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Articles de revues sur le sujet « Anesthetics in obstetrics »

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

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1

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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Smiley, R. M., et Imre Redai. « More failed spinal anesthetics with hyperbaric bupivacaine ». International Journal of Obstetric Anesthesia 13, no 2 (avril 2004) : 132–34. http://dx.doi.org/10.1016/j.ijoa.2004.01.004.

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Dickmann, Zeev, et Paul F. Terranova. « Ovulation blockade through synergism of cycloheximide with assorted anesthetics ». Contraception 41, no 2 (février 1990) : 189–95. http://dx.doi.org/10.1016/0010-7824(90)90147-n.

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Cohen, S., et David Amar. « A974 A COMPARISON BETWEEN GRAVITY AND BOLUS ADMINISTRATION OF LOCAL ANESTHETICS DURING EPIDURAL BLOCK IN OBSTETRICS ». Anesthesiology 73, no 3A (1 septembre 1990) : NA. http://dx.doi.org/10.1097/00000542-199009001-00972.

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Reale, Sharon C., Melissa E. Bauer, Thomas T. Klumpner, Michael F. Aziz, Kara G. Fields, Rachel Hurwitz, Manal Saad, Sachin Kheterpal et Brian T. Bateman. « Frequency and Risk Factors for Difficult Intubation in Women Undergoing General Anesthesia for Cesarean Delivery : A Multicenter Retrospective Cohort Analysis ». Anesthesiology 136, no 5 (21 février 2022) : 697–708. http://dx.doi.org/10.1097/aln.0000000000004173.

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Background Estimates for the incidence of difficult intubation in the obstetric population vary widely, although previous studies reporting rates of difficult intubation in obstetrics are older and limited by smaller samples. The goals of this study were to provide a contemporary estimate of the frequency of difficult and failed intubation in women undergoing general anesthesia for cesarean delivery and to elucidate risk factors for difficult intubation in women undergoing general anesthesia for cesarean delivery. Methods This is a multicenter, retrospective cohort study utilizing the Multicenter Perioperative Outcomes Group database. The study population included women aged 15 to 44 yr undergoing general anesthesia for cesarean delivery between 2004 and 2019 at 1 of 45 medical centers. Coprimary outcomes included the frequencies of difficult and failed intubation. Difficult intubation was defined as Cormack–Lehane view of 3 or greater, three or more intubation attempts, rescue fiberoptic intubation, rescue supraglottic airway, or surgical airway. Failed intubation was defined as any attempt at intubation without successful endotracheal tube placement. The rates of difficult and failed intubation were assessed. Several patient demographic, anatomical, and obstetric factors were evaluated for potential associations with difficult intubation. Results This study identified 14,748 cases of cesarean delivery performed under general anesthesia. There were 295 cases of difficult intubation, with a frequency of 1:49 (95% CI, 1:55 to 1:44; n = 14,531). There were 18 cases of failed intubation, with a frequency of 1:808 (95% CI, 1:1,276 to 1:511; n = 14,537). Factors with the highest point estimates for the odds of difficult intubation included increased body mass index, Mallampati score III or IV, small hyoid-to-mentum distance, limited jaw protrusion, limited mouth opening, and cervical spine limitations. Conclusions In this large, multicenter, contemporary study of more than 14,000 general anesthetics for cesarean delivery, an overall risk of difficult intubation of 1:49 and a risk of failed intubation of 1:808 were observed. Most risk factors for difficult intubation were nonobstetric in nature. These data demonstrate that difficult intubation in obstetrics remains an ongoing concern. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New
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Rodrigues, Acácio, Cidália Pina Vaz, A. Freitas Fonseca, J. Martinez de Oliveira et Henrique Barros. « In Vitro Effect of Local Anesthetics onCandida albicansGerm Tube Formation ». Infectious Diseases in Obstetrics and Gynecology 1, no 4 (1994) : 193–97. http://dx.doi.org/10.1155/s1064744994000074.

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Objective:This study was planned to clarify the in vitro effect of lidocaine and bupivacaine on germ tube formation byCandida albicansisolates from cases of clinical vaginal candidiasis.Methods:FourteenC. albicansstrains (clinical vaginal isolates) were grown on Sabouraud agar for 24 h at 37℃ and tested as follows: 100 μl of a yeast suspension [105colony forming units (CFU)/ml of phosphate buffered saline (PBS)] was added to 500 μl of fresh human serum with lidocaine or bupivacaine (pure salts) in serial concentrations. The test was run in duplicate. Controls were prepared for each strain. After 4 h of incubation at 37℃, samples were taken from each vial and 200 yeasts were counted in a counting chamber. The pH of each suspension was measured.Results:The results are given as the mean of the 2 readings and are expressed as the percentage of blastoconidia with germ tubes/total blastoconidia.Conclusions:Our experiments show that both lidocaine and bupivacaine have a dose-dependent inhibitory effect, pH-independent, on germ tube formation byC. albicansand that both drugs seem to be promising in the treatment of genital candidiasis due to the combination of anesthetic and antifungal properties.
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Fuchi, Isao, et Kiichiro Noda. « Labor Control under Epidural Anesthesia : Placental Transfer and Newborn Metabolism of Local Anesthetics ». Asia-Oceania Journal of Obstetrics and Gynaecology 13, no 4 (24 mai 2010) : 427–32. http://dx.doi.org/10.1111/j.1447-0756.1987.tb00286.x.

