scholarly journals Comparison of 0.1% Ropivacaine-Fentanyl with 0.1% Bupivacaine-Fentanyl Epidurally for Labour Analgesia

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Isha Chora ◽  
Akhlak Hussain
Keyword(s):  
Mode Of Delivery ◽  
Labour Pain ◽  
Local Anaesthetics ◽  
Labour Analgesia ◽  
Motor Blockade ◽  
Pain Scores ◽  
Institutional Review ◽  
Epidural Bupivacaine ◽  
Ethical Approval ◽  
Written Informed Consent

Ropivacaine is an alternative to epidural bupivacaine, with greater selectivity for sensory fibres than motor fibres, thus producing less motor blockade as compared to bupivacaine. The purpose of this study was to evaluate the efficacy of Ropivacaine 0.1% when administered epidurally for the relief of labour pain and to compare it with 0.1% bupivacaine, conducted at Rajindra Hospital Patiala, Baba Farid University of Health and Sciences, on 20 parturients after ethical approval from the institutional review board and obtaining written informed consent. Participants were randomly allocated to the two groups (bupivacaine 0.1% (Sensorcaine) + fentanyl 20 μg versus ropivacaine 0.1% (Ropin) + fentanyl 20 μg). It was observed that ropivacaine 0.1% and bupivacaine 0.1%, with fentanyl 20 μg/mL, produced equivalent analgesia for labour. There were no statistically significant differences in the amount of local anaesthetic used, pain scores, sensory levels, motor blockade, labour duration, mode of delivery, and side effects or patient satisfaction amongst the two local anaesthetics using the intermittent top-up technique. We conclude that the combinations of ropivacaine or bupivacaine with fentanyl achieve equally effective and excellent labour analgesia with no motor blockade and without jeopardizing the safety of the mother and foetus and, hence, are recommended for labour analgesia.

scholarly journals Butorphanol in Labour Analgesia

2018 ◽  
Vol 56 (214) ◽  
pp. 940-944 ◽  
Author(s):  
Jyotsna Yadav ◽  
Mohan Chandra Regmi ◽  
Pritha Basnet ◽  
K.M. Guddy ◽  
Balkrishna Bhattarai ◽  
...  
Keyword(s):  
Neonatal Outcome ◽  
Labour Pain ◽  
Cross Sectional Study ◽  
Labour Analgesia ◽  
Labor Pain ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Fetal Heart Rate Monitoring ◽  
Uterine Contractions ◽  
Pain Scores

Introduction: Labour is the process where uterine contractions lead to expulsion of product of conception through the vagina into the outer world. Labour pain is one of the most severe pains which has ever been evaluated and its fear is one of the reasons women wouldn’t go for natural delivery. Delivery is a painful experience for all of the women except a few of them. The labor pain results from some physiological-psychological causes. Different pharmacological and non-pharmacological methods have been tried for pain relief in labour. The objective of this study is to see the effect of butorphanol injection in labour pain. Methods: It is a descriptive cross-sectional study conducted in B.P. Koirala institute of health sciences. We observed 200 pregnant women meeting the inclusion criteria and giving the informed consent who were on 1 mg butorphanol i.m. at the onset of active stage of labour every 4 hourly and on demand. Pain assessment was done by Numerical Pain analogue scale measured from 1 to 10. Fetal heart rate monitoring was done according to the hospital protocol. Caesarean section was performed for obstetrical indication. Neonatal outcome was evaluated by on duty pediatrician and APGAR score were noted at 1 and 5 min.Results: The pain scores in first, second, third, fourth hour were (8.83±0.773), (9.84±0.544), (9.94±0.338), (9.6±0.298) respectively, where 1st and 2nd hour is statistically significant.Conclusions: Butorphanol is an effective labour analgesia without significant adverse effects on women and the neonatal outcome.

scholarly journals The Addition of Pethidine to Epidural Bupivacaine in Labour — Effect of Changing Bupivacaine Strength

1992 ◽  
Vol 20 (2) ◽  
pp. 151-155 ◽  
Author(s):  
G. Handley ◽  
G. Perkins
Keyword(s):  
Local Anaesthetic ◽  
Labour Pain ◽  
Rapid Onset ◽  
Maximum Effect ◽  
Duration Of Action ◽  
Subsequent Dose ◽  
Injection Duration ◽  
Pain Scores ◽  
Epidural Bupivacaine

