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Journal articles on the topic 'Epidural'

Author: Grafiati

Published: 4 June 2021

Last updated: 25 July 2025

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1

Leighton, Barbara L., Stephen H. Halpern, and Donna B. Wilson. "Lumbar Sympathetic Blocks Speed Early and Second Stage Induced Labor in Nulliparous Women." Anesthesiology 90, no. 4 (1999): 1039–46. http://dx.doi.org/10.1097/00000542-199904000-00017.

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Background Rapid cervical dilation reportedly accompanies lumbar sympathetic blockade, whereas epidural analgesia is associated with slow labor. The authors compared the effects of initial lumbar sympathetic block with those of epidural analgesia on labor speed and delivery mode in this pilot study. Methods At a hospital not practicing active labor management, full-term nulliparous patients whose labors were induced randomly received initial lumbar sympathetic block or epidural analgesia. The latter patients received 10 ml bupivacaine, 0.125%; 50 microg fentanyl; and 100 microg epinephrine epi

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Manchikanti, Laxmaiah. "A Prospective Evaluation of Complications of 10,000 Fluoroscopically Directed Epidural Injections." Pain Physician 2;15, no. 2;3 (2012): 131–40. http://dx.doi.org/10.36076/ppj.2012/15/131.

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Background: Among the multiple modalities of treatments available in managing chronic spinal pain, including surgery and multiple interventional techniques, epidural injections by various routes, such as interlaminar epidural injections, caudal epidural injections, transforaminal epidural injections, and percutaneous adhesiolysis are common. Even though the complications of fluoroscopically directed epidural injections are fewer than blind epidural injections, and have better effectiveness, multiple complications have been reported in scattered case reports, with only minor complications in ra

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Tuuli, Methodius, Molly Stout, Candice Woolfolk, et al. "Epidurals and the Modern Labor Curve: How Epidural Timing Impacts Fetal Station during Active Labor." American Journal of Perinatology 35, no. 05 (2017): 421–26. http://dx.doi.org/10.1055/s-0037-1617457.

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Objective The objective of this study was to estimate epidural timing's impact on fetal station during active labor. Study Design This secondary analysis of a single-institution prospective cohort study included all term singleton pregnancies, stratified by parity. Those with early epidurals (placed at <6 cm) were compared with those with late epidurals (placed at ≥6 cm). The primary outcome was median fetal station from 6 to 10 cm. Secondary outcomes included rate of prolonged first or second stage of labor (>95%). Multivariable logistic regression adjusted for labor type. Results Among

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Bernards, Christopher M., Danny D. Shen, Emily S. Sterling, et al. "Epidural, Cerebrospinal Fluid, and Plasma Pharmacokinetics of Epidural Opioids (Part 1)." Anesthesiology 99, no. 2 (2003): 455–65. http://dx.doi.org/10.1097/00000542-200308000-00029.

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Background The pharmacokinetics of epidurally administered drugs has been the subject of many studies, yet drug concentration in the epidural space has never been measured. This study was undertaken to characterize the epidural, cerebrospinal fluid, and plasma pharmacokinetics of epidurally administered opioids on the basis of measurement of drug concentration in each of these compartments after epidural administration. Methods Morphine plus alfentanil, fentanyl, or sufentanil were administered epidurally in anesthetized pigs. Microdialysis was used to sample the epidural space and the cerebro

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McLaren, Steve, Megan Hughes, Catherine Sheehan, and Jagdish Sokhi. "A guide to epidural management." British Journal of Hospital Medicine 81, no. 1 (2020): 1–7. http://dx.doi.org/10.12968/hmed.2019.0174.

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Epidural analgesia is a key component in the management of inpatient pain relief, particularly in surgical and trauma patients, and those with comorbidities. When used appropriately epidurals can decrease a patient's opiate consumption, as well as reducing the risk of adverse cardiorespiratory outcomes. To non-anaesthetists, or those not versed in their usage, epidurals can appear complex and intimidating, and the potential complications, although rare, can be catastrophic if not picked up on in a timely fashion. This article demystifies the epidural for hospital clinicians, looking at the ana

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Gulamani, Amber, Azhar Rehman, Mohsin Nazir, and Zainab Shabbir. "Intraoperative epidural analgesia practices and their outcomes in major abdominal surgeries at a tertiary care hospital." Journal of the Pakistan Medical Association 73, no. 8 (2023): 1587–91. http://dx.doi.org/10.47391/jpma.6434.

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Objective: To investigate the association involving site, concentrations and dosing of local anaesthetics used intraoperatively on postoperative pain scores, motor block and need for rescue analgesia. Method: The observational study was conducted June 1, 2020, to May 31, 2021, at the Aga Khan University Hospital, Karachi, and comprised patients planned for major abdominal surgeries with epidurals as primary analgesic modality. They were followed prospectively from placement of epidurals to 24h postoperatively. Data was collected from anaesthesia chart and pain management notes. Data was analys

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Manchikanti, Laxmaiah. "Assessment of the Growth of Epidural Injections in the Medicare Population from 2000 to 2011." Pain Physician 4;16, no. 4;7 (2013): E349—E364. http://dx.doi.org/10.36076/ppj.2013/16/e349.