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Browne, Ingrid M., et David J. Birnbach. « A pregnant woman with previous anaphylactic reaction to local anesthetics : A case report ». American Journal of Obstetrics and Gynecology 185, no 5 (novembre 2001) : 1253–54. http://dx.doi.org/10.1067/mob.2001.115115.

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Ayu Rosema Sari, Dewi Yulianti Bisri et Yusmein Uyun. « Perioperatif Anestesia pada Pasien Seksio Sesarea dengan Skizofrenia ». Jurnal Anestesi Obstetri Indonesia 3, no 2 (17 septembre 2020) : 89–95. http://dx.doi.org/10.47507/obstetri.v3i2.46.

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Pasien hamil dengan gangguan kejiwaan menjadi kasus yang menantang bagi ahli anestesi obstetri. Seorang ahli anestesi obstetri harus menyadari aspek hukum, etika, dan medis dari kondisi tersebut dan menyelesaikan setiap masalah secara individual. Penilaian pra operasi dan persiapan harus disesuaikan dengan jenis gangguan pasien. Pilihan teknik anestesi tergantung pada status mental pasien, dan perawatan pasca operasi (pemberian obat anti nyeri dan kelanjutan terapi medis penyakit kejiwaan) harus dikelola dengan baik. Seorang wanita 37 tahun, G2P1A0 hamil 40 minggu dengan skizofrenia dilakukan tindakan seksio sesarea, pasien rutin mengkonsumsi obat antipsikotik. Pasien sempat mengalami penundaan operasi karena tidak kooperatif sehingga dikonsulkan ulang ke psikiater. Teknik pembiusan dengan spinal anestesi menggunakan bupivacaine heavy 10mg. Selama operasi berlangsung hemodinamik stabil, tekanan darah sistolik 100–130 mmHg, diastolik 60–90 mmHg, nadi 80–95x/menit, laju nafas 16–20x/menit dengan saturasi oksigen 100%. Bayi lahir 2 menit setelah insisi dengan Apgar score 8/10. Penanganan pasien skizofrenia yang akan dilakukan tindakan seksio sesarea membutuhkan pemahaman yang baik agar tidak terjadi morbiditas maupun mortalitas, mengingat gangguan kejiwaan adalah hal yang cukup lazim terjadi. Perioperative Anesthesia in Cesarean Section Patients with Schizophrenia Abstract Pregnant patients with psychiatric disorders present as challenging cases for obstetric anesthetists. An obstetric anesthetist should be aware of legal, ethical, and medical aspects of the conditions and solve each problem on a individual basis. Preoperative assessment and the preparation should be adjusted according to the type of patient’s disorder. Choice of anesthetic technique should actively be dependent on the mental status of the patient, and postoperative care should be attentively managed regarding pain relief and continuation of medical therapy for the psychiatric disease. A 37-year-old woman, G2P1A0, 40 weeks pregnant with schizophrenia, was performed a cesarean section, patient taking antipsychotic drugs. Anesthetic technique with spinal anesthesia uses Bupivacaine heavy 10mg. During the operation hemodynamically stable, systolic blood pressure 100-130 mmHg, diastolic 60-90 mmHg, pulse 80-95x/min, breathing rate 16-20x/min with 100% oxygen saturation. The baby is born 2 minutes after incision with an Apgar score 8/10. Management of schizophrenia patients who will undergo cesarean section requires a good understanding to prevent morbidity and mortality, considering psychiatric disorders are quite common.
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Fauza, Dario O., Daniel S. Kohane, Elizabeth B. Beeuwkes, Nicholas Clayton et Timothy J. Maher. « Local Anesthetics Inhibit Uterine Activity in vitro ». Fetal Diagnosis and Therapy 18, no 5 (2003) : 292–96. http://dx.doi.org/10.1159/000071968.

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Shantikaratri, Emilia T., Ruddi H et Isngadi. « The Role Anesthesiologist in Management of Obstetric Haemorrhage : A Literature Review ». Majalah Anestesia & ; Critical Care 42, no 1 (28 février 2024) : 68–80. http://dx.doi.org/10.55497/majanestcricar.v42i1.324.

