent control of hypertensi...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2010.11.004

    authors: Patel A,Felstead D,Doraiswami M,Stocks GM,Waheed U

    更新日期:2011-07-01 00:00:00

  • Combined low-dose spinal-epidural anesthesia versus single-shot spinal anesthesia for elective cesarean delivery.

    abstract::Combined spinal-epidural anesthesia balancing low-dose intrathecal bupivacaine/fentanyl and low-dose epidural bupivacaine may be more useful than single-shot spinal anesthesia for cesarean delivery in reducing incidences of adverse effects such as hypotension and nausea and in shortening motor recovery. Combined spina...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ijoa.2005.05.009

    authors: Choi DH,Ahn HJ,Kim JA

    更新日期:2006-01-01 00:00:00

  • Anesthesia for non-obstetric surgery during pregnancy in a tertiary referral center: a 16-year retrospective, matched case-control, cohort study.

    abstract:INTRODUCTION:This retrospective, matched case-control cohort study describes the incidence, indications, anesthesia techniques and outcomes of pregnancies complicated by surgery in a single tertiary-referral hospital. METHODS:Retrospective review of the hospital records of 171 patients who had non-obstetric surgery in...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2019.01.006

    authors: Devroe S,Bleeser T,Van de Velde M,Verbrugge L,De Buck F,Deprest J,Devlieger R,Rex S

    更新日期:2019-08-01 00:00:00

  • Paradoxical amniotic fluid embolism presenting before caesarean section in a woman with an atrial septal defect.

    abstract::We present a case of presumed amniotic fluid embolism in a 33-year-old parturient at 30 weeks of gestation, which occurred just before she was due to receive spinal anaesthesia for urgent caesarean section. While sitting, the woman suddenly lost consciousness, started having convulsions and finally suffered cardioresp...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2009.02.014

    authors: Kumar V,Khatwani M,Aneja S,Kapur KK

    更新日期:2010-01-01 00:00:00

  • 2012 Gerard W. Ostheimer Lecture--What's new in obstetric anesthesia?

    abstract::The aim of the 2012 "What's new in obstetric anesthesia?" review is to highlight important scientific and medical advances in the fields of obstetric anesthesiology, obstetrics and perinatology from literature published in 2011. This review will consider advances in the prevention and treatment of important obstetric ...

    journal_title:International journal of obstetric anesthesia

    pub_type:

    doi:10.1016/j.ijoa.2012.08.005

    authors: Butwick AJ

    更新日期:2012-10-01 00:00:00

  • A sequential compression mechanical pump to prevent hypotension during elective cesarean section under spinal anesthesia.

    abstract:BACKGROUND:Spinal anesthesia is a standard technique for cesarean section but can cause hypotension which may be related to venous pooling secondary to progesterone-induced decreases in vascular tone. This study investigated the use of a sequential compression mechanical pump with thigh-high sleeves with compression cy...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ijoa.2012.01.003

    authors: Sujata N,Arora D,Panigrahi BP,Hanjoora VM

    更新日期:2012-04-01 00:00:00

  • Labor epidural placement in a woman with a cervical spinal cord stimulator.

    abstract::A 37-year-old female, gravida 1 para 0, in active labor at term, with a cervical spinal cord stimulator in situ, presented for epidural analgesia for labor. She had received the cervical spinal cord stimulator some 30 months before, to treat chronic regional pain syndrome I. She was taking no medication, and was thin ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2005.08.007

    authors: Hanson JL,Goodman EJ

    更新日期:2006-07-01 00:00:00

  • Management of labour and delivery in a woman with refractory supraventricular tachycardia.

    abstract::Supraventricular tachycardia is uncommon in pregnancy. It is defined as intermittent pathological and usually narrow complex tachycardia >120 beats/min which originates above the ventricle, excluding atrial fibrillation, flutter and multifocal atrial tachycardia. It is usually self-limiting or relatively easily treate...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2013.08.012

    authors: Dennis AT,Gerstman MD

    更新日期:2014-02-01 00:00:00

  • Alagille syndrome and pregnancy: anesthetic management for cesarean section.

    abstract::A 34-year-old multiparous woman with a breech presentation, intrauterine growth restriction and premature rupture of membranes was transferred to our referral unit at 33 weeks of gestation. She was diagnosed with Alagille syndrome soon after birth because of cholestasis and pruritus. Her condition was later complicate...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2011.07.012

    authors: Rahmoune FC,Bruyère M,Tecsy M,Benhamou D

    更新日期:2011-10-01 00:00:00

  • Maternal respiratory distress and successful reversal with sugammadex during intrauterine transfusion with fetal paralysis.