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Background: Among the many diagnostic and therapeutic interventions available for the management of chronic pain, epidural steroid injections are one of the most commonly used modalities. The explosive growth of this technique is relevant in light of the high cost of health care in the United States and abroad, the previous literature assessing the effectiveness of epidural injections has been sparse with highly variable outcomes based on technique, outcome measures, patient selection, and methodology. However, the recent assessment of fluoroscopically directed epidural injections has shown im

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Bernards, Christopher M., Danny D. Shen, Emily S. Sterling, et al. "Epidural, Cerebrospinal Fluid, and Plasma Pharmacokinetics of Epidural Opioids (Part 2)." Anesthesiology 99, no. 2 (2003): 466–75. http://dx.doi.org/10.1097/00000542-200308000-00030.

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Background The ability of epinephrine to improve the efficacy of epidurally administered drugs is assumed to result from local vasoconstriction and a consequent decrease in drug clearance. However, because drug concentration in the epidural space has never been measured, our understanding of the effect of epinephrine on epidural pharmacokinetics is incomplete. This study was designed to characterize the effect of epinephrine on the epidural, cerebrospinal fluid, and plasma pharmacokinetics of epidurally administered opioids. Methods Morphine plus alfentanil, fentanyl, or sufentanil was adminis

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Shariful Islam Seraji. "Evaluating the Efficacy and Outcomes of Walking Epidural in Labor Analgesia." Journal of Medical Science & Research 36, Number 1 (2024): 3–10. https://doi.org/10.47648/jmsr.2024.v3601.01.

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Introduction: Labor pain is one of the deepest and most challenging sensations a person can endure, shapingboth the physical and emotional perspective of childbirth, often requiring effective management to ensure apositive childbirth experience. The goal of labor analgesia is to provide sufficient pain relief while minimizingadverse effects on the mother and fetus. Methods: This prospective observational comparative study wasconducted at Holy Family Red Crescent Medical College Hospital, Dhaka, and Popular Medical CollegeHospital, Dhaka, Bangladesh; the study spanned 2.5 years from December 20

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Stark, Mary Ann. "Exploring Women’s Preferences for Labor Epidural Analgesia." Journal of Perinatal Education 12, no. 2 (2003): 16–21. http://dx.doi.org/10.1891/1058-1243.12.2.16.

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The purpose of this study was to explore demographic factors related to women’s prenatal preferences for using an epidural during labor. Women recruited from prenatal classes provided data for this descriptive correlational study. Women with the most education, income, and parity indicated greatest preference for epidural analgesia. Thus, these women may be comfortable with the technology and most likely to be willing to pay for epidurals and to select care providers who provide epidural anesthesia. In this sample, prenatal preference for an epidural was not predictive of actual use, although

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Kamiya, Yoshinori, Tatsuaki Kikuchi, Gaku Inagawa, et al. "Lidocaine Concentration in Cerebrospinal Fluid after Epidural Administration." Anesthesiology 110, no. 5 (2009): 1127–32. http://dx.doi.org/10.1097/aln.0b013e31819daf15.

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Background In this study, lidocaine concentrations in cerebrospinal fluid (CSF) at different interspaces were measured with or without preceding spinal anesthesia, 10 min after epidural injection of lidocaine, to investigate the effects of preceding meningeal puncture on CSF concentrations of epidurally administered local anesthetic. Methods Sixty patients scheduled to receive combined spinal-epidural anesthesia were randomly allocated to receive either spinal anesthesia first (group CSEA) or epidural lidocaine first (group Epi). Each group was divided into three subgroups in which the site of

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Cook, Fabian Alexander Blyth, Emma Millar, Flora Mclennan, Marc Janssens, and Catherine Stretton. "Non-Obstetric Safety of Epidurals (NOSE)." BMJ Open Quality 10, no. 1 (2021): e000943. http://dx.doi.org/10.1136/bmjoq-2020-000943.

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Epidurals are a useful perioperative procedure for effective analgesia that allow early mobilisation after major surgery and help to minimise postoperative pulmonary, cardiovascular and thromboembolic complications. However, there are potential rare but life-changing complications such as an epidural haematoma. These require a high standard of post-epidural care for prompt recognition and prevention of permanent paralysis. Following a local critical incident of delayed diagnosis of an epidural haematoma in a patient after epidural catheter removal, a multidisciplinary team undertook a Quality

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SIDDIQI, K. J., F. ATIQ, A. AMBREEN, and F. M. KHAN. "Complications & Outcome with Epidurals for Labour: Analysis of Seven Years Experience." Annals of King Edward Medical University 13, no. 1 (2021): 24–26. https://doi.org/10.21649/akemu.v13i1.4615.

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Objectives: To audit the incidence of obstetric epidural complications and its outcome at Fatima Memorial Hospital. Lahore Methods: All parturients who received epidurals for painless deliveries in the labour room of Fatima Memorial Hospital from 1999 to 2005 were included in this audit. All parturients received bolus of 500-l000ml of Ringers lactate or 0.9%) Normal saline prior to insertion of epidural catheter. Information regarding parturient’s name, age, gravida (primi or multi), effectiveness of epidural or any complication was noted by anaesthetist on register kept in the anaesthesia off

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Manchikanti, Laxmaiah. "An Updated Analysis of Utilization of Epidural Procedures in Managing Chronic Pain in the Medicare Population from 2000 to 2018." Pain Physician 2;23, no. 4;2 (2020): 111–26. http://dx.doi.org/10.36076/ppj.2020/23/111.