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Hemorrhagic shock in obstetrics is still a major cause of maternal mortality and morbidity worldwide. Recognition of bleeding in obstetric patients is complicated by the normal physiologic changes that occur during pregnancy. Visual estimates of blood loss are often erroneous and underestimated because of contamination with amniotic fluid, or internal or hidden blood loss. Thus, careful clinical observation and a high index of suspicion are required for the early detection and management of obstetric hemorrhage. The usage of ultrasound (US) is considered as the first line method for detecting abnormal condition which might serve as a predictor for hemorrhagic shock. Despite of careful risk assessment given, obstetric-specific bleeding protocols, such as resuscitation and blood transfusion, are required to facilitate the integration and timely escalation interventions. The intervention of choice for hemorrhagic shock in obstetrics encompasses a wide variety of options, such as the usage of tranexamic acid, cell salvage, resuscitative endovascular balloon occlusion of the aorta (REBOA), anesthetic management, and surgical, as well as radiological provides multiple available approach, each with their own risk and advantages. The purpose of this review is to describe the management of obstetric hemorrhage from anesthetic point of view, encompassing the identification of patients at risk, resuscitative management, and perioperative management.
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Humaidan, Peter S., Leif Bungum et Kirsten B. Andersen. « Electro-acupuncture for ovum pick-up—a good alternative to conventional anesthetics ». Fertility and Sterility 80 (septembre 2003) : 95. http://dx.doi.org/10.1016/s0015-0282(03)01192-0.

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Skavinska, O., L. Fishchuk, Y. Cherniavska, V. Pokhylko, O. Yevseienkova et Z. Rossokha. « PHARMACOGENETICS OF ANESTHESIOLOGICAL SUPPORT ». Neonatology, Surgery and Perinatal Medicine 14, no 1(51) (8 avril 2024) : 131–40. http://dx.doi.org/10.24061/2413-4260.xiv.1.51.2024.19.

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Pharmacogenetics studies the relationship between a person’s individual genetic characteristics and the human body’sresponse to the action of various drugs, particularly the occurrence of undesirable side eff ects. Thanks to the development of the latest technologies and methods, this branch of medical genetics and clinical pharmacology is developing very actively. Data are being accumulated, special databases are being created with the aim of creating individual genetic passports in the future, which will allow the selection of personalized treatment schemes.Anesthesiology is a special area of pharmacogenetic research because, more than any other medical specialty, it ischaracterized by polypharmacy-the simultaneous or sequential administration of many drugs. The same dose of a drug may be inadequate for some patients and may be life-threatening or cause unwanted side eff ects for others. Today, information about genetic factors is being used by clinicians to prescribe drugs to tailor drug therapy to a patient’s genome. In anesthesiology, the principles of pharmacogenetics have been explained for neuromuscular blocking agents, opioid metabolism, different types of anesthetics, and postoperative nausea and vomiting. On the other hand, a large number of anesthetics have a narrow therapeutic index.This review summarizes the most recent data from the scientifi c literature on the pharmacogenetics of diff erent types ofanesthetics. Inhalational anesthetics are halogenated derivatives of methyl ethyl ether, the exact mechanism of action of which is not yet fully understood. One of the rare but very serious side eff ects of all halogenated anesthetics is malignant hyperthermia, a genetically determined autosomal dominant disorder that manifests as a hypermetabolic response to drug administration. The dosage of intravenous anesthetics should also be carefully determined, taking into account the patient’s age, cardiovascular, hepatic, and renal status, concomitant drug therapy, and genetic factors. Ontogeny and genetic variability of drug-metabolizing enzymes are interrelated because genetic variability in drug-metabolizing enzyme expression cannot be assessed until the required protein is suffi ciently expressed. Pharmacogenetic variants may contribute to unpredictable drug exposure at the same weight- based drug dose.There are a number of potentially clinically applicable pharmacogenetic data in newborns, but more research is needed toconfi rm these fi ndings and understand how to incorporate them into clinical care.The selection of drugs and dosing regimens based on a patient’s pharmacogenomic profi le may be an important part of thefuture of medicine. Personalized treatment based on the specifi c variants in the genome will ultimately reduce the incidence of side eff ects and length of hospital stay for patients and save healthcare costs. Although pharmacogenomics and its application in clinical practice are still in their infancy, different variants and their implications for many clinical areas, including anesthesiology, are emerging every day.
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mahdy, enas, zeinb Abd-Elwahab et Nahed Abo-Elmaety. « Local anesthetics and regional anesthesia versus conventional analgesia For preventing persistent postoperative pain (Meta-analysis) ». Benha Medical Journal 39, no 1 (1 mars 2022) : 204–16. http://dx.doi.org/10.21608/bmfj.2021.91063.1458.

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Goodman, E. J., M. R. Jacobs, S. Bajaksouzian, A. R. Windau et J. P. Dagirmanjian. « Clinically significant concentrations of local anesthetics inhibit Staphylococcus aureus in vitro ». International Journal of Obstetric Anesthesia 11, no 2 (avril 2002) : 95–99. http://dx.doi.org/10.1054/ijoa.2001.0934.

