Bibliographies thématiques / Anesthetics in obstetrics

Littérature scientifique sur le sujet « Anesthetics in obstetrics »

Auteur : Grafiati
Publié le 25 juillet 2024
Mis à jour le 26 juillet 2024

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Articles de revues sur le sujet "Anesthetics in obstetrics"

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A, Sucharitha. « The Effects of General Anesthetics on the Developing Brain of Fetus ». Anaesthesia & ; Critical Care Medicine Journal 9, no 1 (5 janvier 2024) : 1–7. http://dx.doi.org/10.23880/accmj-16000236.

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General Anesthesia is a practice of medically inducing temporary loss of consciousness accompanied by complete or partial loss of pain reflexes. Anesthesia for obstetrics and pediatric surgery is unpreventable for pregnant women and newborn infants with life-threatening disorders requiring a prolonged stay in the intensive care unit (ICU). Despite this, fetal brain development begins in the third week of gestation of intrauterine life. Volatile anesthetics such as sevoflurane, desflurane, isoflurane nitroprusside, etc are used during pregnancy to prevent preterm contractions and inhibit uterine contractility. These volatile anesthetic agents are highly lipid soluble and are of low molecular weight which readily favors for transplacental passage of the volatile anesthetics by simple diffusion and shows numerous effects on the neuronal transmission system. The basic principles of embryo-fetotoxicity were evaluated in the aspects of embryo-fetal effects of drugs such as anesthetics analyzed, and the most commonly used anesthetics were presented with teratogenic risks. Various studies suggested that prolonged exposure to general anesthetics might result in extensive neuroapoptosis (neuronal death), anesthetic neurotoxicity, neuroinflammation, synaptic loss, activation of caspase, and other neurodegenerative changes in the developing human brain. This review briefly summarizes the growth and development of the brain in fetuses and neonates, the data regarding neurotoxicity, and a few key components accountable for neuroapoptosis and causes long-lasting cognitive impairment in fetuses induced due to general anesthetics that is the progress in neurodevelopment in the offspring on anesthetic exposure will be reviewed.
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Sîrbu, Rodica, Emin Cadar, Cezar Laurențiu Tomescu, Cristina Luiza Erimia, Stelian Paris et Aneta Tomescu. « Local Anesthetics – Substances with Multiple Application in Medicine ». European Journal of Interdisciplinary Studies 2, no 1 (30 avril 2016) : 17. http://dx.doi.org/10.26417/ejis.v2i1.p17-26.

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Local anesthetics are substances which, by local action groups on the runners, cause loss of reversible a painful sensation, delimited corresponding to the application. They allow small surgery, short in duration and the endoscopic maneuvers. May be useful in soothe teething pain of short duration and in the locking of the nervous disorders in medical care. Local anesthesia is a process useful for the carrying out of surgery and of endoscopic maneuvers, to soothe teething pain in certain conditions, for depriving the temporary structures peripheral nervous control. Reversible locking of the transmission nociceptive, the set of the vegetative and with a local anesthetic at the level of the innervations peripheral nerve, roots and runners, a trunk nervous, around the components of a ganglion or coolant is cefalorahidian practice anesthesia loco-regional. Local anesthetics summary and semi-summary have multiple applications in dentistry, consulting, surgery and obstetrics, constituting "weapons" very useful in the fight against the pain.
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Sîrbu, Rodica, Emin Cadar, Cezar Laurențiu Tomescu, Cristina Luiza Erimia, Stelian Paris et Aneta Tomescu. « Local Anesthetics – Substances with Multiple Application in Medicine ». European Journal of Interdisciplinary Studies 4, no 1 (30 avril 2016) : 17. http://dx.doi.org/10.26417/ejis.v4i1.p17-26.

