Management of post-cesarean delivery analgesia: Pharmacologic strategies

Conclusions Notwithstanding the adverse effects described in the literature, the cornerstone of analgesia therapy after cesarean section are opioids, both neuraxial or parenteral administration. Multimodal management using NSAIDs or paracetamol, improves the safety profile and the quality of analgesia, reducing the opioid requirements.
Source: Colombian Journal of Anesthesiology - Category: Anesthesiology Source Type: research

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Discussion: Our survey revealed variations in the clinical management of a failed epidural top up for cesarean delivery, suggesting guidelines to aid decision-making are needed. PMID: 31281354 [PubMed]
Source: Anesthesiology Research and Practice - Category: Anesthesiology Tags: Anesthesiol Res Pract Source Type: research
Rationale: Pain management is an essential part of good obstetrical care. The rapid onset of pain relief after combined spinal-epidural (CSE) analgesia may cause a transient imbalance in maternal catecholamine level, leading to uterine hyperactivity and fetal heart rate (FHR) abnormalities. How to manage the uterine basal tone and FHR abnormalities after labor analgesia still remains controversial. Patient concerns: A 33-year-old nulliparous woman at 40+5 weeks’ gestation underwent induction of labor after premature rupture of membranes. CSE analgesia was provided when the patient described her pain as the top o...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Cesarean section (CS) is one of the most common surgical procedures and postoperative pain control is an important aspect of postoperative management.1 Generally, spinal anesthesia is performed for the peri-operative management of CS. Spinal anesthesia with opioids has gained popularity for postoperative pain relief because it reportedly results in improved analgesia, and ultrasound-guided nerve blocks have also been performed as part of multimodal analgesia after CS.2
Source: International Journal of Obstetric Anesthesia - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
Conclusions: Epidural administration of 0.6 mg hydromorphone coadministered with ropivacaine after cesarean section provided satisfactory pain relief with less sulfentanil consumption. This trial is registered with ChiCTR-IPR-16010026. PMID: 30944686 [PubMed - in process]
Source: Pain Research and Management - Category: Anesthesiology Authors: Tags: Pain Res Manag Source Type: research
The objective of this study is to compare the analgesic efficacy of both the techniques. Materials and Methods: Eighty patients in the ASA I-II risk group, undergone an elective C-section, were randomly assigned to the study. In the TAP group, before the C-section, a single-dose spinal anaesthesia was performed by administering 3 ml of 0.5% hyperbaric bupivacaine to the patients when they were in the sitting position. After the C-section, an ultrasound-guided bilateral TAP block was performed in these patients in the recovery room for postoperative analgesia. In the single-dose EPI group, the patients received ...
Source: Pain Research and Management - Category: Anesthesiology Authors: Tags: Pain Res Manag Source Type: research
Purpose of review Cesarean section is the most common surgical procedure performed in the world. Postoperative pain management remains a challenge, particularly in a context of enhanced recovery after surgery. Several barriers related to the specific condition of ‘postpartum recovery’ may prevent application of effective analgesia in this population. The present review focuses on novel approaches of cesarean section postoperative pain assessment, beyond pain-rating intensity, including objective patient-centered recovery parameters. Predictive tools currently available to target patients at high risk of acute...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Jeanette Bauchat Source Type: research
Performing epidural and spinal anesthesia requires a good deal of training and being able to sense when the needle reaches the desired location. This is certainly not foolproof and some patients are harder to work with than others. One issue is that ...
Source: Medgadget - Category: Medical Devices Authors: Tags: Anesthesiology Neurology Pain Management Source Type: blogs
Ladies and Gentlemen, this is the moment you have all been waiting for – the day that the winners of the Medgadget Medical Sci-Fi Competition are announced and their fantastic stories are published! First, we would like to thank Eko Devices, th...
Source: Medgadget - Category: Medical Devices Authors: Tags: Exclusive Source Type: blogs
Objectives: Intrathecal morphine is used in the postoperative management of pain after caesarean section (CS), but might not be optimal for intraoperative analgesia. We hypothesized that intrathecal fentanyl could supplement intraoperative analgesia when added to a local anesthetic and morphine without affecting management of postoperative pain. Methods: This prospective, randomized, double-blind, parallel-group study included 60 parturients scheduled for elective CS. Spinal anesthesia consisted of bupivacaine with either morphine 100 μg (M group), or fentanyl 25 μg and morphine 100 μg (FM group). The f...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research
ConclusionThese results indicated that patients with C/C genotype may have reduced sensitivity to fentanyl analgesia and/or increased pain perception, and were more willing to use PCEA fentanyl to manage their pain.
Source: Acta Anaesthesiologica Scandinavica - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
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