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Singh, Sukhdip, Shagufta Y. Chaudry, Amy L. Phelps et Manuel C. Vallejo. « A 5-Year Audit of Accidental Dural Punctures, Postdural Puncture Headaches, and Failed Regional Anesthetics at a Tertiary-Care Medical Center ». Scientific World JOURNAL 9 (2009) : 715–22. http://dx.doi.org/10.1100/tsw.2009.94.

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Obstetric anesthesia-related complications occur as a result of labor epidural or spinal placement. The purpose of this continuous quality-improvement audit was to review the occurrence of accidental dural punctures (ADPs), postdural puncture headaches (PDPHs), and failed regional anesthetics at an academic tertiary-care medical center over a 5-year period. Obstetric anesthesia complications contained in three databases consisting of ADPs, PDPHs, and failed regional anesthetics were matched to a perinatal database, with no complications serving as controls. Of the 40,894 consecutive parturients, there were 765 documented complications. Complication rates were 0.73% (95% CI: 0.65–0.82) for ADP, 0.49% (95% CI: 0.43–0.56) for PDPH, and 0.65% (95% CI: 0.57–0.73) for failed regional anesthetic. When compared to the no complication group, factors associated with obstetric anesthesia complications included increased weight and BMI (p< 0.01), epidural block (p< 0.01), and vaginal delivery (p< 0.01).
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Lichtenberg, E. Steve, Lawrence J. Hill, Michelle Howe, Walter Heber et Jeffrey F. Peipert. « A randomized comparison of propofol and methohexital as general anesthetics for vacuum abortion ». Contraception 68, no 3 (septembre 2003) : 211–17. http://dx.doi.org/10.1016/s0010-7824(03)00139-2.

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Wiebe, Ellen R. « Comparison of the efficacy of different local anesthetics and techniques of local anesthesia in therapeutic abortions ». American Journal of Obstetrics and Gynecology 167, no 1 (juillet 1992) : 131–34. http://dx.doi.org/10.1016/s0002-9378(11)91645-7.

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Fuchi, Isao, et Kiichiro Noda. « Placental Transfer and Newborn Metabolism of Local Anesthetics when used for Cesarean Section under Epidural Anesthesia ». Asia-Oceania Journal of Obstetrics and Gynaecology 11, no 4 (décembre 1985) : 525–31. http://dx.doi.org/10.1111/jog.1985.11.4.525.

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Johnson, R. F., H. V. Johnson, T. L. Arney, N. Herman et J. W. Downing. « The effect of pH on the human placental transfer of local anesthetics ». Placenta 15, no 7 (octobre 1994) : A35. http://dx.doi.org/10.1016/0143-4004(94)90112-0.

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Bisch, Steven Peter, Joni Kooy, Sarah Glaze, Anna Cameron, Pamela Chu, Prafull Ghatage, Jill Nation, Gregg Nelson et Garrett M. Fitzmaurice. « Impact of transversus abdominis plane blocks versus non-steroidal anti-inflammatory on post-operative opioid use in ERAS ovarian cancer surgery ». International Journal of Gynecologic Cancer 29, no 9 (11 septembre 2019) : 1372–76. http://dx.doi.org/10.1136/ijgc-2019-000724.

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BackgroundTreatment of ovarian cancer often requires extensive surgical resection. The transversus abdominis plane (TAP) block has been utilized in benign gynecologic surgery to decrease post-operative pain and opioid use. We hypothesized that TAP blocks would decrease total opioid use in the first 24 hours and decrease length of stay following staging and cytoreductive surgery for ovarian cancer compared with either no local anesthetic or local wound infiltration alone.MethodsAll patients undergoing surgery for ovarian cancer from November 2016 to June 2017 were included in this retrospective cohort study. Median opioid use at 24, 48, and 72 hours post-operatively, as well as length of stay, were assessed. Multivariate median regression analysis was performed to adjust for potential confounders: post-operative non-steroidal anti-inflammatory drug (NSAID) usage, pre-operative opioid consumption, and extent of cytoreductive surgery. Length of stay was compared using Cox regression analysis.ResultsOne-hundred-and-twenty patients were included in the analysis. Eighty-two patients had a TAP block, while 38 did not. After adjusting for potential confounders there was no difference in median 24 hours opioid consumption (p=0.29) or length of stay (HR 0.95, p=0.78) between patients receiving TAP block compared with those without. After adjusting for potential confounders, patients receiving scheduled NSAIDs had a 2.6-fold greater likelihood of being discharged (p<0.0005) and a significant reduction in median opioid use at 24 hours (23.5 vs 14.5 mg) (p=0.017) compared with those patients without NSAIDs.DiscussionPost-operative administration of NSAIDs, but not TAP block, was associated with a decrease in post-operative opioid use and length of stay following surgery for ovarian cancer. Further investigation into alternative regional anesthetics for Enhanced Recovery after Surgery (ERAS) protocols is warranted.
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Laszlo, Adam, Nediljka Buljubasic, Bela Zsolnai, John P. Kampine et Zeljko J. Bosnjak. « Interactive effects of volatile anesthetics, verapamil, and ryanodine on contractility and calcium homeostasis of isolated pregnant rat myometrium ». American Journal of Obstetrics and Gynecology 167, no 3 (septembre 1992) : 804–10. http://dx.doi.org/10.1016/s0002-9378(11)91593-2.

