scholarly journals LABOR ANALGESIA IN KIEV (UKRAINE)

2021 ◽  
pp. 39-46
Author(s):  
I. Kuchyn ◽  
D. Govsieiev ◽  
K. Bielka ◽  
A. Romanenko
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Local Level ◽  
The United States ◽  
Labor Analgesia ◽  
Labor Pain ◽  
Maternity Hospitals ◽  
Quality Of Medical Care ◽  
Pharmacological Method ◽  
The Uk

The problem of a labor pain is becoming very important for health care because insufficient analgesia for women during childbirth affects the quality of medical care. The complexity of the use in the system and approaches to providing care to citizens in Ukraine, and at the local level –  the interaction of the obstetrician with the women, anaesthetist and also the technical capabilities of public maternity hospitals [1]. For the last decade, epidural analgesia has been the «golden» method in labor analgesia. We searched numerous meta-analyzes about pain management during labor and delivery in the United States, they prefer epidural analgesia in 80-90% of women, while in the UK - 36% [2, 3]. Statistics from around the world indicate a relationship between pain relief and income levels, so in high-income countries, (HICs) women are more likely to be anesthetized during childbirth than in South Africa or Asia [4]. Although childbirth is a physiological and natural process, it needs pain relief. Nowadays a woman’s desire is a sufficient indication for labor analgesia, and this is her right [5]. The problem is to choose a pharmacological and / or non-pharmacological method of analgesia for a particular woman, which will be best for the parturient. It should be noted that there is a separate group of women who choose to give birth at home to reduce the «aggression» of medical staff against women and her child, but they have a higher incidence of complications and increased mortality [6]. «Homebirth» in maternity hospitals helps to solve this problem. A comprehensive questionnaire was created among seven state maternity hospitals in Kyiv to identify the current situation with the provision of maternity care and to analyze the main issues of labor analgesia in Kyiv.

scholarly journals The Relationship between Virtual Reality Technology and Anxiety State of Parturient Women with Labor Pain

2020 ◽  
Vol 35 (5) ◽  
pp. 236-243
Author(s):  
Haibo Wu ◽  
Bei Zhu ◽  
Peng Jiang
Keyword(s):  
Virtual Reality ◽  
Epidural Analgesia ◽  
Skill Training ◽  
Pain Syndrome ◽  
Nonparametric Test ◽  
Labor Analgesia ◽  
Labor Pain ◽  
Anxiety State ◽  
Tertiary Teaching ◽  
Pharmacological Method

Background: Labor pain is severe physical pain experienced by the parturient. More than 90% of mothers are accompanied by tension-anxiety-pain syndrome during childbirth. Virtual Reality (VR) technology has been widely used in nursing teaching, skill training, and clinical nursing. As a non-pharmacological method, it is rarely used in the management of labor analgesia. This study aims to explore the effect of VR technology on the anxiety state of parturient in labor analgesia. Methods: After the ethics committee approved the study, 102 primiparas who received labor analgesia in a tertiary teaching hospital were included in the study from March to October 2020. The included women were randomly divided into epidural Analgesia (E) and epidural analgesia combined with the VR group (EV). The primary outcome was the maternal anxiety score. The score was obtained using a 0-100 digital scoring scale, collected before and 30 minutes after labor analgesia. Statistical analysis used independent or paired t-test, Willson and Mann-Whitney nonparametric test. Results: After labor analgesia, the anxiety and pain scores of the two groups (E and EV) were significantly reduced (P = 0.000), and the anxiety and pain of the mothers in the EV group were relieved more significantly (P = 0.000). VR intervention significantly reduced the number of additional analgesics needed by women in the EV group (1.51 ± 0.68 vs. 0.32 ± 1.18, P = 0.000) and significantly improved the women’s overall satisfaction (9 vs. 10, P = 0.000). There were no significant differences in adverse reactions, such as nausea and vomiting between the two groups. Conclusion: Our findings indicate that VR can effectively alleviate primipara’s anxiety and pain in labor analgesia.

scholarly journals PERINEAL PAIN RELIEF THERAPIES AFTER POSTPARTUM

2017 ◽  
Vol 26 (2) ◽  
Author(s):  
Marília Vieira Peleckis ◽  
Adriana Amorim Francisco ◽  
Sonia Maria Junqueira Vasconcellos de Oliveira
Keyword(s):  
Pain Relief ◽  
Descriptive Analysis ◽  
Direct Care ◽  
Perineal Pain ◽  
Local Cooling ◽  
Latex Gloves ◽  
Maternity Hospitals ◽  
Pharmacological Method ◽  
Effective Use ◽  
Cooling Technique