The effects of varying the strength of bupivacaine used in epidurals for the relief of labour pain was examined. The trial randomly allocated sixty women in the first stage of labour to one of three groups. All women were of ASA status 1 or 2 and had uncomplicated pregnancies. Subjects in each group received pethidine 25 mg in 10 ml of either 0.125%, 0.1875%, or 0.25% bupivacaine. Pain scores for each patient were then assessed over the following thirty minutes. Duration of analgesia and subsequent dose requirements were examined. No difference in pain scores between groups at thirty minutes after injection of the test solutions was found. The 0.25% solution group did however have a more rapid onset of analgesia with the majority of patients in this group achieving their maximum effect between ten and twenty minutes after injection. Duration of analgesia was not prolonged by using the stronger solutions. This study suggests that when epidural pethidine 25 mg is added to local anaesthetic solutions of bupivacaine, adequate analgesia for the first stage of labour is achieved with the 0.125% bupivacaine solution. The use of stronger solutions of bupivacaine achieves no greater degree of analgesia nor longer duration of action, although the onset of analgesia may be faster with the stronger solutions. Further investigations are needed to determine if 25 mg of pethidine is the best choice of dose to use under these circumstances.

A Randomized Control Trial of Bupivacaine and Fentanyl versus Fentanyl-only for Epidural Analgesia during the Second Stage of Labor

2015 ◽  
Vol 122 (1) ◽  
pp. 172-177 ◽  
Author(s):  
Margaret G. Craig ◽  
Erica N. Grant ◽  
Weike Tao ◽  
Donald D. McIntire ◽  
Kenneth J. Leveno
Keyword(s):  
Mode Of Delivery ◽  
Group Versus ◽  
Postnatal Period ◽  
Neonatal Outcomes ◽  
Motor Blockade ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Nulliparous Women ◽  
Epidural Bupivacaine ◽  
Second Stage Labor

Abstract Background: The purpose of this prospective, double-blinded, parallel-arm, randomized trial was to examine the effects of epidural bupivacaine on the length of the second stage of labor in nulliparous women. Methods: The authors assessed length of second-stage labor, degree of motor blockade, mode of delivery, and visual analog scores in 310 nulliparous women with labor epidurals randomized to receive either: (1) 0.125% bupivacaine and fentanyl 2 μg/ml or (2) fentanyl 10 μg/ml alone via epidural using double blinding. Results: The median duration of the second stage was 75 min (41, 128) in the bupivacaine/fentanyl group versus 73 min (42, 120) in the fentanyl-only group (P = 0.17) with a median difference of 6.0 (95% CI, −6.0 to 18.0). Furthermore, there was no difference in degree of motor blockade, incidence of operative delivery, visual analog scores, or neonatal outcomes between the two groups. No adverse events were reported. Conclusions: Use of epidural bupivacaine/fentanyl or a fentanyl-only infusion during the second stage of labor did not affect the duration of the second stage of labor, degree of motor blockade, mode of delivery, pain relief, and maternal or neonatal outcomes. However, in the fentanyl-only infusion group, there was a fivefold increase in opioid exposure to the fetus with unknown effects on neurobehavior, an outcome not assessed beyond the immediate postnatal period in this study.

Efficacy of ethanol ablation for treatment of benign cystic thyroid nodules: the first hospital-based study in Vietnam

MedPharmRes ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. 18-22
Author(s):  
Van Bang Nguyen ◽  
Van Vy Hau Nguyen ◽  
Binh Thang Tran ◽  
Chi Van Le
Keyword(s):  
Thyroid Nodules ◽  
Multiple Logistic Regression Analysis ◽  
Volume Reduction ◽  
Efficacy And Safety ◽  
Inclusion Criteria ◽  
Ethanol Ablation ◽  
Institutional Review ◽  
Thyroid Cyst ◽  
Secondary Endpoints ◽  
Written Informed Consent