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McPherson, Christopher, et Ruth E. Grunau. « Neonatal Pain Control and Neurologic Effects of Anesthetics and Sedatives in Preterm Infants ». Clinics in Perinatology 41, no 1 (mars 2014) : 209–27. http://dx.doi.org/10.1016/j.clp.2013.10.002.

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Borkar Patil, Vijaya P., et Jayshree J. Upadhye. « Anesthetic complications in cesarean section ». International Journal of Research in Medical Sciences 6, no 10 (25 septembre 2018) : 3215. http://dx.doi.org/10.18203/2320-6012.ijrms20183849.

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Background: Obstetric anesthetists need to face with the unique situation of providing anesthesia for caesarean sections, where they have to provide care for both the mother and the unborn baby. This study was performed in 100 women who underwent cesarean section, either elective or emergency to evaluate type of anesthesia, anesthetic complications and neonatal outcome.Methods: A retrospective study was conducted in 100 women with singleton pregnancy undergoing cesarean section in the department of Anesthesiology in collaboration with department of Obstetrics and gynecology at Dr PDMMC and Hospital, Amravati from January 2017 to March 2018. Detailed information regarding medical and obstetric history, intrapartum course, postpartum complications diagnosed before hospital discharge, and infant outcome were collected directly from maternal and infant charts. Other details like age of the patient, parity, type of cesarean section and type of anesthesia was noted. American Society of Anesthesiologists (ASA) scores and type of anesthesia was noted.Results: In our study, spinal anesthesia was given in 62 (62%) patients, epidural anesthesia was given in 20 (20%) patients, combined spinal-epidural anesthesia was given in 10 (10%) patients while general anesthesia was given in 8 (8%) patients. Anesthetic complications were less. About 10 (10%) patients had spinal headache, 4 (4%) patients had failed regional anesthesia, 2 (2%) patients had failed intubation while 2 (2%) patients had high spinal anesthesia. Babies of 96 (96%) patients had Apgar score at 5 minutes of more than 7 and babies of 4 (4%) patients had Apgar score at 5 minutes of less than 7. Only babies of 2 (2%) patients required intubation for resuscitation.Conclusions: This study provides strong evidence that the guidelines recommending regional block over GA for most cesarean section. It is beneficial for neonates as well as for mothers.
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Langhoff-roos, Jens, et Gunilla Lindmark. « Analgesia and maternal side effects of pudendal block at delivery : A comparison of three local anesthetics ». Acta Obstetricia et Gynecologica Scandinavica 64, no 3 (janvier 1985) : 269–73. http://dx.doi.org/10.3109/00016348509155127.

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Strümper, D., F. Louwen, M. E. Durieux, H. F. Gramke, J. Stuessel, D. Marcus-Soekarman, H. van Aken et M. A. E. Marcus. « Epidural Local Anesthetics : A Novel Treatment for Fetal Growth Retardation ? » Fetal Diagnosis and Therapy 20, no 3 (2005) : 208–13. http://dx.doi.org/10.1159/000083907.

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Fehm, Tanja N., Manfred Welslau, Volkmar Müller, Diana Lüftner, Florian Schütz, Peter A. Fasching, Wolfgang Janni et al. « Update Breast Cancer 2022 Part 5 – Early Stage Breast Cancer ». Geburtshilfe und Frauenheilkunde 83, no 03 (mars 2023) : 289–98. http://dx.doi.org/10.1055/a-2018-9053.

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AbstractThe treatment of patients with early stage breast cancer has changed in recent years due to the introduction of pembrolizumab, olaparib, and abemaciclib. These and other drugs with the same class of active ingredient are currently in trial for various indications. This review article summarizes the latest results that have either been presented at major conferences such as the ESMO 2022 or published recently in international journals. This includes reports on newly discovered breast cancer genes, atezolizumab in neoadjuvant therapy in HER2-positive patients, long-term data from the APHINITY study, and on how preoperative peritumoral application of local anesthetics can influence the prognosis. We also present solid data on dynamic Ki-67 from the ADAPT studies.
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Lee, Lorri A., Karen L. Posner, Karen B. Domino, Robert A. Caplan et Frederick W. Cheney. « Injuries Associated with Regional Anesthesia in the 1980s and 1990s ». Anesthesiology 101, no 1 (1 juillet 2004) : 143–52. http://dx.doi.org/10.1097/00000542-200407000-00023.

