The Current Role of General Anesthesia for Cesarean Delivery

AbstractPurpose of the ReviewThe use of general anesthesia for cesarean delivery has declined in the last decades due to the widespread utilization of neuraxial techniques and the understanding that neuraxial anesthesia can be provided even in urgent circumstances. In fact, the role of general anesthesia for cesarean delivery has been revisited, because despite recent devices facilitating endotracheal intubation and clinical algorithms, guiding anesthesiologists facing challenging scenarios, risks, and complications of general anesthesia at the time of delivery for both mother and neonate(s) remain significant. In this review, we will discuss clinical scenarios and risk factors associated with general anesthesia for cesarean delivery and address reasons why anesthesiologists should apply strategies to minimize its use.Recent FindingsUnnecessary general anesthesia for cesarean delivery is associated with maternal complications, including serious anesthesia-related complications, surgical site infection, and venous thromboembolic events. Racial and socioeconomic disparities and low-resource settings are major contributing factors in the use of general anesthesia for cesarean delivery, with both maternal and perinatal mortality increasing when general anesthesia is provided. In addition, more significant maternal pain and higher rates of postpartum depression requiring hospitalization are associated with general anesthesia for cesarean delivery.SummaryRates of general anesthesia...
Source: Current Anesthesiology Reports - Category: Anesthesiology Source Type: research

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AbstractObjectivesTo explore how caregivers ’ (birth parents, adoptive parents, relative caregivers, and unrelated caregivers) depressive symptoms moderate the concordance between their and their youth’s assessment of the youth’s physical health symptoms, diseases, and physical health status.MethodsParticipants included 224 youth with mean age of 18.0  years (SD = 1.3) and their caregivers. Multiple-group models were run to test whether caregiver depression status moderated the concordance between youth and caregiver report of physical health outcomes. Models compared caregivers above t...
Source: Maternal and Child Health Journal - Category: Health Management Source Type: research
ConclusionsPrescription opioid use during pregnancy is associated with an increased risk of maternal complications.
Source: Drug Safety - Category: Drugs & Pharmacology Source Type: research
Front Psychiatry. 2021 Sep 14;12:699740. doi: 10.3389/fpsyt.2021.699740. eCollection 2021.ABSTRACTPostpartum depression (PPD) is one of the three major categories on the spectrum of postpartum psychiatric syndromes. Postpartum psychiatric syndromes are classified as either postpartum blues, postpartum depression, or postpartum psychosis. Postpartum depression is important to recognize clinically because of the effect it can have on the mother-child bond. The neurosteroid allopregnanolone, a progesterone derivative, is important for its role in positively modulating GABAA receptors. GABA-mediated signaling has been previous...
Source: Pain Physician - Category: Anesthesiology Authors: Source Type: research
AbstractIntroductionPostpartum depression (PPD) is a severe psychiatric disorder that negatively affects postnatal mothers worldwide. The aim of the study is to investigate the association between postpartum pain sensitivity and PPD as well as to identify the other potential risk factors for PPD and their interconnections.MethodsThe current study was a prospective observational clinical study that enrolled 210 singleton pregnant women in a tertiary referral hospital from January to December 2020. Postpartum pain sensitivity was assessed by the Mandarin Chinese version of the Pain Sensitivity Questionnaire (PSQ), and PSQ-C-...
Source: Pain and Therapy - Category: Anesthesiology Source Type: research
Discussion In two samples of low-income mothers, psychoneurological symptoms were prevalent and associated with chronic stressors and with maternal function and may mediate the association between those two factors. These findings extend prior research on depressive symptoms in mothers by investigating pain as an additional key symptom. The studies advance symptom science by highlighting psychoneurological symptoms in a heterogeneous sample without known health conditions.
Source: Nursing Research - Category: Nursing Tags: ORIGINAL ARTICLES Source Type: research
Obstet Gynecol. 2021 Sep 1;138(3):507-517. doi: 10.1097/AOG.0000000000004517.ABSTRACTPain in the postpartum period is common and considered by many individuals to be both problematic and persistent (1). Pain can interfere with individuals' ability to care for themselves and their infants, and untreated pain is associated with risk of greater opioid use, postpartum depression, and development of persistent pain (2). Clinicians should therefore be skilled in individualized management of postpartum pain. Though no formal time-based definition of postpartum pain exists, the recommendations presented here provide a framework fo...
Source: Obstetrics and Gynecology - Category: OBGYN Source Type: research
Conditions:   Pregnancy;   Postpartum;   Childbirth;   Health Status;   Physical Fitness;   Noncommunicable Diseases;   Metabolism;   Diabetes Mellitus, Gestational;   Pregnancy Induced Hypertension;   Body Composition;   Back Pain;   Pain Threshold;   Biomechanics;   Pelvic Floor Dis orders;   Urinary Incontinence;   Cognitive Function;   Depression;   Anxiety Interventions:   Behavioral: High intensity interval training program for pregnant women;   Beha...
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conclusions: Magnesium sulfate is an important adjuvant drug in the practice of anesthesia, with several clinical effects and a low incidence of adverse events when used at recommended doses. Introduction Magnesium is the fourth most common ion in the body, and it participates in several cellular processes, including protein synthesis, neuromuscular function and stability of nucleic acid, as well as regulating other electrolytes such as calcium and sodium. Magnesium acts as a cofactor in protein synthesis, neuromuscular function and stability and the function of nucleic acids. It is a component of adenosine 5-triph...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
More News: Anesthesia | Anesthesiology | Depression | Endotracheal Intubation | Pain | Perinatology & Neonatology | Postnatal Depression