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Background: With increasing costs of health care in the United States, attention is focused on expensive conditions. Musculoskeletal disorders with low back and neck pain account for the third highest amount of various disease categories. Minimally invasive interventional techniques for managing spinal pain, including epidural injections, have been considered to be growing rapidly. However, recent analyses of utilization of interventional techniques from 2000 to 2018 has shown a decline of 2.6% and a decline of 21% from 2009 to 2018 for epidural and adhesiolysis procedures. Objectives: The obj

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Wahezi, Sayed E. "Hemiparesis and Facial Sensory Loss following Cervical Epidural Steroid Injection." Pain Physician 6;17, no. 6;12 (2014): E761—E767. http://dx.doi.org/10.36076/ppj.2014/17/e761.

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Interlaminar cervical epidural steroid injections (ic-ESI) are safe and effective treatment options for the management of acute and chronic radiculopathy, spinal stenosis, and other causes of neck pain not responding to more conservative measures. However, the procedure inherently lends itself to possible spinal cord injury (SCI). Though reports of such events have been documented, the clinical presentation of patients with needle puncture SCI varies. In part, this may be due to anatomic considerations, as symptoms may be dependent on the cervical level intruded, as well as the volume and type

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Masue, Tatsuhiko, Shuji Dohi, Toshio Asano, and Hiroyuki Shimonaka. "Spinal Antinociceptive Effect of Epidural Nonsteroidal Antiinflammatory Drugs on Nitric Oxide-induced Hyperalgesia in Rats." Anesthesiology 91, no. 1 (1999): 198–206. http://dx.doi.org/10.1097/00000542-199907000-00028.

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Background Nonsteroidal antiinflammatory drugs (NSAIDs) suppress various hyperalgesia perhaps via inhibition of cyclooxygenase activity at the spinal cord. The present study aimed to examine whether epidural application of NSAIDs affects hyperalgesia induced by nitric oxide. Methods The authors studied the antinociceptive effects of epidurally administered NSAIDs in rats with a chronically in-dwelling epidural catheter by three hyperalgesic models, including nitric oxide-induced hyperalgesia by nitroglycerin (10 microg) or l-arginine (100 microg), and the biphasic response in the formalin test

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Davis, Stephanie, and Samuel Hird. "Intermittent epidural boluses vs continuous epidural infusion for labour analgesia: which is superior?" British Journal of Hospital Medicine 82, no. 5 (2021): 1–2. http://dx.doi.org/10.12968/hmed.2020.0704.

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Epidurals are considered the gold standard for labour analgesia. The possibility of newer pumps reducing staff workload has reignited interest in the advantages of the intermittent bolus technique, but is this superior to a continuous epidural infusion?

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Mahrose, Ramy, and Mohamed M. Kamal. "Repeated Epidural Anesthesia and Incidence of Unilateral Epidural Block." Open Anesthesia Journal 13, no. 1 (2019): 6–11. http://dx.doi.org/10.2174/2589645801913010006.

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Background: Epidural block is today the most common method of pain relief during labor. Nowadays, facing a multiparus parturient requiring epidural for the second or third time is common due to increased frequency of using epidural analgesia during labor. Objectives: Examination of the performance and outcome of women receiving their first versus repeated epidural block. Methods: The study included 140 American Society of Anesthesiologists (ASA) Physical Status II parturients (age range 20 to 40 years) and scheduled for normal vaginal delivery. The parturients were divided randomly into two eq

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Cummings, Kenneth C., Fang Xu, Linda C. Cummings, and Gregory S. Cooper. "A Comparison of Epidural Analgesia and Traditional Pain Management Effects on Survival and Cancer Recurrence after Colectomy." Anesthesiology 116, no. 4 (2012): 797–806. http://dx.doi.org/10.1097/aln.0b013e31824674f6.

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Background Cancer recurrence after surgery may be affected by immunosuppressive factors such as surgical stress, anesthetic drugs, and opioids. By limiting exposure to these, epidural analgesia may enhance tumor surveillance. This study compared survival and cancer recurrence rates for resection of colorectal cancer between patients who received perioperative epidurals and those who did not. Methods The linked Medicare-Surveillance, Epidemiology, and End Results database was used to identify patients ages 66 yr or older with nonmetastatic colorectal cancer diagnosed between 1996 and 2005 who u

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Lisnyy, Ivan, and Yurii Kuchin. "Modern approach to perioperative pain relief using various modern methods and anesthetics." Pain medicine 7, no. 3 (2022): 4–8. http://dx.doi.org/10.31636/pmjua.v7i3.1.

