Articles: analgesia.
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To evaluate fetal and maternal adverse effects of intrathecal opioid analgesia during labour. ⋯ Intrathecal opioids for labour increase the risk of fetal bradycardia and maternal pruritus. The risk of subsequent caesarean section is not increased.
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Obstetrics and gynecology · Mar 2002
Randomized Controlled Trial Multicenter Study Clinical TrialRisk factors for difficult delivery in nulliparas with epidural analgesia in second stage of labor.
To identify risk factors for difficult delivery among nulliparas in the second stage of labor with continuous epidural analgesia, and to develop a multivariable model that is predictive of difficult delivery. ⋯ Our observations concerning maternal characteristics and obstetric variables are consistent with previous observations with the exception of time of induction of the epidural. The predictive model may be useful in defining high-risk populations for subsequent intervention studies designed to assess approaches to reduce difficult delivery.
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Reg Anesth Pain Med · Mar 2002
Case ReportsPatient-controlled epidural analgesia for labor and delivery in a parturient with chronic inflammatory demyelinating polyneuropathy.
The anesthetic management of labor and delivery in patients with any form of chronic inflammatory demyelinating polyneuropathy (CIDP) is not well defined. Using patient-controlled epidural analgesia (PCEA), or epidural analgesia, in such a rare clinical situation has not been previously reported. ⋯ PCEA had no apparent detrimental affect on the patient's disease and may be a reasonable option for patients with CIDP presenting for labor and delivery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Remifentanil by patient-controlled analgesia compared with intramuscular meperidine for pain relief in labour.
The pharmacokinetics of remifentanil suggests that it may be suitable for analgesia during labour. ⋯ In this pilot study, remifentanil by PCA gave better pain relief to mothers in labour than intramuscular meperidine. However, remifentanil is a potent respiratory depressant and adequate continuous monitoring is necessary.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cesarean delivery: a randomized trial of epidural analgesia versus intravenous meperidine analgesia during labor in nulliparous women.
Controversy concerning increased cesarean births as a result of epidural analgesia for relief of labor pain has been attributed, in large part, to difficulties interpreting published studies because of design flaws. In this study, the authors compared epidural analgesia to intravenous meperidine analgesia using patient-controlled devices during labor to evaluate the effects of labor epidural analgesia, primarily on the rate of cesarean deliveries while minimizing limitations attributable to study design. ⋯ Epidural analgesia compared with intravenous meperidine analgesia during labor does not increase cesarean deliveries in nulliparous women.