Abstract：
:Current pain and analgesic management strategies apply a standardized one-size-fits-all approach to women undergoing cesarean delivery. These standardized protocols do not account for significant variability in women's pain and may lead to under-treatment in patients with high analgesic needs and overtreatment, associated with increased analgesic-related side effects, in women with low analgesic needs and higher analgesic drug sensitivity. Pre-operative identification of patients at-risk of developing severe pain might allow clinicians to optimize care by offering personalized, stratified or targeted analgesic treatment protocols. Pre-operative pain prediction tools are only of moderate value in this regard. Pain reporting during local anesthetic infiltration and answering simple rating questions about anticipated pain and analgesic needs are the easiest tools to apply and show some promise for post-cesarean delivery pain prediction. Patient-driven analgesic dose and protocol selection (based on individual preferences for pain relief and for avoidance of side effects after cesarean delivery) may optimally balance individual pain needs and side effect concerns compared to standardized postoperative pain treatment protocols. Individualized or stratified post-discharge opioid prescribing practices have been shown to reduce unnecessary opioid analgesic prescriptions and consumption, so should be implemented routinely. Outcomes other than pain and analgesic use, including recovery measures and maternal satisfaction metrics, should be considered when evaluating personalized or patient-selected pain treatment protocols.
journal_name
Int J Obstet Anesthjournal_title
International journal of obstetric anesthesiaauthors
Carvalho B,Habib ASdoi
10.1016/j.ijoa.2019.02.124subject
Has Abstractpub_date
2019-11-01 00:00:00pages
91-100eissn
0959-289Xissn
1532-3374pii
S0959-289X(18)30574-0journal_volume
40pub_type
杂志文章,评审abstract：:We present the case of a 30-year-old parturient diagnosed in the first trimester of her first pregnancy as having paroxysmal nocturnal haemoglobinuria. Pancytopenia necessitated regular transfusion of blood products. The risks of infection, haemorrhage and thrombosis, in the presence of severe thrombocytopenia, mild n...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2004.02.003
更新日期：2004-07-01 00:00:00
abstract：BACKGROUND:Between 10-22% of the general population experience needle phobia. Needle phobic parturients are at increased risk of adverse outcomes. We assessed the efficacy of topical Ametop™ (tetracaine 4%) gel in reducing the pain associated with local anesthetic skin infiltration before neuraxial block in non-laborin...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ijoa.2016.03.005
更新日期：2016-08-01 00:00:00
abstract：:HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome is an obstetric complication with heterogeneous presentation, multisystem involvement and variable prognosis, but which usually resolves after delivery. We report a case of HELLP syndrome with subcapsular hematoma of the liver causing extrapericardia...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2012.04.007
更新日期：2012-07-01 00:00:00
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
更新日期：2019-05-01 00:00:00
abstract：:We present two cases in which anesthesia was needed for the reduction of uterine incarceration. The first case was managed with a combined spinal/epidural technique and the second with a single intrathecal injection of opioid and low dose local anesthetic. The anesthetic issues pertinent to the reduction of an incarce...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/s0959-289x(99)80013-2
更新日期：1999-04-01 00:00:00
abstract：:We present two cases of neurovascular disease in pregnancy in which transcranial Doppler was used to assess the status of the cerebral circulation during cesarean section under regional anesthesia. One woman had been found to have moyamoya disease, following a series of transient ischemic attacks during her first preg...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1054/ijoa.2002.0947
更新日期：2002-07-01 00:00:00
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
更新日期：2011-07-01 00:00:00
abstract：INTRODUCTION:Delayed respiratory depression is a feared complication of intrathecal morphine in patients undergoing cesarean delivery. The incidence, timing and risk factors for hypoxia in this population are not known. METHODS:Patients undergoing cesarean delivery under spinal anesthesia at a tertiary care center fro...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2017.06.003
更新日期：2017-11-01 00:00:00
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
更新日期：1996-04-01 00:00:00
abstract：:Hereditary neuropathy with liability to pressure palsy (HNPP) is a rare but probably under-diagnosed disorder of peripheral nerves in which individuals suffer from repeated motor and sensory neuropathies (pressure palsies) following brief nerve compression or mild trauma. A seemingly trivial insult such as sitting or ...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1054/ijoa.2000.0828
更新日期：2001-07-01 00:00:00
abstract：BACKGROUND:A common polymorphism of the μ-opioid receptor gene (OPRM1, p.118A/G), which has been shown to effect the response to neuraxial opioids, occurs in 30% of Caucasian women. This double-blind up-down sequential allocation study was designed to examine the effect of p.118A/G on the ED50 of epidural sufentanil fo...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2011.10.001
更新日期：2012-01-01 00:00:00
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
更新日期：2002-01-01 00:00:00