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Adequate postoperative analgesia remains unresolved problem of the acute pain treatment. In spite of wide choice of different groups of analgesics, epidural analgesia is the most adequate and efficient method of the postoperative analgesia. Continuous epidural analgesia is broadly used for postoperative pain relief. Such approach has own advantage over periodic administration of anesthetics into epidural space. These positive effects include constant level of the good pain relief, possibility of patients to participate in process of the pain management, reduction of probability of infectious c

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Torre, Abraham Ibarra-de la, Verónica Bautista-Piña, and Antonio Avilés-Aguilar. "Hemangioma cavernoso espinal epidural puro." Archivos de Neurociencias 19, no. 3 (2014): 166–68. http://dx.doi.org/10.31157/an.v19i3.52.

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Los hemangiomas espinales epidurales; son entidades raras. La mayoría de estas lesiones afectan los cuerpos vertebrales y tienen extensión ocasional al espacio epidural. La ocurrencia pura (espinal) de hemangioma epidural es poco común, localizados con más frecuencia en nivel torácico, puede presentarse con síntomas sobre raíz nerviosa y/o compresión medular. Presentamos un caso de hemangioma cavernoso espinal epidural puro a nivel lumbar, manifestado con radiculopatía crónica, con mejoría posterior a la resección quirúrgica total.

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Torre, Abraham Ibarra-de la, Verónica Bautista-Piña, and Antonio Avilés-Aguilar. "Hemangioma cavernoso espinal epidural puro." Archivos de Neurociencias 19, no. 3 (2014): 166–68. http://dx.doi.org/10.31157/archneurosciencesmex.v19i3.52.

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Los hemangiomas espinales epidurales; son entidades raras. La mayoría de estas lesiones afectan los cuerpos vertebrales y tienen extensión ocasional al espacio epidural. La ocurrencia pura (espinal) de hemangioma epidural es poco común, localizados con más frecuencia en nivel torácico, puede presentarse con síntomas sobre raíz nerviosa y/o compresión medular. Presentamos un caso de hemangioma cavernoso espinal epidural puro a nivel lumbar, manifestado con radiculopatía crónica, con mejoría posterior a la resección quirúrgica total.

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Botfield, Claire, and Paul Howell. "The use of spinal anaesthesia in severe pre-eclampsia." Fetal and Maternal Medicine Review 12, no. 1 (2001): 67–79. http://dx.doi.org/10.1017/s0965539501000146.

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Women with severe pre-eclampsia (PE) commonly require delivery by Caesarean section (CS). Whilst the choice of anaesthetic technique in this group of women has been controversial for a number of years, clinical experience has demonstrated the relative safety and value of well-managed incremental epidural anaesthesia. Several studies attest to the benefits of epidural analgesia in labour and epidural anaesthesia for CS. It is now widely recognised that epidurals provide relatively smooth control of blood pressure, maintain or improve utero-placental perfusion, optimising fetal outcome, and elim

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Parekh, Shrutika, and Arushi Arvind. "EPIDURAL BLOOD PATCH VIA IN SITU EPIDURAL CATHETER FOR POST DURAL PUNCTURE HEADACHE." International Journal of Advanced Research 12, no. 08 (2024): 382–86. http://dx.doi.org/10.21474/ijar01/19265.

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Post Dural Puncture Headache (PDPH) is a known complication of epidural procedures during labor analgesia and cesarean sections. In this study, we investigated the efficacy of managing PDPH using an Epidural Blood Patch (EBP) via an in-situ epidural catheter within 48 hours of accidental Dural puncture (ADP). Out of 1688 epidurals, 65 resulted in ADP (3.85%) with 43 cases developing PDPH (2.85% of total epidurals). Patients with ADP were managed by redirecting the needle and placing the catheter carefully, and those developing symptoms were monitored post-delivery and taken up for EBP if neede

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Ammirati, Mario, and Florence Perino. "Symptomatic air trapped in the spine after lumbar epidural corticosteroid injection." Journal of Neurosurgery: Spine 5, no. 4 (2006): 359–61. http://dx.doi.org/10.3171/spi.2006.5.4.359.

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✓ The authors report the first case involving trapped epidural air in the spine that mimicked a mass lesion and caused neurological symptoms after epidural corticosteroid injection in the lumbar region. New neurological symptoms developed immediately after injection, and magnetic resonance (MR) imaging demonstrated trapped air displacing the dural sac. After the patient underwent conservative treatment, the new symptoms resolved, and follow-up MR imaging and computed tomography demonstrated resorption of the epidural air in the lumbar region. To limit this problem, the clinician should decreas

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Seidelman, Jessica, Sarah Lewis, and Becky Smith. "CAUTIs in Patients With Thoracic Epidurals." Infection Control & Hospital Epidemiology 41, S1 (2020): s155. http://dx.doi.org/10.1017/ice.2020.676.

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Background: The Surgical Care Improvement Project 9 (SCIP 9) mandates the removal of urinary catheters within 48 hours following surgery to reduce the risk of catheter-associated urinary tract infections (CAUTIs). Although patients with thoracic epidurals are not exempt from SCIP 9, these patients may be inherently different from other surgical patients. Early removal of Foley catheters may cause urinary retention and recatheterization, which in turn can lead to CAUTI or urethral trauma. Our hospital’s current policy is to allow Foley catheters to remain in place until the thoracic epidural is

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Rengel Pinzon, Tatiana Lisbeth, Alex Bladimir Zaldua Gorozabel, and Luis Carlos Demera Demera. "Anestesia epidural en cesárea." RECIAMUC 8, no. 1 (2024): 935–46. http://dx.doi.org/10.26820/reciamuc/8.(1).ene.2024.935-946.

