Inadequate pain relief with labor epidurals: a multivariate analysis of associated factors

Agaram, R.; Douglas, Molly; McTaggart, Ryan; Gunka, V.

doi:10.1016/j.ijoa.2007.10.008

Cited by 53 publications

(23 citation statements)

References 18 publications

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“…29 In turn, primary failure can be ascribed to misidentification of the epidural space or suboptimal catheter position. Primary epidural failure rates for labor and surgical analgesia vary between 2.0% and 16.9% in large studies (n > 200) published over the last 10 years (2005-2014) [30][31][32][33] (Table 1). Because prudence dictates that LA boluses be fragmented and administered through the catheter (and not the needle), it can be difficult to ascertain if these reported failure rates stem from misidentification of the epidural space (nonepidural LOR) or catheter malposition (eg, intervertebral foramen).…”

Section: Primary Failure Of Epidural Analgesia and Incidence Of Falsementioning

confidence: 99%

Confirmation of Loss-of-Resistance for Epidural Analgesia

Tran

González

Bernucci

et al. 2015

Regional Anesthesia and Pain Medicine

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Section: Primary Failure Of Epidural Analgesia and Incidence Of Falsementioning

confidence: 99%

Confirmation of Loss-of-Resistance for Epidural Analgesia

Tran

González

Bernucci

et al. 2015

Regional Anesthesia and Pain Medicine

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“…The animals displayed more aggression with more pregnancies and lactations, as if the combination of pregnancy, hormone exposure, and pup sensory stimulation built a foundation upon which substrate, subsequent pregnancies acted, like stories in a high-rise building. Parity-induced changes in the endogenous opioid system likewise show a step-wise pattern of effects, with primiparous females being significantly different than virgins, and multiparous being significantly different than primiparous in their sensitivities to both endogenous and exogenous opiates (Kinsley et al 1999;Mann and Bridges 1992; and in humans, Agaram et al 2009). Their underlying opioid systems are similarly modified (Bridges and Hammer 1992).…”

Section: Evidence For Reproductive Experiential Mediation Of Nervous mentioning

confidence: 99%

Reproductive Experience may Positively Adjust the Trajectory of Senescence

Kinsley

Franssen

Meyer

2011

Behavioral Neurobiology of Aging

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Although aging is inexorable, aging well is not. From the perspective of research in rats and complementary models, reproductive experience has significant effects; indeed, benefits, which include better-than-average cognitive skills, a slowing of the slope of decline, and a healthier brain and/or nervous system well later into life. Work from our lab and others has suggested that the events of pregnancy and parturition, collectively referred to as reproductive experience-an amalgam of hormone exposure, sensory stimulation, and offspring behavioral experience and interaction-may summate to flatten the degree of decline normally associated with aging. Mimicking the effects of an enriched environment, reproductive experience has been shown to: enhance/protect cognition and decrease anxiety well out to two-plus years; result in fewer hippocampal deposits of the Alzheimer's disease herald, amyloid precursor protein (APP); and, in general, lead to a healthier biology. Based on a suite of recent work in organisms as diverse as nematodes, flies, and mammals, the ubiquitous hormone insulin and its large family of related substances and receptors may play a major role in mediating some of the effects of RE on the parameters of aging studied thus far. We will discuss the current set of data that suggest mechanisms for successful biological and neurobiological aging, and the implications for understanding aging and senescence in their broadest terms.

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“…An association between impaired maternal satisfaction and greater cervical dilatation at admission has previously been reported, and the higher pain level at epidural placement might well be responsible. 12,20 When cervical dilatation occurs rapidly, a short duration of labor could explain the low analgesic effectiveness of the epidural technique. 21 We found that nationality was not associated with epidural analgesia effectiveness.…”

Section: Discussionmentioning

confidence: 99%