ABSTRACT Objective: identifying therapies for treating perineal pain after vaginal birth and to verify indication, technique and duration of local cooling. Method: an exploratory study (survey) conducted in 32 public maternity hospitals in the city of São Paulo (Brazil). A nurse or midwife who provided direct care to the woman was interviewed in each maternity ward. We investigated: institutional characterization, professional qualification, pain relief method, criterion for administration of therapies, indication, contraindication, method, local cooling technique and interval. A descriptive analysis was also carried out. Results: pharmacological and non-pharmacological methods were used for perineal pain relief, despite the use of non-pharmacological therapies not having protocols in these institutions. Among the pharmacological-based methods, analgesics and anti-inflammatories were the most common. Local cooling was the most used non-pharmacological method, and its main indication was perineal edema. Application time and local cooling interval ranged from 10-30 min and 3-8 h, respectively. Ice cubes in latex gloves were the main cooling technique. Conclusion: drug therapies predominated for control of perineal pain. Considering the advantages of non-pharmacological therapies, it is necessary to develop protocols to ensure their safe and effective use in maternity care.

scholarly journals PAIN RELIEF DURING LABOR – WHAT DO WE KNOW AND WHAT SHOULD WE KNOW? RESEARCH BASED ON THE STUDENT POPULATION IN WARSAW

2020 ◽  
Vol 73 (7) ◽  
pp. 1339-1344
Author(s):  
Martyna Rozek ◽  
Zuzann Smiech ◽  
Marcin Kolacz ◽  
Dariusz Kosson
Keyword(s):  
Pain Relief ◽  
Labor Analgesia ◽  
Labor Pain ◽  
Reproductive Age ◽  
Internet Survey ◽  
Childbearing Age ◽  
Breathing Techniques ◽  
Cord Injury ◽  
Twin Delivery ◽  
Medical University

The aim: Women of reproductive age often think of motherhood and labor with fear of intense labor pain. The anxiety they experience can lead to their postponing pregnancy. There are not many studies in the literature that research the knowledge young women have about the analgesia of labor. The aim of the present work was to evaluate the state of awareness about the possible methods of labor analgesia among women of childbearing age. Material and methods: An Internet survey was conducted among 160 women. It consisted of questions on the pharmacological and non-pharmacological methods of labor analgesia. Most of the respondents were not medical university students (96.2%). Correct answers ranged between 11.3% and 97.5% of the total responses. Results: The greatest number of incorrect answers were given to the question regarding contraindications to labor anesthesia (only 11.3% of answers were correct). There was also a low percentage of correct answers to questions about the risk of spinal cord injury during the procedure of inducing anesthesia (18.8% of correct answers), the motor activity of a woman after analgesia (22.5%) and the reimbursement of anesthesia (29.4%). Nearly 40% of the respondents did not know the correct answer to the question about the possibility of breastfeeding after anesthesia. The problem of aalgesia during twin delivery also posed a challenge. Over half of the respondents (54.1%) incorrectly answered the question about the occurrence of complications among women who want to become pregnant again after the procedure of labor anesthesia. Moreover, 70.6% of the women surveyed considered non-pharmacological methods of labor anesthesia to be safer compared to pharmacological analgesia. The most commonly mentioned methods of non-pharmacological labor pain relief included breathing techniques and water birth. Conclusions: The study shows that women

Baricity, Needle Direction, and Intrathecal Sufentanil Labor Analgesia

1997 ◽  
Vol 86 (3) ◽  
pp. 592-598 ◽  
Author(s):  
Fazeela Ferouz ◽  
Mark C. Norris ◽  
Valerie A. Arkoosh ◽  
Barbara L. Leighton ◽  
Louis M. Boxer ◽  
...  
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Normal Saline ◽  
Analgesic Efficacy ◽  
Study Drug ◽  
Labor Analgesia ◽  
Labor Pain ◽  
Double Blind Study ◽  
Drug Injection ◽  
Double Blind