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Local anesthetics are substances which, by local action groups on the runners, cause loss of reversible a painful sensation, delimited corresponding to the application. They allow small surgery, short in duration and the endoscopic maneuvers. May be useful in soothe teething pain of short duration and in the locking of the nervous disorders in medical care. Local anesthesia is a process useful for the carrying out of surgery and of endoscopic maneuvers, to soothe teething pain in certain conditions, for depriving the temporary structures peripheral nervous control. Reversible locking of the transmission nociceptive, the set of the vegetative and with a local anesthetic at the level of the innervations peripheral nerve, roots and runners, a trunk nervous, around the components of a ganglion or coolant is cefalorahidian practice anesthesia loco-regional. Local anesthetics summary and semi-summary have multiple applications in dentistry, consulting, surgery and obstetrics, constituting "weapons" very useful in the fight against the pain.
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Wright, Kelly N., Alexandra I. Melnyk, Jordan Emont et Jane Van Dis. « Sustainability in Obstetrics and Gynecology ». Obstetrical & ; Gynecological Survey 79, no 3 (mars 2024) : 162–63. http://dx.doi.org/10.1097/01.ogx.0001010444.52038.f1.

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ABSTRACT The greatest threat to human health, otherwise known as the climate crisis, disproportionately affects women and pregnant people via exposure to air pollution, heat, extreme weather events, and toxic substances. These effects lead to increased mortality and morbidity in patient populations, but the overall role of the healthcare system and its contribution remains unknown to medical professionals. This review aims to educate clinicians on the effects of the climate crisis on health outcomes and how the current US healthcare system practices drive climate change. Solutions for decarbonizing operating rooms (ORs), neonatal intensive care units (and nurseries), and labor and delivery units are also addressed. The impact on health can be categorized by the effect of heat (rising temperatures), air pollution, and toxic substances such as microplastics. These have variously been shown to impact fertility; rates of miscarriage, stillbirth, and preterm birth; and hypertensive disorders of pregnancy. Notably, the healthcare industry contributes more carbon emissions than even global aviation, with the US healthcare industry producing 27% of the world’s healthcare carbon emissions through its energy and water usage, but also via the supply chain, its waste, and pharmaceuticals. Petroleum-based plastic single-use supplies (ie, gowns, instruments, drapes) in hospitals are also a major contributor to this crisis. Up to 95% of the environmental imprint of the healthcare supply chain stems from these single-use supplies. In addition, biohazard waste must be incinerated prior to landfill disposal, further adding to the environmental impact. Evidence supports the immediate impact of systemic change in terms of decarbonizing healthcare. Replacing single-use instruments with sterilized reusable ones, for instance, has a major impact, such as replacing acrylic specula with stainless steel ones. Another study indicated lower rates of surgical site infections when single-use materials were unavailable in the OR. Beyond this, many single-use supplies are never utilized for patients and go directly to waste. In addition, over carbon dioxide, inhaled anesthetics such as desflurane have 2540 times the potential for global warming while lacking noticeable benefit over other anesthetics. Instead, intravenous anesthetic use can greatly decarbonizing surgeries due to the lower carbon footprint of these medications. Finally, decreasing energy use in climate control measures within buildings can also impact the environment for the better. Powering down unused ORs saved one institution $33,000 annually. Powering down computers over weekends and on nights can also greatly reduce carbon emissions.
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Hawkins, Joy L., Charles P. Gibbs, Miriam Orleans, Gallice Martin-Salvaj et Brenda Beaty. « Obstetric Anesthesia Work Force Survey, 1981 versus 1992 ». Anesthesiology 87, no 1 (1 juillet 1997) : 135–43. http://dx.doi.org/10.1097/00000542-199707000-00018.