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La analgesia epidural es una técnica utilizada para aliviar el dolor durante el parto. Su historia se remonta al siglo XIX, cuando se empleaba cocaína como anestésico epidural. Con el tiempo, se introdujeron mejoras, como el uso de procaína y la adopción de catéteres epidurales. Estos avances aumentaron la seguridad y eficacia del procedimiento. A lo largo de los años, se han implementado diversas mejoras en la analgesia epidural. La infusión continua a través de catéteres permite un control más preciso del dolor. Además, se ha desarrollado la analgesia epidural controlada por la paciente, que

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Ting, Chien-Kun, Mei-Yung Tsou, Pin-Tarng Chen, et al. "A New Technique to Assist Epidural Needle Placement." Anesthesiology 112, no. 5 (2010): 1128–35. http://dx.doi.org/10.1097/aln.0b013e3181d3d958.

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Background Up to 10% of epidurals fail due to incorrect catheter placement. We describe a novel optical method to assist epidural catheter insertion in a porcine model. Methods Optical emissions were tested on ex vivo tissues from porcine paravertebral tissues to identify optical reflective spectra. The wavelengths of 650 and 532 nm differentiated epidural space from the ligamentum flavum. We then used a hollow stylet that contained optical fibers to place epidural needles in anesthetized pigs. Real-time data were displayed on an oscilloscope and stored for analysis. A total of 50 punctures we

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Lucas, T., R. K. Parker, N. R. Connelly, V. Vallurupalli, S. Bhopatkar, and S. Dunn. "COMPARISON OF EPIDURAL FENTANYL VERSUS EPIDURAL SUFENTANIL FOR EARLY LABOR AMBULATORY EPIDURALS." Anesthesiology 2000, no. 4 (2000): NA. http://dx.doi.org/10.1097/00000542-200004001-00067.

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Privado, Marcelo Soares, Adriana Machado Issy, Vera Lucia Lanchote, João Batista Santos Garcia, and Rioko Kimiko Sakata. "Epidural versus intravenous fentanyl for postoperative analgesia following orthopedic surgery: randomized controlled trial." Sao Paulo Medical Journal 128, no. 1 (2010): 5–9. http://dx.doi.org/10.1590/s1516-31802010000100002.

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CONTEXT AND OBJECTIVE: Controversy exists regarding the site of action of fentanyl after epidural injection. The objective of this investigation was to compare the efficacy of epidural and intravenous fentanyl for orthopedic surgery. DESIGN AND SETTING: A randomized double-blind study was performed in Hospital São Paulo. METHODS: During the postoperative period, in the presence of pain, 29 patients were divided into two groups: group 1 (n = 14) received 100 µg of fentanyl epidurally and 2 ml of saline intravenously; group 2 (n = 15) received 5 ml of saline epidurally and 100 µg of fentanyl int

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Higuchi, Hideyuki, Yushi Adachi, and Tomiei Kazama. "Factors Affecting the Spread and Duration of Epidural Anesthesia with Ropivacaine." Anesthesiology 101, no. 2 (2004): 451–60. http://dx.doi.org/10.1097/00000542-200408000-00027.

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Background Epidural anesthesia has an unpredictable extent and duration. Differences in the surface area of the lumbosacral dura, epidural fat volume, and epidural venous plexus velocity might explain the variability in the extent and duration of epidural anesthesia with ropivacaine. Methods Twenty-six healthy patients, aged 18-45 y, undergoing peripheral orthopedic surgery were enrolled. Dural surface area and posterior epidural fat volume were calculated from low thoracic, lumbar, and sacral axial magnetic resonance images obtained at 8-mm increments. Epidural venous plexus velocity at the L

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Nguyen, Lam D., Anh D. Nguyen, Michaela K. Farber, et al. "Sociodemographic Factors Associated with Request for Labor Epidural Analgesia in a Tertiary Obstetric Hospital in Vietnam." BioMed Research International 2021 (January 30, 2021): 1–5. http://dx.doi.org/10.1155/2021/8843390.

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This study is aimed at examining the sociodemographic factors associated with the utilization of labor epidural analgesia at a large obstetric and gynecology hospital in Vietnam. This was a cross-sectional study of women who underwent vaginal delivery in September 2018 at the Hanoi Obstetrics and Gynecology Hospital. The utilization of epidural analgesia during labor was determined. Univariate and multivariate regression models were applied to evaluate the association between patient demographic and socioeconomic factors and request for labor epidural analgesia. A total of 417 women had vagina

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Jain, Divya, Komal Gandhi, Medha Gupta, Kajal Jain, and Ishwar Bhukal. "A survey on labor epidural test dose practices in India." Journal of Anaesthesiology Clinical Pharmacology 41, no. 1 (2025): 189–92. https://doi.org/10.4103/joacp.joacp_353_23.