Background Intrathecal sufentanil relieves labor pain but centrally mediated side effects are common. Preventing rostral spread of intrathecal sufentanil should limit these side effects. Both direction of the lateral opening of a pencil-point needle and drug baricity modify the spread of intrathecal local anesthetics. This randomized, prospective, double-blind study examines the effects of these variables on intrathecal sufentanil labor analgesia. Methods Forty laboring, full-term parturients, whose cervixes were dilated less than 5 cm and who requested analgesia for labor were enrolled. Combined spinal epidural analgesia was induced in patients in the sitting position. They were allocated to receive 10 micrograms intrathecal sufentanil diluted with either normal saline or dextrose with the aperture of the pencil-point needle directed cephalad or caudad during drug injection. Thus there were four groups of ten patients: dextrose up, dextrose down, saline up, and saline down. Sufentanil was diluted with normal saline to a concentration of 10 micrograms/ml. The study drug was made by mixing 1 ml sufentanil solution with either 1 ml 10% dextrose or 1 ml normal saline. Visual analog scores for pain, pruritus, nausea, and pain relief were recorded before and 5, 10, 15, and 30 min after drug injection. Results Baricity, but not needle orientation, influenced pain relief and pruritus. Sufentanil in dextrose produced less itching but also less analgesia. Nine of 20 women in the dextrose groups compared with 1 of 20 in the saline groups requested additional analgesia by 30 min. Conclusions Little or no labor analgesia developed for patients receiving sufentanil with dextrose. A supraspinal action may contribute to intrathecal sufentanil's analgesic efficacy.

scholarly journals Development of the Labor Pain Relief Attitude Questionnaire for Pregnant Women (LPRAQ-p)

2020 ◽  
Author(s):  
Lianne P Hulsbosch ◽  
Ivan Nyklíček ◽  
Eva S Potharst ◽  
Myrthe GBM Boekhorst ◽  
Victor JM Pop
Keyword(s):  
Factor Analysis ◽  
Pain Relief ◽  
Confirmatory Factor Analysis ◽  
Epidural Analgesia ◽  
Pregnant Women ◽  
Labor Pain ◽  
Attitude Questionnaire ◽  
Distress Symptoms ◽  
Confirmatory Factor ◽  
Explorative Factor Analysis

Abstract Background: Receiving epidural analgesia during labor can possibly have negative consequences for mother and child. Yet, the use of epidural analgesia rapidly increased in the Netherlands over the last decade. Since antenatal plans for labor pain relief have been related to epidural analgesia use during labor, the aim of the current study was to develop a Labor Pain Relief Attitude Questionnaire for pregnant women (LPRAQ-p).Methods: Three focus group interviews were conducted with pregnant women, new mothers and caregivers and 13 candidate items were derived. Psychometric properties were tested with explorative factor analysis in sample I (N = 429) and a subsequent confirmatory factor analysis in a different sample II (N = 432).Results: The explorative factor analysis suggested a two-factor seven-item solution: a ‘women’s perception’ and ‘social environment’ subscale. The confirmatory factor analysis confirmed an excellent six-item model fit with appropriate internal consistency. Higher scores on the six-item LPRAQ-p indicate greater willingness for request of pain relief medication during labor. Two-tailed t-tests showed that women with elevated levels of depression and pregnancy-specific distress symptoms, nulliparous women and multiparous women with complications during previous delivery had greater willingness for request of pain relief medication during labor. Linear regression showed that the most important association with higher scores on the LPRAQ-p were high pregnancy-specific distress symptoms.Conclusions: This study showed the LPRAQ-p to be a valid instrument to evaluate attitude towards labor pain relief in pregnant women. High scores on this questionnaire are associated with high levels of pregnancy-specific distress symptoms.

scholarly journals A pilot study comparing dural puncture epidural with 27G Whitacre needle and conventional lumbar epidural labor analgesia

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Ashok Jadon ◽  
Surabhi Srivastawa ◽  
Neelam Sinha ◽  
Swastika Chakraborty ◽  
Apoorva Bakshi ◽  
...  
Keyword(s):  
Side Effects ◽  
Epidural Analgesia ◽  
Dural Puncture ◽  
Mode Of Delivery ◽  
Labor Analgesia ◽  
Labor Pain ◽  
Spinal Needle ◽  
Lumbar Epidural Analgesia ◽  
A New Technique ◽  
Dural Puncture Epidural

Abstract Background The dural puncture epidural (DPE) technique is relatively a new technique of labor analgesia and has been advocated with the advantage of faster onset of pain relief. However, there are differences of opinion regarding the efficacy of the DPE technique and the size of the spinal needle to be used for the DPE. Various studies have suggested that DPE can only be done with a larger gauge of a spinal needle; however, recent studies have variable observations. We have compared the conventional lumbar epidural analgesia and DPE using a 27G pencil-point needle to assess the efficacy of DPE and its possible side effects. Results The time to achieve a 50% reduction in VAS was 7.06 ± 0.79 min in group CLE (n = 15) and 5.0 ± 1.06 min in group DPE (n = 15) (difference of two means was 2.06, 95% CI [1.36, 2.75], t = 5.99, p < 0.0001). The time to achieve VAS < 3 in group CLE was 14.93 ± 1.98 min, and in the group DPE, it was 10.13 ± 1.45 min (difference of two means was 4.8, 95% CI [3.52, 6.09], t = 7.55, p < 0.0001). The mode of delivery, APGAR scores, and side effects were comparable (p > 0.05). Conclusions DPE provided faster relief of labor pain than the conventional labor epidural analgesia. There were no added side effects by DPE in conventional lumbar epidural analgesia for labor. A 27G Whitacre pencil-point needle can be used for DPE. Trial registration CTRI, CTRI/2020/08/027060. Registered on 10/08/2020. Trial registered prospectively. CTRI website URL: http://ctri.nic.in

scholarly journals Labor pain relief and postpartum depression. Is there a correlation?