Background: In Vietnam, surgery or aspiration is preferred to treat thyroid cysts however each of them still have limitations. Purposes of this study were to evaluate the efficacy and safety of ethanol ablation in treating thyroid cysts and determine factors that predict the outcome of treatment. Methods: This prospective study was approved by the Ethics Committee of the Institutional Review Board of Family hospital and written informed consent for procedures was obtained. From May 2018 to March 2019, 23 patients who underwent treatment for thyroid cysts by EA were enrolled in this study and were followed up for 1 month at Family hospital. The primary endpoint was efficient after one month as the volume reduction ratio was ≥ 50%. Secondary endpoints were improvements in symptoms, cosmetic scores, and safety. Multiple logistic regression analysis was used. Results: In the finding, from May 2018 to March 2019, only 17 patients who matched inclusion criteria were included in the analyst, including 7 purely thyroid cysts, and 10 predominantly cystic nodules. Mean volume decreased significantly from 5.21 ± 3.37 ml to 2.35 ± 2.52 ml in corresponding to 52.87% of volume reduction with p < 0.05. Ethanol ablation (EA) success rate was 52.90% after 1 month. Symptoms and cosmetic scores were improved significantly. The thyroid function was constant. No adverse events occurred. Purely thyroid cyst was a predictive factor contributing to the success of EA. Conclusion: EA seems likely to be a safe and an efficient therapy for patients who had purely or predominantly cystic thyroid nodules.

scholarly journals Awareness and perception of epidural labor analgesia among pregnant women visiting antenatal clinic in National Referral Hospital

2021 ◽  
Vol 16 (1) ◽  
pp. 10-15
Author(s):  
Tandin Tshomo ◽  
Karma Tenzin ◽  
Jamphel Tshering
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Pregnant Women ◽  
Labour Pain ◽  
Good Method ◽  
Antenatal Clinic ◽  
Cross Sectional Study ◽  
Labour Analgesia ◽  
Cross Sectional ◽  
Labour Epidural Analgesia

Aims: To assess the awareness and perception of labour epidural analgesia among pregnant women visiting the antenatal clinic. Methods: This was an observational cross-sectional study. Study participants included pregnant women visiting the antenatal clinic during 2nd and 3 rd trimester conducted from 21 st September 2018 till 20 th September 2019. Data were collected by using an interviewer-administered questionnaire. Ethics approval was granted by the research Ethics Board of health, Bhutan. Results: Total 450 parturients participated in this study; 61.4% of the participants knew that labour epidural services were available and 37.5% got information through media. A total of 57.3% of respondents had severe fear about labour pain; 62.4% had severe fear about delivery complication; 85.2% thought that epidural labour analgesia was a good method of pain relief; and 67% were willing to accept it for their current pregnancy. However, 86.6% would recommend epidural labour analgesia as an option of pain relief to other pregnant women. Conclusion: Awareness about the availability of labour epidural analgesia services needs to be improved, as a majority of the parturient was keen to avail epidural analgesia after the information about its availability was provided.

scholarly journals Medical terminology circulation and interactional organisation in interpreter-mediated medical encounters

2021 ◽  
Vol 11 ◽  
Author(s):  
Sara Pittarello
Keyword(s):  
Informed Consent ◽  
Active Participation ◽  
Point Of View ◽  
Personal Interest ◽  
Medical Terminology ◽  
Institutional Talk ◽  
Italian Hospital ◽  
Ethical Approval ◽  
Medical Interpreters ◽  
Written Informed Consent

Two medical encounters taking place in a Northern Italian hospital are analysed in this paper from a qualitative point of view, based on the author’s previous research. The aim is to reveal the strategies adopted by medical interpreters, in these two specific cases, to translate medical terminology and promote/exclude interlocutors’ active participation. This latter aspect is influenced by the way the interaction is socially and linguistically organised and, in particular, by how interlocutors’ utterances are translated. The prevalence of dyadic or triadic sequences and especially the shifts between such communication exchanges are pivotal in fostering or hindering interlocutors’ participation. Furthermore, medical interactions, as a form of institutional talk, enshrine specific expectations, which are mainly of a cognitive nature but may also be affective, as in the two encounters observed. By conveying such expectations and expressions of personal interest, interpreters have proved to contribute to the fair distribution of active participation among primary interlocutors. Hospital ethical approval and subjects’ written informed consent have been obtained.

scholarly journals Rest Evaluation for Active Concussion Treatment (ReAct) Protocol: a prospective cohort study of levels of physical and cognitive rest after youth sports-related concussion