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Abstract There is a lack of consensus and uniformity about the test dose in epidurals for labor analgesia. We, therefore, conducted a questionnaire-based survey to assess the current practice in India regarding test-dose for labor epidurals among practicing obstetric anesthetists. A Google form based questionnaire was circulated to 300 members of the Association of Obstetric Anesthesiologists (AOA) of India of which 128 (42.7%) responded. According to our survey, labor analgesia is routinely practiced by only 40 (32%) responders. Sixty-eight (53.1%) responders reported placement of an epidural

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Potdar, Meenoti P., Ajay Tomar, and Laxmi Kamat. "Comparison of Ropivacaine with Fentanyl vs Bupivacaine with Fentanyl for Postoperative Epidural Analgesia in Total Knee Arthroplasty: A Prospective, Randomized, Single-blinded Controlled Study." Journal of Research & Innovation in Anesthesia 2, no. 2 (2017): 51–57. http://dx.doi.org/10.5005/jp-journals-10049-0033.

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ABSTRACT Aim The primary aim of the study was to compare epidural ropivacaine with fentanyl and epidural bupivacaine with fentanyl for postoperative epidural analgesia after total knee arthroplasty (TKA). The secondary objective was to assess the outcomes of passive and active mobilizations postoperatively, requirement of rescue analgesia, and adverse effects, such as nausea vomiting, sedation, numbness, motor weakness, hypotension, and respiratory depression. Materials and methods After obtaining hospital ethics committee approval and written informed consent, 100 patients were randomly alloc

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Manchikanti, Laxmaiah. "Analysis of the Growth of Epidural Injections and Costs in the Medicare Population: A Comparative Evaluation of 1997, 2002, and 2006 Data." Pain Physician 3;13, no. 3;5 (2010): 199–212. http://dx.doi.org/10.36076/ppj.2010/13/199.

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Background: Interventional techniques for the treatment of spinal techniques are commonly used and are increasing exponentially. Epidural injections and facet joint interventions are the 2 most commonly utilized procedures in interventional pain management. The current literature regarding the effectiveness of epidural injections is sparse with highly variable outcomes based on the technique, outcome measures, patient selection, and methodology. Multiple reports have illustrated the exponential growth of lumbosacral injections with significant geographic variations in the administration of epi

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KC, NB, S. Rai, P. Chand, A. Joshi, and BR Kunwar. "Combined Spinal Epidural Anesthesia for Total Hip Replacement Surgery in Birendra Army Hospital." Medical Journal of Shree Birendra Hospital 10, no. 1 (2012): 32–36. http://dx.doi.org/10.3126/mjsbh.v10i1.6447.

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Introduction: Total Hip Replacement surgery is one of the most commonly performed surgeries worldwide. Epidural anaesthesia have shown decrease incidence of DVT in these patient. Hence, combined spinal epidural spinal anesthesia is now a preferred technique over spinal anesthesia alone. We have been practicing combined spinal epidural anesthesia routienely in total joint replacement, but have not analyzed the result. The aim of this study was to analyse various aspect of combined spinal epidura anesthesia. Methods: thirteen cases of ASA I and II who underwent Total Hip Arthroplasty under combi

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van den Bosch, O. F. C., Y. Gleicher, C. Arzola, N. Siddiqui, K. Downey, and J. C. A. Carvalho. "Color Flow Doppler in Spinal Ultrasound: A Novel Technique for Assessment of Catheter Position in Labor Epidurals." Obstetric Anesthesia Digest 43, no. 3 (2023): 127. http://dx.doi.org/10.1097/01.aoa.0000946308.56901.60.

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(Reg Anesth Pain Med 2022;47:775–779) Epidural analgesia is one of the most common pain relief treatments during labor and delivery and is usually very effective. In a small percentage of epidurals, misplacement of the epidural catheter can cause inadequate anesthetic effects. To reduce instances of insufficient pain relief, it would be beneficial to be able to assess the position and flow of the catheter before administering medication. This study was designed to visualize flow in the epidural space using a structured color flow Doppler assessment, and to describe the location of the flow rel

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Grouls, R. J. E., T. F. Meert, H. H. M. Korsten, L. J. Hellebrekers, and D. D. Breimer. "Epidural and Intrathecal n-Butyl-p-Aminobenzoate Solution in the Rat." Anesthesiology 86, no. 1 (1997): 181–87. http://dx.doi.org/10.1097/00000542-199701000-00022.

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Background Epidural administration of an aqueous suspension of n-butyl-p-aminobenzoate (BAB) to humans results in long-lasting sensory blockade without motor block. The dose-response of BAB administered epidurally and intrathecally as a solution was studied in rats to define the local anesthetic properties in an established animal model. Methods The time course of changes in tail withdrawal latency and motor function were determined in rats after epidural or intrathecal administration of solutions of BAB or bupivacaine. The dose-response relation was determined and median effective dose values

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Watts, R. W. "A Five-Year Prospective Analysis of the Efficacy, Safety and Morbidity of Epidural Anaesthesia Performed by a General Practitioner Anaesthetist in an Isolated Rural Hospital." Anaesthesia and Intensive Care 20, no. 3 (1992): 348–53. http://dx.doi.org/10.1177/0310057x9202000314.