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Background In 1981, with support from the American Society of Anesthesiologists and the American College of Obstetricians and Gynecologists, anesthesia and obstetric providers were surveyed to identify the personnel and methods used to provide obstetric anesthesia in the United States. The survey was expanded and repeated in 1992 with support from the same organizations. Methods Comments and questions from the American Society of Anesthesiologists Committee on Obstetrical Anesthesia and the American College of Obstetricians and Gynecologists Committee on Obstetric Practice were added to the original survey instrument to include newer issues while allowing comparison with data from 1981. Using the American Hospital Association registry of hospitals, hospitals were differentiated by number of births per year (stratum I, > or = 1,500 births; stratum II, 500-1,499 births; stratum III, < 500 births) and by U.S. census region. A stratified random sample of hospitals was selected. Two copies of the survey were sent to the administrator of each hospital, one for the chief of obstetrics and one for the chief of anesthesiology. Results Compared with 1981 data, there was an overall reduction in the number of hospitals providing obstetric care (from 4,163 to 3,545), with the decrease occurring in the smallest units (56% of stratum III hospitals in 1981 compared with 45% in 1992). More women received some type of labor analgesia and there was a 100% increase in the use of epidural analgesia. However, regional analgesia was unavailable in 20% of the smallest hospitals. Spinal analgesia for labor was used in 4% of parturients. In 1981, obstetricians provided 30% of epidural analgesia for labor; they provided only 2% in 1992. Regional anesthesia was used for 78-85% (depending on strata) of patients undergoing cesarean section, resulting in a marked decrease in the use of general anesthesia. Anesthesia for cesarean section was provided by nurse anesthetists without the medical direction of an anesthesiologist in only 4% of stratum I hospitals but in 59% of stratum III hospitals. Anesthesia personnel provided neonatal resuscitation in 10% of cesarean deliveries compared with 23% in 1981. Conclusions Compared with 1981, analgesia is more often used by parturients during labor, and general anesthesia is used less often in patients having cesarean section deliveries. In the smallest hospitals, regional analgesia for labor is still unavailable to many parturients, and more than one half of anesthetics for cesarean section are provided by nurse anesthetists without medical direction by an anesthesiologist. Obstetricians are less likely to personally provide epidural analgesia for their patients. Anesthesia personnel are less involved in newborn resuscitation.
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Pedersen,, Hilda, et Mieczyslaw Finster. « Selection and Use of Local Anesthetics ». Clinical Obstetrics and Gynecology 30, no 3 (septembre 1987) : 505–14. http://dx.doi.org/10.1097/00003081-198709000-00006.

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Tkachenko, R. O. « Modern anesthesia in obstetrics as a component of the concept of safe anesthesia ». Infusion & ; Chemotherapy, no 3.2 (15 décembre 2020) : 280–82. http://dx.doi.org/10.32902/2663-0338-2020-3.2-280-282.