abstract：BACKGROUND:In South Africa, hypertensive disorders of pregnancy are the leading cause of maternal mortality. More than 50% of anaesthesia-related maternal deaths are attributed to complications of airway management. We compared the prevalence and risk factors for hypoxaemia during induction of general anaesthesia in pa...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2020.10.012
更新日期：2020-11-04 00:00:00
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
更新日期：1996-07-01 00:00:00
abstract：:Primary pulmonary hypertension is a fatal disease that frequently becomes evident in pregnancy. The management of pregnant women with primary pulmonary hypertension poses a number of difficult problems, especially where regional anesthesia is considered to be contraindicated. A 30-year-old woman who developed primary ...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2008.08.001
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:The combined spinal-epidural technique for labor analgesia has several advantages over the traditional epidural technique, including faster onset, greater maternal satisfaction, and decreased need for physician boluses. Proponents of the epidural technique criticize the combined spinal-epidural technique, ar...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2016.01.004
更新日期：2016-05-01 00:00:00
abstract：:In type III hereditary angioedema (HAE type III), the phenotype is the same as type I and type II disease, but the level and function of C1-esterase inhibitor (C1-INH) is normal. Hereditary angioedema type III has been described as an oestrogen-sensitive form because it can be triggered or aggravated by exposure to hi...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2018.07.003
更新日期：2018-11-01 00:00:00
abstract：:In order to estimate how long a medication can remain prepared before the integrity or concentration of the drug is compromised, we assessed the sterility and potency of medications commonly used in our obstetric anesthesia practice. Our goal was to evaluate the following drugs over a 30-day period: epinephrine, atrop...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1054/ijoa.2002.0983
更新日期：2002-10-01 00:00:00
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
更新日期：2019-08-01 00:00:00
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
更新日期：2015-11-01 00:00:00
abstract：:It is generally believed that bolus injections of local anesthetic through an epidural needle produce a more rapid onset of blockade, but at the expense of an increased incidence and severity of hypotension, whereas intermittent injections through a catheter take longer to achieve adequate anesthesia but with a lower ...
journal_title：International journal of obstetric anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0959-289x(97)80006-4
更新日期：1997-04-01 00:00:00
abstract：BACKGROUND:Post-dural puncture headache following trauma to the dural membrane during neuraxial anaesthesia occurs in 0.13-6.5% of pregnant patients. Identifying factors beyond individual performance that contribute to this adverse event is crucial to developing improvement strategies. METHODS:We used a root cause ana...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2018.05.007
更新日期：2018-11-01 00:00:00
abstract：BACKGROUND:After accidental dural puncture in labour it is suggested that inserting an intrathecal catheter and converting to spinal analgesia reduces postdural puncture headache and epidural blood patch rates. This treatment has never been tested in a controlled manner. METHODS:Thirty-four hospitals were randomised t...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ijoa.2011.10.005
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND:Pruritus is the most common side effect of intrathecal morphine, especially in parturients. The exact mechanism is not clear and many possible mechanisms have been suggested. Among these is the activation of the 5-hydroxytryptamine sub-type-3 receptors by intrathecal morphine. METHODS:Forty parturients who ...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ijoa.2018.02.004
更新日期：2018-08-01 00:00:00
abstract：:Pregnancy has been reported to enhance the sensitivity of nerves to local anesthetics and to decrease anesthetic requirements during regional anesthesia. In this study, whether pregnancy increased the efficacy of lumbar epidural anesthesia was evaluated. Two populations (14 pregnant and 14 non-pregnant women) undergoi...
journal_title：International journal of obstetric anesthesia
pub_type： 临床试验,杂志文章
doi：10.1016/j.ijoa.2003.10.008
更新日期：2004-04-01 00:00:00
abstract：:Clinical hyperthyroidism is found in approximately 5% of women with a hydatidiform mole, as human chorionic gonadotropin secreted by molar tissue is structurally similar to thyroid-stimulating hormone. A hydatidiform mole occasionally presents with a co-existing viable fetus. Surgical evacuation may be indicated for s...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2006.12.004
更新日期：2007-10-01 00:00:00
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
更新日期：2006-01-01 00:00:00
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
更新日期：2006-07-01 00:00:00
abstract：:We describe the case of a 29-year-old parturient who, after undergoing elective cesarean delivery, displayed symptoms of lower extremity weakness and sensory deficit. Her past medical history was significant for asymptomatic Arnold Chiari Type I malformation and asthma. She had received spinal anesthesia that failed t...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2013.01.006
更新日期：2013-04-01 00:00:00
abstract：:Urticaria pigmentosa is a cutaneous variant of mastocytosis. This is a complex group of diseases distinguished by abnormal aggregation of mast cells within the skin and other organs. Mast cell degranulation and subsequent release of vasoactive amines may occur in response to a variety of non-immune triggers leading to...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/s0959-289x(98)80049-6
更新日期：1998-10-01 00:00:00