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During a five-year period, 324 epidurals were performed by a general practitioner anaesthetist in an isolated rural hospital. Of these 160 were for obstetric purposes, 72% in primagravida patients, the majority in early and established labour (median cervical dilatation of 3.0 cm). The median epidural insertion time was seven minutes: 80% were free of all complications, there were no dural taps and there was a failure rate of 2%. The median visual analogue pain score (VAPS) was 8.3 prior to insertion and at peak of epidural blockade it was reduced to 0.5. Ten per cent of patients had unblocked

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Anuradha, Malliwal. "Evaluation of Epidural Buprenorphine for Postoperative Analgesia for Below Umbilical Surgical Procedures." International Journal of Research and Review 6, no. 5 (2019): 1–9. https://doi.org/10.5281/zenodo.3989193.

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<strong>Introduction: </strong>Epidural analgesia with local anaesthetics is extremely effective in controlling postoperative pain, but its use has been limited by concerns about possible hypotension, tachyphylaxis, systemic toxicity, technical difficulty with insertion of an epidural catheter and problems of postoperative surveillance. Addition of opiates to epidural local anaesthetic avoids many of these side effects. Buprenorphine, as an additive is attractive choice since it is not a controlled drug, has minimum addition potential, is marketed preservative-free and provides a long dur

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Samuel C Ojiakor, Afam B Obidike, Kenneth N Okeke, et al. "Factors associated with demand for epidural analgesia among women in labor at a tertiary hospital in Nnewi, South-East, NigeriaFactors associated with demand for epidural analgesia among women in labor at a tertiary hospital in Nnewi, South-East, Nigeria." Magna Scientia Advanced Research and Reviews 2, no. 1 (2021): 08–013. http://dx.doi.org/10.30574/msarr.2021.2.1.0028.

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Background: Epidural labor analgesia has become prevalent in high income countries, but its use in low and middle income countries such as Nigeria is poorly studied. Objectives: To determine the rate of demand, indications, post-dural puncture headache rate and factors affecting demand for epidural analgesia among women in labor. Method: This was a across sectional analytical study of women in labor who were managed at Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria from 1st January 2017 to 31st December 2017. Data was obtained from women’s case files from Medical record department,

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Kynes, J. Matthew, Matthew S. Shotwell, Camila B. Walters, David P. Bichell, Jason T. Christensen, and Stephen R. Hays. "Epidurals for Coarctation Repair in Children Are Associated with Decreased Postoperative Anti-Hypertensive Infusion Requirement as Measured by a Novel Parameter, the Anti-Hypertensive Dosing Index (ADI)." Children 6, no. 10 (2019): 112. http://dx.doi.org/10.3390/children6100112.

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Background: Sympathetically-associated hypertension after coarctation repair is a common problem often requiring anti-hypertensive infusions in an intensive care unit. Epidurals suppress sympathetic output and can reduce blood pressure but have not been studied following coarctation repair in children. We sought to determine whether epidurals for coarctation repair in children were associated with decreased requirement for postoperative anti-hypertensive infusions, if they were associated with changes in hospital course, or with complications. Methods: In this observational retrospective cohor

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Patel, Aarjvi, Sara Mary Thomas, Arpit Shah, and Dushyant Bharatbhai Chavda. "A comparative study of epidural nalbuphine versus tramadol as an adjuvant to bupivacaine for post operative analgesia in lower limb orthopaedic surgeries." Indian Journal of Clinical Anaesthesia 11, no. 4 (2024): 485–91. http://dx.doi.org/10.18231/j.ijca.2024.090.

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Post operative pain management plays a vital role in ensuring optimal patient recovery and satisfaction, particularly in lower limb surgery where pain can significantly impede mobility and rehabilitation. Epidural anaesthesia provides targeted analgesia with lesser complications. tramadol and nalbuphine are two frequently used opioids for epidural analgesia to reduce postoperative pain. This study aims to compare the post-operative analgesic efficacy of epidural nalbuphine versus epidural tramadol as adjuvant with inj. bupivacaine 0.125% in lower limb orthopedics surgery.This study aimed to co

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Pedachenko, Eugene G., Mykhaylo V. Khyzhnyak, Olena P. Krasylenko, et al. "The comparative analysis of MRI data in the early period after lumbar microdiscectomies with epidural injection of polyacrylamide hydrogel." Ukrainian Neurosurgical Journal 27, no. 2 (2021): 16–24. http://dx.doi.org/10.25305/unj.223481.

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Objective: To perform a comparative analysis of MRI data obtained in the early postoperative period after repeated lumbar microdiscectomies in patients with and without epidural injection of “Nubiplant” polyacrylamide hydrogel (HG). Material and methods: The MRI data of the lumbar spine in the early postoperative period after repeated removal of herniated disc (on the 3-15th day) in 84 (100%) patients were analyzed: 30 (35,7%) patients were injected intraoperatively epidurally with “Nubiplant” HG to prevent epidural fibrosis (main group (MG) and in 54 (64,3%) patients the HG was not injected (

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Shahar, Rodhiyah, Sanihah Che Omar, Shamsul Kamaruljan Hassan, et al. "Interscapular Pain During Epidural Labour Analgesia and Its Associated Risk Factors." Malaysian Journal of Medicine and Health Sciences 20, no. 6 (2024): 3–9. https://doi.org/10.47836/mjmhs.20.6.2.