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Background. Anesthesia should be selected individually for each labor. Systemic analgesia of labor includes suggestive analgesia, narcotic analgesics, local infiltration and regional blockade, inhalation analgesia. It should be noted that there is no analgesic, sedative or local anesthetic that does not penetrate the placenta, affecting the fetus in any way. Objective. To describe modern anesthesia in obstetrics. Materials and methods. Analysis of literature sources on this issue. Results and discussion. Three groups of antispasmodics are used for analgesia: neurotropic (atropine, scopolamine), myotropic (papaverine, drotaverine) and neuromyotropic (baralgin). The main non-steroidal anti-inflammatory drugs used for this purpose include metamizole sodium, ketorolac tromethamine, diclofenac sodium. Inhalation autoanalgesia with nitrous oxide (N2O) is effective only in 30-50 % of women. When the concentration of N2O exceeds 50 %, the sedative effect increases and oxygenation decreases, which leads to the loss of consciousness and protective laryngeal reflexes. Such analgesia is indicated for low-risk patients who have refused from regional anesthesia. Epidural anesthesia (EDA) is the gold standard of labor anesthesia. The advantages of EDA include the option to change the degree of analgesia, the ability to continue pain relief until the end of labor and the minimal impact on the condition of both child and mother. Before manipulation, be sure to determine the platelet count and heart rate of the fetus. It is recommended to start EDA in the latent stage of labor. In patients with uterine scarring, early EDA is a mandatory component of medical care. The woman’s wish is the main indication for EDA. Indications for early catheterization of the epidural space include the presence of twins, preeclampsia, obesity, respiratory tract with special features. Headache is the most common complication of EDA. The use of pencil-point spinal needles minimizes the frequency of this complication. Adequate analgesia for uncomplicated labor should be performed with minimal concentrations of anesthetics with the least possible motor block. Local anesthetics (lidocaine, bupivacaine (Longocaine, “Yuria-Pharm”), ropivacaine) are used for EDA). Combined spinal-epidural anesthesia provides a rapid effect and long-term analgesia. For this purpose, 0.25 % Longocaine heavy (“Yuria-Pharm”) 2 mg and fentanyl 20 μg are administered intrathecally, followed by 0.225 % Longocaine 10 mg and fentanyl 20 μg epidurally. The technique of epidural dural puncture is a modification of combined spinal-epidural anesthesia. This technique improves the caudal spread of analgesia compared to the epidural technique without the side effects seen with spinal-epidural anesthesia. The ideal local anesthetic should be safe for both mother and fetus, provide sufficient analgesia with minimal motor block, and not affect labor process. A single spinal injection of opioids may be effective, but it should be limited in time. The use of systemic opioids during labor increases the need for resuscitation of newborns and worsens the condition of their acid-base balance compared to basic regional anesthesia. Catheter techniques can be used in case of the increased labor duration. Nalbuphine (“Yuria-Pharm”), which eliminates the side effects of regional anesthesia, can also be successfully used. Analgesic effect of paracetamol (Infulgan, “Yuria-Pharm”) in case of intravenous administration exceeds the analgetic effect of tramadol, and the effect on the newborn condition according to the Apgar scale does not differ (Meenakshi et al., 2015). Paracetamol (Infulgan) is moderately effective for perineal pain on the first day after delivery. The possibility of use during lactation is an another advantage of paracetamol. Conclusions. 1. Pain during labor is an extremely stressful factor, so women should have access to quality analgesia and anesthesia. 2. There is no analgesic, sedative or local anesthetic that does not penetrate the placenta, affecting the fetus. 3. EDA is the gold standard of labor anesthesia. 4. Combined spinal-epidural anesthesia provides rapid effect and long-term analgesia. 5. The use of systemic opioids during labor increases the need for resuscitation of newborns and worsens the condition of their acid-base balance. 6. Nalbuphine and Infulgan have been used successfully for labor pain relief.
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Grizhimalsky, Yevhenii, et Andrii Harha. « Patient-controlled epidural analgesia for labor – a step forward in Ukrainian obstetrics ». Pain medicine 4, no 3 (1 novembre 2019) : 67–70. http://dx.doi.org/10.31636/pmjua.v4i3.5.

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Labour pain is recognized by some women as the most severe pain that they have ever felt in their life. Epidural analgesia is an effective method of pain relief in labour and is considered as the gold standard of analgesia for delivery. Traditionally, epidural analgesia in Ukraine is performed without the ability for the patient to control the process of anesthesia. The authors became interested in the delivery of local anesthetics by patient­controlled epidural analgesia instead of the traditional physician methods. In randomized controlled studies there is an evidence that the PCEA method tends to improve the quality of pain relief and increase the patient satisfaction.
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Hryzhymalskyi, Ye V. « Sedation in obstetrics and gynecology ». Infusion & ; Chemotherapy, no 3.2 (15 décembre 2020) : 63–65. http://dx.doi.org/10.32902/2663-0338-2020-3.2-63-65.