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Background The authors used the American Society of Anesthesiologists Closed Claims Project database to identify specific patterns of injury and legal liability associated with regional anesthesia. Because obstetrics represents a unique subset of patients, claims with neuraxial blockade were divided into obstetric and nonobstetric groups for comparison. Methods The American Society of Anesthesiologists Closed Claims Project is a structured evaluation of adverse anesthetic outcomes collected from closed anesthesia malpractice insurance claims of professional liability companies. An in-depth analysis of 1980-1999 regional anesthesia claims was performed with a subset comparison between obstetric and nonobstetric neuraxial anesthesia claims. Results Of the total 1,005 regional anesthesia claims, neuraxial blockade was used in 368 obstetric claims and 453 of 637 nonobstetric claims (71%). Damaging events in 51% of obstetric and 41% of nonobstetric neuraxial anesthesia claims were block related. Obstetrics had a higher proportion of neuraxial anesthesia claims with temporary and low-severity injuries (71%) compared with the nonobstetric group (38%; P &lt;or=0.01) and a lower proportion of claims with death or brain damage and permanent nerve injury compared with the nonobstetric group (P &lt;or= 0.01). Cardiac arrest associated with neuraxial block was the primary damaging event in 32% of obstetric and 38% of nonobstetric neuraxial anesthesia claims involving death or brain damage. Eye blocks accounted for 5% of regional anesthesia claims. Conclusion Obstetric claims were predominately associated with minor injuries. Permanent injury from eye blocks increased in the 1990s. Neuraxial cardiac arrest and neuraxial hematomas associated with coagulopathy remain sources of high-severity injury.
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Alas, Alexandriah, Laura Martin, Hemikaa Devakumar, Lawrence Frank, Sneha Vaish, Neeraja Chandrasekaran, G. Willy Davila et Eric Hurtado. « Anesthetics' role in postoperative urinary retention after pelvic organ prolapse surgery with concomitant midurethral slings : a randomized clinical trial ». International Urogynecology Journal 31, no 1 (23 mars 2019) : 205–13. http://dx.doi.org/10.1007/s00192-019-03917-w.

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Mena, Shayla, Ana Costa, Michelle DeLemos, Joy Schabel et Morgane Factor. « Labor Analgesia in Brugada Syndrome and the Importance of Contingency Planning ». Case Reports in Anesthesiology 2022 (15 juillet 2022) : 1–7. http://dx.doi.org/10.1155/2022/8940704.

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Brugada syndrome is an autosomal dominant disorder that affects cardiac sodium channels and predisposes patients to an increased risk of sudden cardiac death. Obstetric anesthesia management in patients with Brugada syndrome poses a challenge due to the prevalence of local anesthetic use for labor analgesia or cesarean section. However, central neuraxial techniques and local anesthetics have been used safely in parturients with this syndrome and may be offered to patients during preadmission counseling. We present the case of a primigravida who opted for further labor analgesia via a combined spinal-epidural technique. To our knowledge, this is the first case report of a lidocaine infusion administered via an epidural catheter to a laboring parturient with Brugada syndrome. We further discuss the use of local anesthetics, other medications, and central neuraxial techniques in those with Brugada syndrome to assist anesthesiologists caring for expectant mothers.
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Zacharakis, Dimitrios, Anastasia Prodromidou, Athanasios Douligeris, Stavros Athanasiou, Sophia Hadzilia, Nikolaos Kathopoulis, Veatriki Athanasiou et Themos Grigoriadis. « Preemptive Infiltration of Local Anesthetics During Vaginal Hysterectomy : A Systematic Review and Meta-analysis of Randomized Controlled Trials ». Obstetrical & ; Gynecological Survey 78, no 1 (janvier 2023) : 22–23. http://dx.doi.org/10.1097/ogx.0000000000001118.

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Davies, Joanna M., Karen L. Posner, Lorri A. Lee, Frederick W. Cheney et Karen B. Domino. « Liability Associated with Obstetric Anesthesia ». Anesthesiology 110, no 1 (1 janvier 2009) : 131–39. http://dx.doi.org/10.1097/aln.0b013e318190e16a.

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Background Obstetrics carries high medical liability risk. Maternal death and newborn death/brain damage were the most common complications in obstetric anesthesia malpractice claims before 1990. As the liability profile may have changed over the past two decades, the authors reviewed recent obstetric claims in the American Society of Anesthesiologists Closed Claims database. Methods Obstetric anesthesia claims for injuries from 1990 to 2003 (1990 or later claims; n = 426) were compared to obstetric claims for injuries before 1990 (n = 190). Chi-square and z tests compared categorical variables; payment amounts were compared using the Kolmogorov-Smirnov test. Results Compared to pre-1990 obstetric claims, the proportion of maternal death (P = 0.002) and newborn death/brain damage (P = 0.048) decreased, whereas maternal nerve injury (P &lt; 0.001) and maternal back pain (P = 0.012) increased in 1990 or later claims. In 1990 or later claims, payment was made on behalf of the anesthesiologist in only 21% of newborn death/brain damage claims compared to 60% of maternal death/brain damage claims (P &lt; 0.001). These payments in both groups were associated with an anesthesia contribution to the injury (P &lt; 0.001) and substandard anesthesia care (P &lt; 0.001). Anesthesia-related newborn death/brain damage claims had an increased proportion of delays in anesthetic care (P = 0.001) and poor communication (P = 0.007) compared to claims unrelated to anesthesia. Conclusion Newborn death/brain damage has decreased, yet it remains a leading cause of obstetric anesthesia malpractice claims over time. Potentially preventable anesthetic causes of newborn injury included delays in anesthesia care and poor communication between the obstetrician and anesthesiologist.
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Nastoulis, Evangelos, Gregory Tsoucalas, Valeria Karakasi, Pavlos Pavlidis et Aliki Fiska. « Complete dorsal wall agenesis of the sacral canal in a Greek population : an osteological study ». Folia Medica 66, no 3 (30 juin 2024) : 386–94. http://dx.doi.org/10.3897/folmed.66.e118790.