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Introduction: Epidural analgesia is a gold standard for the management of labour pain. Despite that, there was a small incidence of interscapular pain, which can be as severe as contraction pain and interfere with patient management. This study's objective was to identify possible risk factors associated with interscapular pain during epidural labour analgesia and its delivery outcome. Materials and methods: This study was carried out in the Department of Anaesthesia, Hospital Sultan Ismail, Johor Bharu. A total of 256 parturient who received epidural labour analgesia from January 2017 to Dece

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Calderón Lozano, Marjorie Lisseth, Renato Moreno Gonzales, Dante Segura Pinedo, Gunther Vásquez Rojas, and Anibal Arenas Velásquez. "Bolos epidurales intermitentes programados para mantenimiento de la analgesia del trabajo de parto: Estudio observacional, analítico de tipo cohorte." Revista Peruana de Investigación Materno Perinatal 9, no. 3 (2020): 28–34. http://dx.doi.org/10.33421/inmp.2020194.

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Objetivo: Evaluar la asociación entre analgesia epidural mantenida mediante Bolos epidurales intermitentes programados (BEIP) y las complicaciones materno-perinatales. Materiales y Métodos: Estudio de tipo Cohorte en gestantes entre 18 y 35 años, en trabajo de parto con dilatación cervical de 4 centímetros o más, agrupadas en dos cohortes según administración o no de analgesia epidural: En las gestantes del Grupo A, se administró analgesia epidural en bolo, con mantenimiento mediante BEIP con bupivacaína 0.0625% y fentanilo 25 ug en 10cc cada 60 minutos; en las gestantes del grupo B, no se adm

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Kallidaikurichi Srinivasan, Karthikeyan, Anthony Gallagher, Niall O’Brien, et al. "Proficiency-based progression training: an ‘end to end’ model for decreasing error applied to achievement of effective epidural analgesia during labour: a randomised control study." BMJ Open 8, no. 10 (2018): e020099. http://dx.doi.org/10.1136/bmjopen-2017-020099.

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BackgroundTraining procedural skills using proficiency-based progression (PBP) methodology has consistently resulted in error reduction. We hypothesised that implementation of metric-based PBP training and a valid assessment tool would decrease the failure rate of epidural analgesia during labour when compared to standard simulation-based training.MethodsDetailed, procedure-specific metrics for labour epidural catheter placement were developed based on carefully elicited expert input. Proficiency was defined using criteria derived from clinical performance of experienced practitioners. A PBP c

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Debon, Richard, Dominique Chassard, Frédéric Duflo, Emmanuel Boselli, Boris Bryssine, and Bernard Allaouchiche. "Chronobiology of Epidural Ropivacaine." Anesthesiology 96, no. 3 (2002): 542–45. http://dx.doi.org/10.1097/00000542-200203000-00006.

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Background A temporal pattern of the kinetics of local anesthetics is demonstrated in dental and skin anesthesia, with an important variation in the duration of action related to the hour of administration. The aim of this study is to determine whether the hour of injection influences the duration of epidurally administered ropivacaine during labor. Methods One hundred ninety-four women in the first stage of labor were assigned to one of four groups throughout the day period: group 1 (night: from 1:01 to 7:00 am), group 2 (morning: from 7:01 am to 1:00 pm), group 3 (afternoon: from 1:01 to 7:0

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Vialle, Emiliano, Luiz Roberto Vialle, and Guillermo Holtmann. "Abcesso epidural pós-traumático." Acta Ortopédica Brasileira 16, no. 5 (2008): 311–13. http://dx.doi.org/10.1590/s1413-78522008000500012.

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Abcessos epidurais são formas incomuns de infecção na coluna, com complicações graves em decorência de seu difícil diagnóstico e tratamento. Apesar dos avanços em métodos diagnósticos e de tratamento medicamentoso e cirúrgico, a taxa de mortalidade encontrada na literatura varia de 5 a 32%. Os autores apresentam um caso de fratura de coluna torácica, que evoluiu com abcesso epidural, num paciente portador de espondilite anquilosante. Houve déficit neurológico rapidamente progressivo, que regrediu após descompressão de emergência e fixação cirúrgica da fratura. Apesar do curso longo de antibiot

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Pereira, Carlos Umberto, João Domingos Barbosa Carneiro Leão, Antonio Ribas, Egmond Alves Silva Santos, João Tiago Silva Monteiro, and Gustavo Cabral Duarte. "Frontal Epidural Haematoma." JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA 15, no. 1 (2018): 18–21. http://dx.doi.org/10.22290/jbnc.v15i1.471.

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Background: The epidural haematoma is the most important space-occupying lesion due to head injury with high index of mortality and morbidity when the correct management is not done. Frontal epidural haematoma are considered rare lesions, representing about 10% of the whole epidural haematomas. They are usually unilateral and may present with subacute and chronic evolution in 40% of the cases. Objective: To study thirty cases of frontal epidural haematoma andanalyze the causes, clinical findings, evolution, and outcome. Patients and Methods: Thirty patients presenting with frontal epidure hema

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