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Background. Sedation is a controlled medical depression of consciousness with the preservation of protective reflexes, independent effective breathing and response to physical stimulation and verbal commands. Requirements for sedation include rapid onset of effect, short action, minimal impact on the cardiorespiratory system, lack of delirium and emetic effect. The goals of sedation include patient comfort, minimization of pain and discomfort, anxiolysis, amnesia, control of patient behavior, rapid recovery. Objective. To describe the features of sedation in obstetrics and gynecology. Materials and methods. Analysis of literature data on this topic; own research. The study included 64 women with gynecological diseases who underwent elective surgery under regional anesthesia. Longocaine and Longocaine Heavy (“Yuria-Pharm”) were used as local anesthetics. Sedation by dexmedetomidine ("Yuria-Pharm") was used in group 1, and by propofol in group 2. Results and discussion. Cesarean section is characterized by high levels of stress. The main requirements for sedation during caesarean section include the preservation of consciousness, self-breathing and protective reflexes of the respiratory tract, minimal impact on hemodynamics, short duration of action of drugs. Subjective methods (different scales, verbal contact with the patient, assessment of pupil dilation, pulse, respiratory rate, blood pressure) and objective methods (electroencephalography, BIS spectral index) are used to determine the degree of sedation. Mandatory monitoring during sedation includes non-invasive blood pressure measurement, pulse oximetry, electrocardiography, capnography, BIS monitoring. Capnography is the most effective type of monitoring. For the safety of procedure carefully trained personnel, the device for mechanical lung ventilation, a set for ensuring passability of respiratory tracts, a defibrillator, and drugs for emergency medical care are necessary. For procedural sedation, drugs such as propofol, barbiturates, benzodiazepines, dexmedetomidine, ketamine, and inhalation anesthetics are used. The advantages of benzodiazepines are rapid effect and amnestic action, the disadvantages include the promotion of delirium and respiratory depression, no analgesic effect. The last two effects are also typical for propofol, which also causes pain in the vein during administration and the propofol infusion syndrome. The advantages of propofol include rapid onset of effect and rapid awakening, ease of titration, amnestic and antiemetic action. Ketamine also provides a rapid onset of effect and rapid awakening, and has an analgesic effect, however, causes hallucinations and hypersalivation, increased motor activity. Dexmedetomidine is an analgesic, has a sedative effect and a minimal effect on respiratory status. Disadvantages of dexmedetomidine include slow onset of effect and dose-dependent decrease in blood pressure. A number of scientific studies indicate the absence of adverse effects of dexmedetomidine during cesarean section under regional anesthesia. According to our own study, sedation with dexmedetomidine caused hypotension 26.5 % less often than sedation with propofol. Targeted sedation with dexmedetomidine caused almost no respiratory depression, whereas sedation with propofol led to moderate hypoxemia in 21 % of patients and severe hypoxemia in 35.9 % of patients. Dexmedetomidine contributed to a more pronounced reduction in pain, which can be explained by its own analgesic effect. Conclusions. 1. The goals of sedation include patient comfort, minimization of pain and discomfort, anxiolysis, amnesia, control of patient behavior, rapid recovery. 2. The main requirements for sedation during caesarean section include the preservation of consciousness, independent breathing and protective reflexes of the respiratory tract, minimal impact on hemodynamics, short duration of action of drugs. 3. Capnography is the most effective type of monitoring during sedation. 4. Sedation with dexmedetomidine caused hypotension 26.5 % less often than sedation with propofol. 5. Targeted sedation with dexmedetomidine caused almost no respiratory depression. 6. Dexmedetomidine contributed to a more pronounced reduction in pain than propofol.
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Pina-Vaz, Cid�lia, Ac�cio Gon�alves Rodrigues, Filipe Sansonetty, J. Martinez-De-Oliveira, Ant�nio F. Fonseca et Per-Anders M�rdh. « Antifungal activity of local anesthetics againstCandida species ». Infectious Diseases in Obstetrics and Gynecology 8, no 3-4 (2000) : 124–37. http://dx.doi.org/10.1002/1098-0997(2000)8:3/4<124 ::aid-idog6>3.0.co;2-g.

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Thèses sur le sujet "Anesthetics in obstetrics"

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Gutiérrez, Blancas Yazmín Salome, et Rivera Juana Olivia Hernández. « “COMPARACION DE ROPIVACAINA VS BUPIVACAINA VIA PERIDURAL PARA ANALGESIA OBSTETRICA” ». Tesis de Licenciatura, Medicina-Quimica, 2013. http://ri.uaemex.mx/handle/123456789/14029.