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Introduction: The failure of closure of the dorsal wall of the sacral canal (SC) has been known since the eve of modern osteology, appearing in prehistoric times. Variants include partial or complete absence of the dorsal wall of the SC. SC presents a pathway for minimally invasive therapeutic and diagnostic procedures for spinal diseases and for ensuring analgesia and anesthesia in operations, including labor and genitourinary surgery. Aim: Our objective is to verify the incidence of complete agenesis of the SC dorsal wall in Greek population. Material and methods: We collected 155 adult dry sacra of known sex from the Third Cemetery of Athens for the study of the dorsal wall of the sacrum. Damaged or variated sacra were excluded. We also performed an exhaustive review of the relevant literature and compared our results with those of international studies. Results: Complete dorsal wall agenesis of the sacral canal was found in three cases (1.93%), two men (1.29%) and one woman (0.64%). Our review examines its incidence in other populations and explores the possibility of regional or racial correlation. Conclusion: Knowing the complete dorsal wall agenesis of the sacral canal by medical professionals is crucial for avoiding complications in spinal surgery, anesthetics and obstetrics, as well as in the differential diagnosis of neurological and urological diseases.
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Reyes Espinoza, Ixchel Suyapa. « Obstetric Hemorrhage, its role in maternal morbidity and mortality and the importance of its diagnosis, prevention and timely management ». Mexican Journal of Medical Research ICSA 8, no 15 (5 janvier 2020) : 37–44. http://dx.doi.org/10.29057/mjmr.v8i15.3906.

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Background: In recent years, different international and national campaigns have been implemented to combat obstetric haemorrhage. Maternal mortality (MM) is one of the main concerns of public health and represents a good indicator to measure the quality of care, an indicator that also allows to establish the socioeconomic differences between countries. There are still many activities to be carried out and achieve the objective set by the World Health Organization (WHO) and the Latin American Federation of Societies in Obstetrics and Gynaecology (FLASOG) "Zero deaths due to haemorrhage". Objective: Based on the scientific evidence available, deepen the knowledge of the role of obstetric haemorrhage as the main avoidable cause of maternal morbidity and mortality. Methodology: retrospective study through the search of original articles and systematic reviews in: Elsevier, Lancet, Intramed, PubMed, EMBASE, ScienceDirect and Cochrane Library. The following keywords were used for all sites: "Obstetric haemorrhage", "Maternal mortality and obstetric haemorrhage", "Maternal morbidity and obstetric haemorrhage", "Postpartum, late, secondary haemorrhage". The items with the highest level of evidence were selected. Conclusions: Obstetric haemorrhage is still a potential cause of maternal and fetal morbidity and mortality. Its appearance at any time of pregnancy is a cause for concern and alarm. Despite advances in obstetric and anesthetic care, its treatment remains a challenge for the surgical team, anesthesiologist, gynaecologist and Pediatrician.
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OKUTOMI, Toshiyuki. « Obstetric Anesthetic Skills ». JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA 26, no 4 (2006) : 353–59. http://dx.doi.org/10.2199/jjsca.26.353.

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Boulton, T. B. « Obstetric anesthetic services. » BMJ 293, no 6546 (30 août 1986) : 560. http://dx.doi.org/10.1136/bmj.293.6546.560.

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Hopkin, D. A. « Obstetric anesthetic services. » BMJ 293, no 6551 (4 octobre 1986) : 886. http://dx.doi.org/10.1136/bmj.293.6551.886-b.

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Sibiryakov, Mikhail M., Igor M. Milstein, Mikhail I. Barashkin et Ekaterina S. Eroshenko. « Experience in the use of non-inhalation anesthesia in rabbits ». Veterinariya, Zootekhniya i Biotekhnologiya 6, no 103 (2022) : 18–24. http://dx.doi.org/10.36871/vet.zoo.bio.202206002.