    abstract::A 70 kg, 34-year-old woman at 29 weeks-of-gestation required intrauterine transfusion for Rh (D) alloimmunization. In the ambulatory treatment clinic, 19 mg of rocuronium was administered intramuscularly in split doses into the fetal buttock. The fetus moved and inadvertent maternal neuromuscular blockade occurred, le...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2019.01.002

    authors: Munro A,McKeen D,Coolen J

    更新日期:2019-08-01 00:00:00

  • Spontaneous intracranial hypotension--lessons to be learned for the investigation of post dural puncture headache.

    abstract::We describe a case of spontaneous intracranial hypotension in a 36-year-old woman. This condition shares many of the features of post dural puncture headache, but without a dural puncture having been performed. The aetiology and management of this rare condition are discussed. We believe from experience within our own...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1054/ijoa.2001.0902

    authors: Adams MG,Romanowski CA,Wrench IJ

    更新日期:2002-01-01 00:00:00

  • Chagas' disease in an obstetrical patient.

    abstract::We report a case of a parturient with documented chronic Chagas' disease with cardiac manifestations presenting for labor management and complicated by the need for emergent hysterectomy after delivery. Chagas' disease is a common human hematogenous trypanosomiasis in Central and South America which is now, because of...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/s0959-289x(96)80005-7

    authors: Martin HB,Wills J

    更新日期:1996-04-01 00:00:00

  • Obstetric anaesthesia in Hungary.

    abstract::A nation-wide survey of pain relief in childbirth in Hungary was carried out in 1993. Information was provided on 104 137 deliveries in 98 units. The frequencies of different methods of pain relief for vaginal delivery were as follows: systemic opiates in 7387 cases (8.3%), epidural analgesia in 4611 cases (5.2%) and ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/s0959-289x(97)80029-5

    authors: Beke A,Takács G,Sziller I,Fedák L,Papp Z

    更新日期:1997-10-01 00:00:00

  • Failure of neuraxial anaesthesia in a patient with Velocardiofacial syndrome.

    abstract::Velocardiofacial or 22q11 deletion syndrome is a genetic condition caused by deletion 22q11, the deletion of a small segment of the long arm of chromosome 22. To our knowledge this is the first case report of a woman with Velocardiofacial syndrome presenting in late pregnancy for caesarean delivery. She had undergone ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2010.12.007

    authors: Cohen V,Powell E,Lake C

    更新日期:2011-07-01 00:00:00

  • A systematic review of the association between postpartum depression and neuraxial labor analgesia.

    abstract:BACKGROUND:Postpartum depression (PPD) is the most common complication after childbirth, affecting 10-15% of women. It is associated with serious long-term consequences for the mother and family. Whether or not neuraxial labor analgesia mitigates the risk is uncertain and controversial. The purpose of this review was t...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,评审

    doi:10.1016/j.ijoa.2020.10.004

    authors: Orbach-Zinger S,Heesen M,Grigoriadis S,Heesen P,Halpern S

    更新日期:2020-10-17 00:00:00

  • Metoclopramide induced akathisia during cesarean section.

    abstract::We report a case of akathisia developed after administration of 2.5 mg metoclopramide for treatment of nausea during cesarean section. The relevant literature as well as options for prevention and treatment of this phenomenon are reviewed. ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1054/ijoa.1999.0346

    authors: Cohen Y,Glantz L,Ezri T,Geva D

    更新日期:2000-04-01 00:00:00

  • Pain and pain relief in labour: parturients' experiences.

    abstract::The experiences of 890 parturients were studied across Finland during one week to determine how they experienced labour pain and how effective they regarded the means to alleviate it. The majority of women (72%) had been afraid of labour and 88% had intended to request some pharmacological pain relief. 84% of primipar...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/0959-289x(94)90172-4

    authors: Kangas-Saarela T,Kangas-Kärki K

    更新日期:1994-04-01 00:00:00

  • Differences in maternal temperature during labour with remifentanil patient-controlled analgesia or epidural analgesia: a randomised controlled trial.

    abstract:BACKGROUND:Epidural analgesia and remifentanil patient-controlled analgesia are two popular techniques for the treatment of labour pain, each with its own efficacy and toxicity. METHODS:Parturients requesting analgesia were randomly assigned to either patient-controlled intravenous remifentanil or epidural analgesia. ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ijoa.2015.06.003

    authors: Douma MR,Stienstra R,Middeldorp JM,Arbous MS,Dahan A

    更新日期:2015-11-01 00:00:00

  • Treatment of obstetric post-dural puncture headache. Part 1: conservative and pharmacological management.

    abstract::The 2009-12 MBRRACE-UK report highlighted the deaths of two women in whom dural puncture had occurred during insertion of a labour epidural catheter. One woman received an epidural blood patch, the other did not, but both suffered with chronic headaches following discharge from hospital. Neither woman was adequately f...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,评审

    doi:10.1016/j.ijoa.2018.12.006

    authors: Russell R,Laxton C,Lucas DN,Niewiarowski J,Scrutton M,Stocks G

    更新日期:2019-05-01 00:00:00

  • Arm and ankle blood pressure during caesarean section.

