Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Feb 2021
Effect of a stepwise opioid-sparing analgesic protocol on in-hospital oxycodone use and discharge prescription after cesarean delivery.
Opioid exposure during hospitalization for cesarean delivery increases the risk of new persistent opioid use. We studied the effectiveness of stepwise multimodal opioid-sparing analgesia in reducing oxycodone use during cesarean delivery hospitalization and prescriptions at discharge. ⋯ Multimodal stepwise analgesia after cesarean delivery increases the proportion of oxycodone-free women during in-hospital stay and at discharge.
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Reg Anesth Pain Med · Feb 2021
The world needs our science: broadening the research pipeline in anesthesiology.
Anesthesiologists are innovative and adaptable problem solvers. Despite these talents, our field is still working to consistently develop and support the translation of innovation and creativity into productive scientists. This article is focused on opening the discussion on identifying the gaps and move toward developing a sustainable and diverse research pipeline.
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Reg Anesth Pain Med · Feb 2021
Quality of labor epidural analgesia at a high-volume tertiary care obstetric unit: a before-and-after study.
We wanted to better understand the quality of our labor epidural practice at a large urban academic medical center. Several practice changes were implemented between 2011 and 2017, namely a more uniform epidural loading dose of local anesthetic that includes fentanyl, an increase in both the hourly baseline offer and maximum allowed hourly amount of bupivacaine, and the change from a continuous epidural infusion to a programmed intermittent epidural bolus (PIEB) regimen. We aimed to assess the impact of those changes on the quality of labor analgesia. ⋯ A bundle of practice changes implemented in our clinical practice, including the PIEB regimen, has resulted in a significant improvement in the quality of labor analgesia. However, despite all the implemented changes, 30% of women still experience pain during labor and further optimization of our practice is warranted.