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OBJECTIVE: To quantify the time of labor using ropivacaine 0.2% vs 0.2% bupivacaine epidural. Assess the quality of obstetric analgesia using the ropivacaine 0.2% versus the bupivacaine 0.2% with fentanyl in the scale of EVA via epidural. MATERIAL AND METHODS: We conducted a randomized controlled clinical trial in pregnant patients of 17-35 years primigravida with 37-40 weeks gestation in labor in active phase, ASA I-II in the surgical unit of the General Hospital Ecatepec “Las Américas”. Through this simple randomization, will chosen in one of the two groups. Group R (I): 0.2% ropivacaine plus fentanyl 50mcg, and group B (II): 0.2% bupivacaine plus fentanyl 50 mcg. We compared the duration of analgesia and calculated the number of additional doses for each group, we determined the Apgar score of infant for each group and hemodynamic changes were assessed. RESULTS: Both ropivacaine & bupivacaine to 0.2% at the same concentration associated with fentanyl is highly effective in epidural analgesia in labor, being these clinically indistinguishable from one another. The duration of analgesia shows a difference between group I that was handled with ropivacaine with a half time in minutes, of 87 ± 38 compared with group II that was handled with bupivacaine 109 ± 23; was significant with P = 0.002 with Student's T test. The group I of ropivacaine shows a mean of 0.2 ± 0.4 and the group II of bupivacaine of 55 ± 0.5, with p = 0.004 being significant with Student's T test and Mann Whitney's U. With hemodynamic changes, no patient in either group showed hypotension, the hemodynamic changes were minimal in both groups presenting slightly between the groups changes in heart rate at 25 minutes, for group I of 94 ± 16 & for the group II 89 ± 5 with a value of p = 0.003 showing significant with the Student's T test. CONCLUSIONS: The total duration of sensory block was sufficient because it allowed: maintaining good analgesia in the three periods of in labor, and prevent in occasions a booster for both local anesthetics studied.
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Livres sur le sujet "Anesthetics in obstetrics"

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W, Ostheimer Gerard, et Zundert André van, dir. Pain relief and anesthesia in obstetrics. New York : Churchill Livingstone, 1996.

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H, Chestnut David, dir. Chestnut's obstetric anesthesia : Principles and practice. 4e éd. Philadelphia : Mosby / Elsevier, 2009.

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G, Hughes David, Mather S. James et Wolf Andrew R, dir. Handbook of neonatal anaesthesia. London : Saunders, 1996.

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G, Hughes David, Mather S. James et Wolf Andrew R, dir. Handbook of neonatal anaesthesia. London : Saunders, 1995.

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Sanjay, Datta, dir. Anesthetic and obstetric management of high-risk pregnancy. St. Louis : Mosby Year Book, 1991.

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1939-, Scanlon John W., dir. Perinatal anesthesia. Boston : Blackwell Scientific Publications, 1985.

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Datta, Sanjay, et David L. Hepner, dir. Anesthetic and Obstetric Management of High-Risk Pregnancy. New York, NY : Springer New York, 2004. http://dx.doi.org/10.1007/b97286.

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Sanjay, Datta, dir. Anesthetic and obstetric management of high-risk pregnancy. 2e éd. St. Louis : Mosby, 1996.

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H, Diaz James, dir. Perinatal anesthesia and critical care. Philadelphia : Saunders, 1991.

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Van, Zunder, et Andre Van Zundert. Pain Relief in Anesthesia in Obstetrics. W.B. Saunders Company, 1996.

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Chapitres de livres sur le sujet "Anesthetics in obstetrics"

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Crawford, J. S. « Volatile Anesthetics in Pregnancy and Obstetrics ». Dans Inhalation Anesthetics, 264–69. Berlin, Heidelberg : Springer Berlin Heidelberg, 1987. http://dx.doi.org/10.1007/978-3-642-71232-6_30.