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The article describes the experience of conducting and developing a scheme for long-term intravenous anesthesia in rabbits within the framework of the scientific and practical school "The Art of Lung Ventilation" in cooperation with the Ural Research Institute for Maternal and Infant Health (SRI OMM) and with the support of LLC Shvabe-Yekaterinburg. In the course of the experiment, the analysis of the effect on rabbits of the developed scheme of long-term intravenous anesthesia was performed. It is worth noting that none of the drugs listed in the scheme can be used as mononarcosis; the desired result can be obtained only in the combined use of drugs according to the proposed method. The work was performed at the Department of Surgery, Obstetrics and Microbiology of the Faculty of Veterinary Medicine and Expertise of the Ural State Agrarian University from September to November 2021. During the entire period of the presented experience, it was not possible to identify clinically significant complications, except for severe hypothermia with prolonged use of drugs. The research results suggest that the indicated anesthesia scheme can be used for both short-term and long-term surgical interventions. It should also be understood that the use of inhalation anesthesia entails the need to use specialized equipment, inhalation apparatus, anesthetics and liquefied oxygen, and this is not always possible in conditions of limited availability of the above equipment.
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Hameed, Nazneen, Khairunnisa ., Asma Ali Depar, Hina Habib et Safia Abdullah. « Compare Second Stage of Labour with or without Epidural Analgesia ». Pakistan Journal of Medical and Health Sciences 16, no 8 (31 août 2022) : 929–32. http://dx.doi.org/10.53350/pjmhs22168929.

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Background: Epidural analgesia involves the injection of a local anesthetics agent into spinal cord. Delayed pushing has found association between epidural analgesia, instrumental deliveries and prolongation of second stage of labour. Objective: To compare second stage of labour with or without epidural analgesia at Aga Khan University Hospital. Study Design: Cohort study Setting: The Department of Obstetrics and Gynaecology, Aga Khan University Hospital, Karachi. Duration: From 1st March, 2020 to 1st August, 2020 Material and Methods: Total 80 patients were included and equally divided into group who received epidural analgesia and group who did not get epidural analgesia. Dependent variable was epidural analgesia and Independent variables are labor outcome as prolonged 2nd stage of labour with or without epidural analgesia. Stratification was done. Post stratification chi-square test was applied. P-value ≤0.05 was taken as significant. Results: The mean mother’s age in epidural and non-epidural groups was 29.48±4.38 years and 28.08±4.68 years. Prolonged second stage of labour was observed in 12.5% patients of epidural group and 5% patients of non-epidural group. The results showed significant association of prolonged second stage of labour with exposed and unexposed groups. Conclusion: Our study results showed that, prolonged second stage of labour was observed more among women in epidural group as compared to them women in non-epidural group. Keywords: Second Stage Labour, With or Without Epidural Analgesia
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Matt, Dennis W., Kenneth A. Steingold, Celia M. Dastvan, Cathy A. James et Walter Dunwiddie. « Effects of sera from patients given various anesthetics on preimplantation mouse embryo development in vitro ». Journal of In Vitro Fertilization and Embryo Transfer 8, no 4 (août 1991) : 191–97. http://dx.doi.org/10.1007/bf01130803.

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Ganguly, Deeptangshu, Dharani D. Ranganath, Manohar Herle, Rajasekhar C. H. et Kokila B. Nagaraj. « A prospective study on the use of anesthetic agents in modern surgical practice at a tertiary care hospital, Karnataka, India ». International Journal of Basic & ; Clinical Pharmacology 6, no 7 (23 juin 2017) : 1612. http://dx.doi.org/10.18203/2319-2003.ijbcp20172718.

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Background: The choice of local anesthetic is based on potency of the agent, onset and duration of anesthesia, and side effects of the drug Objectives of the study were, the study proposes to analysis the pattern, trend, rationality and frequency of use of anesthetic agents in modern surgical procedures.Methods: The study records relevant data obtained from surgical case records of patients from department of General surgery, Obstetrics and Gynecology and Orthopedics during the period December 2014 to May 2015 including first one month of pilot study, at KVGMC, Sullia (D.K), Karnataka.Results: A total of 744 cases were collected and screened according to inclusion and exclusion criteria and finally 348 cases were recorded and critically analysed. Sub-arachnoid block is the most common type of anesthetic procedure (75.28%) performed by the anesthetists. Of 348 cases undergoing anesthesia using local anesthetic agents, 228 cases required only a single agent and 120 cases required a combination anesthetic agents. 206 underwent sub-arachnoid block, 16 epidural block (EPID) and only 2 brachial block. The most commonly used agent for maintainence of general anesthesia is Isoflurane (68%) followed by Halothane (32%) and the combination of skeletal muscle relaxants were Succinylcholine with either Atracurium (39.8%) or Vecuronium (37.16%). Analgesics were the most commonly used adjuvants followed by ondansetron.Conclusions: The study showed that the most common anesthetic procedure performed using local anesthetic agents is SA/SAB block and the most common agent used is bupivacaine which was frequently employed at the dose range of 3-4 ml. There was significant association found between the no. of anesthetic agents used and the type of anesthetic procedure performed and also between the concerned department and the type of anesthetic procedure performed. Thus, the rationality in the usage of relevant anesthetic agents with appropriate adjuvants is evident.
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