2017 ◽  
Vol 66 (5) ◽  
pp. 11-20 ◽  
Author(s):  
Oksana V. Riazanova ◽  
Yury S. Aleksandrovich ◽  
Vitaly A. Reznik ◽  
Irina A. Gorkovaya ◽  
Maria A. Korgozha ◽  
...  
Keyword(s):  
Pain Relief ◽  
Postpartum Depression ◽  
Epidural Analgesia ◽  
Vaginal Delivery ◽  
Local Anesthetic ◽  
Pain Syndrome ◽  
Vaginal Birth ◽  
Labor Pain ◽  
Gestation Period ◽  
Ropivacaine Hydrochloride

The article is dedicated to the evaluation of the effect of labor pain relief by using epidural analgesia during vaginal delivery on the frequency of postpartum depression. Materials and methods. 159 women were included in the study. The average age of the patients was 29 years, the average gestation period was 39.7 weeks. In the first group, in order to relief the pain while vaginal birth, an epidural analgesia was administered. A continuous patient-controlled infusion was used along with 0.08% solution of ropivacaine hydrochloride in the capacity of a local anesthetic. Patients of the second group gave birth without any anesthesia. Evaluation of the depression progress was carried out several times: before birth, 6 hours after delivery, 3 days and 6 weeks after delivery. Results of the study. Usage of epidural analgesia during vaginal delivery leads to a significant pain syndrome relief, but does not reduce the probably of postpartum depression.

PATIENT CONTROLLED EPIDURAL ANALGESIA versus CONTINUOUS INFUSION FOR LABOR PAIN RELIEF

1998 ◽  
Vol 86 (Supplement) ◽  
pp. 371S
Author(s):  
Susan Harke ◽  
Gordon Mandell ◽  
Sivam Ramanathan
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Continuous Infusion ◽  
Labor Pain

scholarly journals Epidural analgesia in labor: specific characteristics, dilemmas and controversies

2012 ◽  
Vol 65 (9-10) ◽  
pp. 441-447 ◽  
Author(s):  
Marija Kutlesic ◽  
Ranko Kutlesic
Keyword(s):  
Blood Flow ◽  
Pain Relief ◽  
Epidural Analgesia ◽  
Epidural Block ◽  
Labor Pain ◽  
Active Management ◽  
Delivery Rate ◽  
Epidural Puncture ◽  
Small Doses ◽  
Uteroplacental Blood Flow

Introduction. Epidural analgesia has become the most popular method for labor pain relief. Analgesia in Labor: Yes or No? Labor pain is a complex phenomenon with sensory, cognitive, motivational, emotional, social, and cultural variables. Pain and anxiety lead to adrenergic hyperactivity, hyperventilation, hypocapnia with reduced uteroplacental blood flow and uncoordinated uterine activity, so pain relief is recommended and even indicated in cases of maternal comorbidity. Analgesia in Labor: Method of Choice. The quality of epidural analgesia is better than the one achieved by parenteral or inhalation agents, with increased uteroplacental blood flow and improved fetal-maternal oxygenation. Epidural Analgesia in Labor: What is Specific? The increased weight, lumbar lordosis, soft tissue edema and engorgement of epidural veins make it more difficult to perform epidural block in pregnancy. Epidural puncture should be performed by medial approach, at L2 - 3 or L3 - 4 level by loss of resistance technique between contractions. Epidural Analgesia in Labor: What With? Local anesthetics, bupivacaine, levobupivacaine, ropivacaine, are used and they can be combined with small doses of opioids (fentanyl or sufentanyl). Epidural Analgesia in Labor: How? Available techniques are epidural, spinal and combined spinal - epidural analgesia. Epidural Analgesia in Labor: Controversies. The most important controversy is the influence of epidural analgesia on operative or instrumental delivery rate. Low concentrations of local anesthetic in combination with small doses of opioids, together with active management of labor by an obstetrician, would lead to increased spontaneous delivery rate. Conclusion. Although there still are some difficulties, complications and controversies, epidural analgesia provides safe and effective labor pain control.

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