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Datta, Sanjay, Bhavani Shankar Kodali et Scott Segal. « Local Anesthetic Pharmacology ». Dans Obstetric Anesthesia Handbook, 15–28. New York, NY : Springer New York, 2009. http://dx.doi.org/10.1007/978-0-387-88602-2_2.

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Cosgrove, Susan, et Richard Smiley. « Prior Anesthetic Problems ». Dans Consults in Obstetric Anesthesiology, 479–83. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-59680-8_129.

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Kodali, Bhavani Shankar, et Scott Segal. « Local Anesthetic Pharmacology ». Dans Datta's Obstetric Anesthesia Handbook, 19–33. Cham : Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-41893-8_2.

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Wasson, Cassandra, Albert Kelly, David Ninan et Quy Tran. « Pharmacology of Local Anesthetic Drugs ». Dans Absolute Obstetric Anesthesia Review, 27–29. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-96980-0_12.

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Wasson, Cassandra, Albert Kelly, David Ninan et Quy Tran. « Pharmacology of Local Anesthetic Adjuvants ». Dans Absolute Obstetric Anesthesia Review, 31–33. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-96980-0_13.

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Wasson, Cassandra, Albert Kelly, David Ninan et Quy Tran. « Influence of Anesthetic Technique on Labor ». Dans Absolute Obstetric Anesthesia Review, 73. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-96980-0_24.

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Murugan, Shobana, Lisa Mouzi Wofford, Sandeep Markan et Yi Deng. « Anesthetic Considerations in the Critically Ill Gravida with Cardiac Disease ». Dans Critical Care Obstetrics, 731–53. Chichester, UK : John Wiley & Sons, Ltd, 2018. http://dx.doi.org/10.1002/9781119129400.ch44.

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Lerman, J. « New Inhalational Anesthetics in Infants and Children ». Dans Pediatric and Obstetrical Anesthesia, 265–76. Dordrecht : Springer Netherlands, 1995. http://dx.doi.org/10.1007/978-94-011-0319-0_19.

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Hickey, P. R. « Anesthetic Considerations in Congenital Heart Disease ». Dans Pediatric and Obstetrical Anesthesia, 335–43. Dordrecht : Springer Netherlands, 1995. http://dx.doi.org/10.1007/978-94-011-0319-0_26.

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Actes de conférences sur le sujet "Anesthetics in obstetrics"

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Cavanagh, Daniel P., Asena Abay, Jessica M. Brito, Jasmine R. Joyner, Jordyn N. Nally et Xianren Wu. « A Novel Epidural Catheter Fixation Device ». Dans 2017 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/dmd2017-3490.

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Epidurals are a method of long-term pain relief administered by injecting and continuously delivering an anesthetic via catheter in the spine. This method of pain relief is often used for patients in the Obstetrics/Gynecology unit as well as those in pre- and post-operational care. For almost 2 million singleton vaginal deliveries across 27 states in 2008 (representing 65% of all US singleton vaginal births in 2008), 61% of patients received some form of an epidural or spinal injection [1]. Additionally, this number has been increasing. For the 18 states for which 2006 and 2008 data are available, the average of the state-level increases in epidural/spinal injections is approximately 4.2% revealing an overall increase in these injections. Just between 2000 and 2010, the use of epidural injections increased by 160% [2]. Commonly, epidural catheters are inserted into the patient’s back in the appropriate location and then secured to the body with an adhesive medical dressing. Movement and subsequent dislocation of the catheter beneath the adhesive medical dressing can result in inefficient anesthetic delivery, increased patient discomfort, and repeated administration of the epidural. Secondary migration of epidural catheters is a problem responsible for failure in approximately 6.8% of epidurals administered [3]. Requiring an anesthesiologist to repeat the procedure is also an increased cost. A solution to secondary migration of epidural catheters would ensure effective delivery of the anesthetic to the patient, reduce the need for a repeated procedure, and prevent unwanted additional healthcare expenses.
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