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e028386 ◽  
Author(s):  
Jingzhen Yang ◽  
Keith Yeates ◽  
Lindsay Sullivan ◽  
Bhavna Singichetti ◽  
Alison Newton ◽  
...  
Keyword(s):  
Electronic Devices ◽  
Optimal Level ◽  
Youth Athletes ◽  
Institutional Review ◽  
Postconcussive Symptoms ◽  
Ethical Approval ◽  
Cognitive Rest ◽  
Concussion Treatment ◽  
Current Guidelines ◽  
Return To Activity

IntroductionAlthough current guidelines for the early clinical management of sports-related concussion (SRC) call for a gradual return-to-activity, the optimal level of rest needed to promote recovery remains unknown. This paper describes the protocol of the Rest Evaluation for Active Concussion Treatment (ReAct) study which objectively measures physical and cognitive rest following SRC and its relation to recovery among youth athletes.Methods and analysisYouth athletes aged 11–17 years are recruited preinjury and enrolled within 72 hours following a physician-diagnosed concussion. Injury information and acute clinical presentation are assessed at the time of injury. Youth participants are prospectively followed to objectively monitor daily physical and cognitive rest using two electronic devices: ActiGraph (to measure physical rest and sleep) and Narrative Clip (to measure cognitive rest), along with self-reported postconcussive symptoms using daily surveys. Other concussion outcomes, including functional outcomes, are assessed by surveying youth and their parents at three time points: (1) within 72 hours of injury, (2) at day 7 postenrolment and (3) at symptom resolution (or a maximum of 45 days postconcussion).Ethics and disseminationThis study has received ethical approval from the Institutional Review Board (IRB) at the participating institution (IRB at Nationwide Children’s Hospital, IRB16-00613). The results of the study will be presented at national and international scientific conferences and published in peer-reviewed journals.

Narcotrend Monitoring Allows Faster Emergence and a Reduction of Drug Consumption in Propofol–Remifentanil Anesthesia

2003 ◽  
Vol 99 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Sascha Kreuer ◽  
Andreas Biedler ◽  
Reinhard Larsen ◽  
Simone Altmann ◽  
Wolfram Wilhelm
Keyword(s):  
Demographic Data ◽  
Clinical Parameters ◽  
Standard Practice ◽  
Institutional Review Board Approval ◽  
Institutional Review ◽  
Target Values ◽  
Recovery Times ◽  
The Impact ◽  
To Receive ◽  
Written Informed Consent

Background The Narcotrend is a new electroencephalographic monitor designed to measure depth of anesthesia, based on a six-letter classification from A (awake) to F (increasing burst suppression) including 14 substages. This study was designed to investigate the impact of Narcotrend monitoring on recovery times and propofol consumption in comparison to Bispectral Index (BIS) monitoring or standard anesthetic practice. Methods With institutional review board approval and written informed consent, 120 adult patients scheduled to undergo minor orthopedic surgery were randomized to receive a propofol-remifentanil anesthetic controlled by Narcotrend, by BIS(R), or solely by clinical parameters. Anesthesia was induced with 0.4 micro x kg-1 x min-1 remifentanil and a propofol target-controlled infusion at 3.5 microg/ml. After intubation, remifentanil was reduced to 0.2 micro x kg-1 x min-1, whereas the propofol infusion was adjusted according to clinical parameters or to the following target values: during maintenance to D(0) (Narcotrend) or 50 (BIS); 15 min before the end of surgery to C(1) (Narcotrend) or 60 (BIS). Recovery times were recorded by a blinded investigator, and average normalized propofol consumption was calculated from induction and maintenance doses. Results The groups were comparable for demographic data, duration of anesthesia, and mean remifentanil dosages. Compared with standard practice, patients with Narcotrend or BIS monitoring needed significantly less propofol (standard practice, 6.8 +/- 1.2 mg x kg-1 x h-1 vs. Narcotrend, 4.5 +/- 1.1 mg x kg-1 x h-1 or BIS(R), 4.8 +/- 1.0 mg x kg-1 x h-1; P &lt; 0.001), opened their eyes earlier (9.3 +/- 5.2 vs. 3.4 +/- 2.2 or 3.5 +/- 2.9 min), and were extubated sooner (9.7 +/- 5.3 vs. 3.7 +/- 2.2 or 4.1 +/- 2.9 min). Conclusions The results indicate that Narcotrend and BIS monitoring are equally effective to facilitate a significant reduction of recovery times and propofol consumption when used for guidance of propofol titration during a propofol-remifentanil anesthetic.

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