A 10-year update: national survey questionnaire of obstetric anesthesia units in Israel

Shatalin, Daniel; Weiniger, Carolyn F.; Buchman, I.; Ginosar, Yehuda; Orbach‐Zinger, Sharon; Ioscovich, A.

doi:10.1016/j.ijoa.2018.10.014

Cited by 21 publications

(11 citation statements)

References 27 publications

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“…Epidural analgesia is the most common option for pain relief during delivery with a rate of 60% in Israel 1 and 71% in the United States 2 . The most common complication is accidental dural puncture, 3,4 occurring in 0.4%‐6% of cases 5 .…”

Section: Introductionmentioning

confidence: 99%

Chronic pain in parturients with an accidental dural puncture: A case‐controlled prospective observational study

Binyamin

Heesen

Orbach‐Zinger

et al. 2021

Acta Anaesthesiol Scand

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Background: We set out to examine incidence of chronic headache and back pain in women with PDPH after accidental dural puncture during labor.Methods: Chronic headache, backache, and disability were assessed 18-24 months postpartum. Women with PDPH treated with epidural blood patch (PDPH-EBP) were identified and matched with women who had a PDPH without epidural blood patch (PDPH-no EBP), with women with uncomplicated epidural analgesia and with women without epidural analgesia. Our primary outcome was incidence of chronic headache and backache. Secondary outcome was the effect of epidural blood patch on chronic pain development. We used Chi-square or Fisher's exact test to calculate odds ratios.Results: There was no statistically significant difference in demographic characteristics between groups. In the no epidural group, no women reported chronic headache and 2/116 (1.7%) reported chronic backache. In the uncomplicated epidural group, no women reported chronic headache and 7/116 (6.0%) reported chronic backache.In the PDPH-no EBP group, 9/56 (16.1%) women reported chronic headache and 10/56 (17.9%) reported chronic backache. In the PDPH-EBP group, 12/59 (20.3%) had chronic headache and 14/59 (23.7%) had chronic backache. No women in the no epidural or uncomplicated epidural group reported disability (chronic pain score of 3 or 4). High disability was reported by 8.9% of women in the PDPH-no EBP group and by 8.4% in the PDPH-EBP group. Conclusion:Women with PDPH had a high incidence of chronic headache, back pain, and disability. We did not find a statistically significant difference in chronic pain development between conservatively treated and EBP-treated patients. Editorial CommentThere is limited evidence concerning long-term effects of post-dural puncture headaches in the obstetric patient. In this prospective, observational case-control study, PDPH was associated with chronic backache and headache disability, but not to choice of headache treatment, conservative versus epidural blood patch. Parturients suffering from PDPH may need long-term follow up.How to cite this article: Binyamin Y, Heesen P, Orbach-Zinger S, et al. Chronic pain in parturients with an accidental dural puncture: A case-controlled prospective observational study.

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Section: Introductionmentioning

confidence: 99%

Chronic pain in parturients with an accidental dural puncture: A case‐controlled prospective observational study

Binyamin

Heesen

Orbach‐Zinger

et al. 2021

Acta Anaesthesiol Scand

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“…In Israel, labor analgesia options were evaluated in a national survey in 2005 and again in 2016. Among 25 units (100% response rate), the median (range) epidural rate was 60% (22-85%), a small increase in rate from 50% (15-93%) reported in 2005 [10].…”

Section: Neuraxial Analgesiamentioning

confidence: 94%

Update on Non-neuraxial Labor Analgesia

Karol

Weiniger

2021

Curr Anesthesiol Rep

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Purpose of Review This review will present recent updates for the use of non-neuraxial analgesia for laboring women. Recent Findings Non-neuraxial labor analgesia by nitrous oxide and intravenous opioids are described, and safety concerns with regard to remifentanil administration have been a major focus of recent studies. Fentanyl and nitrous oxide offer some efficacy, albeit less than remifentanil, however with a greater safety margin. Summary Women may request or require alternatives to neuraxial labor analgesia, in some cases due to concurrent comorbidities. Remifentanil offers the most efficacious alternative analgesia option; however, safety concerns may preclude widespread use.

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“…Комбінована спінально-епідуральна аналгезія використовується рідше, ніж класична епідуральна, але в розвинених країнах інтерес до неї зростає і відсоток її використання доходить до 20 %. В Україні показник використання нейроаксіальних методик знеболювання пологів значно варіюється і залежить від вподобань та оснащення клініки -від 10 до 80 % [14][15][16].…”

Section: місце епідуральної аналгезії з проколом твердої мозкової оболонки як сучасного методу знеболювання пологівunclassified

Місце Епідуральної Аналгезії З Проколом Твердої Мозкової Оболонки Як Сучасного Методу Знеболювання Пологів

Zhezher¹,

Sulimenko²,

Лоскутов³

2021

ЕМ

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Childbirth is a physiological process that is accompanied by severe pain. Physiological and psychological factors may be involved in the pathological process. Increasing the concentration of catecholamines may help reduce uteroplacental perfusion. Pain during childbirth can lead to hyperventilation of the mother, which in turn can affect the acid-base status of the fetus and the state of the newborn. Prolonged pain can lead to the development of severe psychological disorders with a violation of the connection between mother and newborn. Acute pain during childbirth can transform into chronic in the postpartum period. The most effective are neuroaxial methods of analgesia: epidural analgesia, combined spinal-epidural analgesia and their modifications. Classical epidural analgesia has minimal adverse and side effects, but may be associated with a high incidence of insufficient analgesia. The frequency of inadequate epidural block reaches 23 %. Combined spinal-epidural analgesia, in contrast to epidural analgesia, has a higher quality of sensory block, but it is associated with a higher frequency of side effects such as hypotension, severe motor block, fetal arrhythmia. Since 2005, dural puncture epidural has been introduced into the practice of obstetric anesthesiologists as a method to improve the quality of classical epidural analgesia with minimal side effects of combined spinal-epidural analgesia. Data from existing studies show that dural puncture epidural potentially improves the quality of analgesia (faster onset of analgesia, better sacral coverage, lower incidence of inadequate block) compared with epidural analgesia and causes less hypotension, disorders of fetal heart rate compared with combined spinal-epidural analgesia. But the spinal needle size is important in achieving these effects. Further researches may be aimed at determining the duration of labor, the option of delivery and the possible impact of dural puncture epidural on the vegetative regulation of labor and a broader study of the impact of this method on the fetus and newborn.

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A 10-year update: national survey questionnaire of obstetric anesthesia units in Israel

Cited by 21 publications

References 27 publications

Chronic pain in parturients with an accidental dural puncture: A case‐controlled prospective observational study

Chronic pain in parturients with an accidental dural puncture: A case‐controlled prospective observational study

Update on Non-neuraxial Labor Analgesia

Місце Епідуральної Аналгезії З Проколом Твердої Мозкової Оболонки Як Сучасного Методу Знеболювання Пологів

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