International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2017
Comparative Study Observational StudyAn observational study of agreement between percentage pain reduction calculated from visual analog or numerical rating scales versus that reported by parturients during labor epidural analgesia.
This study aimed to determine the level of agreement between calculated percentage pain reduction, derived from visual analog or numerical rating scales, and patient-reported percentage pain reduction in patients having labor epidural analgesia. ⋯ The agreement between calculated percentage pain reduction from a visual analog or numerical rating scale and patient-reported percentage pain reduction in the context of labor epidural analgesia was moderate. The difference could range up to 30%. Patient-reported percentage pain reduction has advantages as a measurement tool for assessing pain management for childbirth but differences compared with other assessment methods should be taken into account.
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Int J Obstet Anesth · May 2017
Observational StudyImmediate postpartum neurological deficits in the lower extremity: a prospective observational study.
Neurological deficits noted immediately after childbirth are usually various obstetric neuropathies, but prospective studies are limited. The main study aim was to quantify and describe immediate postpartum neurological deficits of the lower extremity, including the buttocks. ⋯ Transient neurological complications after labour and delivery are infrequent, mainly sensory involving multiple lumbosacral nerve roots or specific sacral cutaneous nerves, and they typically resolve within a short time.
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Int J Obstet Anesth · May 2017
Lessons learned from a single institution's retrospective analysis of emergent cesarean delivery following external cephalic version with and without neuraxial anesthesia.
To evaluate the risk of emergent cesarean delivery with the use of neuraxial anesthesia for external cephalic version in a single practice. ⋯ In this single hospital's practice, patients who may be at higher risk of complications and have a lesser likelihood of success were provided NA for ECV. As a result, the use of neuraxial anesthesia for external cephalic version was associated with a higher rate of emergent cesarean delivery. Obstetric and anesthetic practices should evaluate their patient selection and procedure protocol for external cephalic version under neuraxial anesthesia.
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Int J Obstet Anesth · May 2017
Neuraxial analgesia in a pregnant woman with Fowler's syndrome and sacral neuromodulation.
We report the anesthetic management of a 16-year-old woman with Fowler's syndrome who became pregnant three years after sacral neuromodulation was initiated for treatment of the condition. Multidisciplinary consensus was to switch off the neurostimulator during pregnancy, and attempt vaginal delivery with a neuraxial block. ⋯ Sacral neuromodulation was restarted uneventfully in the early puerperium and the Fowler's syndrome remains well controlled. The baby continues to develop normally three years after delivery.