    abstract:BACKGROUND:We have previously reported that measurement of non-invasive blood pressure during caesarean section under spinal anaesthesia fails in over 50% of cases. We felt that errors would be less likely if blood pressure could be measured at the ankle as it is immobile during caesarean section. The purpose of our st...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2005.04.016

    authors: Sanghera S,North A,Abernethy S,Wrench I

    更新日期:2006-01-01 00:00:00

  • General anesthesia for cesarean section in a Singapore maternity hospital: a retrospective survey.

    abstract::We conducted a retrospective study of all cases of cesarean section at the KK Women's and Children's Hospital over a one-year period from September 1, 2002 to August 31, 2003, with the aim of evaluating current anesthetic practice. These cases were identified using hospital databases and relevant data was extracted fr...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2004.04.007

    authors: Kan RK,Lew E,Yeo SW,Thomas E

    更新日期:2004-10-01 00:00:00

  • Insertion of an intrathecal catheter following accidental dural puncture: a meta-analysis.

    abstract:BACKGROUND:Inserting an intrathecal catheter after accidental dural puncture in parturients to prevent postdural puncture headache is becoming increasingly popular. We aimed to identify relevant published articles investigating this intervention and subject data to a meta-analysis. METHODS:A systematic literature sear...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,meta分析

    doi:10.1016/j.ijoa.2012.10.004

    authors: Heesen M,Klöhr S,Rossaint R,Walters M,Straube S,van de Velde M

    更新日期:2013-01-01 00:00:00

  • Acute dystonia in labour: side-effect of concealed self-medication attributed to epidural analgesia.

    abstract::Any convulsion during labour requires immediate action, but before this can occur a correct diagnosis must be made. Here we describe a case where a 'fit' was wrongly attributed to epidural analgesia. This was in fact a dystonic reaction secondary to undeclared self-medication with metoclopramide. It is therefore impor...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/0959-289x(93)90088-y

    authors: Jankowski S,Arrigoni PB

    更新日期:1993-01-01 00:00:00

  • Anaesthesia for emergency caesarean section in a parturient with bleeding placenta praevia and a potentially malignant hyperthermia-susceptible fetus.

    abstract::A parturient who was 35 weeks' pregnant by her husband who was known to be susceptible to malignant hyperthermia, required anaesthesia for caesarean section for bleeding placenta praevia. The patient was considered to be haemodynamically stable and the procedure was carried out uneventfully under subarachnoid block. A...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1054/ijoa.2000.0394

    authors: Nanson JK,Sheikh A

    更新日期:2000-10-01 00:00:00

  • Haemodynamic responses to laryngoscopy and intubation in patients with pregnancy-induced hypertension: effect of intravenous esmolol with or without lidocaine.

    abstract::The pressor response is known to be exaggerated in patients with pregnancy-induced hypertension, which can result in increased morbidity and mortality in both mother and newborn. Various pharmacological agents have been used before induction in an attempt to attenuate the adrenergic response but with varying degree of...

    journal_title:International journal of obstetric anesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1054/ijoa.2001.0918

    authors: Bansal S,Pawar M

    更新日期:2002-01-01 00:00:00

  • Extending epidural blockade for emergency caesarean section. Evaluation of 2% lignocaine with adrenaline.

    abstract::Pre-existing epidural analgesia was rapidly extended in 36 consecutive patients presenting for emergency caesarean section by using 20 ml of 2% lignocaine + 1/200,000 adrenaline freshly prepared given by slow bolus injection. Despite a wide range of initial analgesic sensory levels the technique produced blocks that w...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/0959-289x(91)90024-k

    authors: Price ML,Reynolds F,Morgan BM

    更新日期:1991-09-01 00:00:00

  • Does midwifery-led intrapartum care require anaesthetic services?

    abstract::The report of the Expert Maternity Group 'Changing Childbirth' (The Cumberlege Report) advocates a greater role for midwives in the care of the low risk pregnant woman, and has promoted much discussion about the future development of maternity services in the UK. At Leicester Royal Infirmary NHS Trust the 'Home from H...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/s0959-289x(96)80022-7

    authors: Pickett JA,Oppenheimer CA,May AE

    更新日期:1996-07-01 00:00:00

  • Incidence and risk factors for chronic pain after elective caesarean delivery under spinal anaesthesia in a Chinese cohort: a prospective study.

    abstract:BACKGROUND:China has one of the highest rates of caesarean delivery in the world. The aim of this study was to investigate the incidence and risk factors for chronic pain after caesarean delivery in a Chinese cohort. METHODS:Patients undergoing elective caesarean delivery with a Pfannenstiel incision under spinal anae...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2018.01.009

    authors: Wang LZ,Wei CN,Xiao F,Chang XY,Zhang YF

    更新日期:2018-05-01 00:00:00