Pain management in labor

CONTEXT: Labor pain is considered one of the most well-known types of severe pain. For this reason, non-pharmacological methods employed for managing labor pain are necessary to help pregnant women cope with labor pain and increase their childbirth comfort. OBJECTIVES: The aim of this study was to determine the effect of cold and warm acupressure applied to the LI4 acupressure point on childbirth comfort in primiparous women during labor. DESIGN: This study was designed as a randomized controlled experimental trial...

BACKGROUND: According to clinical data, a significant percentage of patients experience pain after surgery, highlighting the importance of alleviating postoperative pain. The current approach involves intravenous self-control analgesia, often utilizing opioid analgesics such as morphine, sufentanil, and fentanyl. Surgery for colorectal cancer typically involves general anesthesia. Therefore, optimizing anesthetic management and postoperative analgesic programs can effectively reduce perioperative stress and enhance postoperative recovery...

There is ample evidence to suggest that upright positions and mobility during labor improve birth outcome, including shorter duration of childbirth and reduced risk of cesarean section. The use of nonpharmacological interventions for pain management during childbirth are recommended by major health-care institutions and medical providers, however, the current methodologies for training coping strategies for use during labor have not shown to be effective on mobility or birth outcome. The purpose of this study was to apply an in-vivo teaching technology to the current childbirth model to prompt an imitative repertoire of empirically demonstrated labor coping strategies...

Korean Native Black Goats deliver mainly during the cold season. However, in winter, there is a high risk of stunted growth and mortality for their newborns. Therefore, we conducted this study to develop a KNBG parturition detection system that detects and provides managers with early notification of the signs of parturition. The KNBG parturition detection system consists of triaxial accelerometers, gateways, a server, and parturition detection alarm terminals. Then, two different data, the labor and non-labor data, were acquired and a Decision Tree algorithm was used to classify them...

This cross-sectional descriptive study aimed to analyze the relationship between maternal positions during the expulsion phase and perineal outcomes in 367 eutocic births attended by midwives or midwifery residents at a public hospital in northern Spain in 2018. A total of 94.3% of women opted for horizontal positions. Limited sacral retroversion was observed in 71.7%, potentially influencing perineal outcomes. A low incidence of tears indicated effective management during the expulsive phase, with an episiotomy rate of 15...

BACKGROUND: Childbirth self-efficacy is a pregnant women's perception of their ability to cope with labor stress. Low childbirth self-efficacy is linked to pain intolerance and poor labor progression, which increase the possibility of operative delivery. However, Ethiopia has limited data. So, the aim of this study was to assess childbirth self-efficacy and its factors among pregnant women attending antenatal care in public health facilities in Arba Minch town, Southern Ethiopia, in 2023...

BACKGROUND: Postdural puncture headache has been traditionally viewed as benign, self-limited, and highly responsive to epidural blood patching (EBP) when needed. A growing body of data from patients experiencing unintended dural puncture (UDP) in the setting of attempted labor epidural placement suggests a minority of patients will have more severe and persistent symptoms. However, the mechanisms accounting for the failure of EBP following dural puncture remain obscure. An understanding of these potential mechanisms is critical to guide management decisions in the face of severe and persistent cerebrospinal fluid (CSF) leak...

BACKGROUND AND OBJECTIVES: We aim to characterize the sociodemographic and clinical factors associated with loss of jobs, income, and work hours in people with neuromyelitis optica spectrum disorder (NMOSD) in the United States. METHODS: A REDCap-based survey was administered to working-age NMOSD patients (18-70 years old) querying demographic information, symptoms, immunosuppression, work hours, income, and caregiver work (11/2022-07/2023). Regression models were developed using MATLAB...

In adults, partial rotator cuff injuries can frequently be the root cause of pain in the shoulder. One recurrent pathology that may significantly impact a broad spectrum of individuals, including athletes, laborers, and sedentary people, is partial rotator cuff tears (RCTs). Physical therapy, anti-inflammatories, painkillers, rest or activity modifications, and corticosteroid injections are a few nonoperative treatment options for partial RCTs. We report a case of a 27-year-old male who sustained a rotator cuff injury of the right shoulder...

Spontaneous intracranial hypotension (SIH) is a rare disorder characterized by continuous or intermittent cerebrospinal fluid (CSF) leakage from the CSF cavity, which causes symptoms such as headache or neck pain upon standing. However, no well-established measures concerning the type of delivery and anesthesia for pregnant women with a history of SIH have been reported. A woman had developed SIH 9 years earlier from lifting luggage into an overhead bin with stretching movements, which required continuous saline epidural infusion for recovery...

BACKGROUND: Labor pain is the most intense pain experienced in woman's life. Epidural anesthesia is recommended as the most effective method for pain relief, but it has several limitations. Fentanyl is a high analgesic potency with short-acting duration, but the large-scale trials assessing the effectiveness and safety in labor pain management are still limited. OBJECTIVES: To compare the effectiveness and harm as well as maternal satisfaction of subcutaneous (S...

INTRODUCTION: Chronic pain (pain >3 months) is a growing epidemic. Normal pregnancy may give rise to recurrent and sometimes constant pain for women. Women with worse pain symptoms are more likely to report symptoms of anxiety, depression, and/or insomnia during the perinatal period, which may impact labor and delivery outcomes. We examined the relationship between demographic and psychological predictors of pain throughout pregnancy and into the postpartum. OBJECTIVES: To examine trajectories of pain intensity, pain catastrophizing, and pain interference during pregnancy and the early postpartum, and associated sociodemographic predictors of trajectory membership...

As the scientific understanding of the intricate relationship between maternal analgesia and neonatal neurological outcomes continues to evolve, it becomes imperative to explore strategies aimed at optimizing this critical facet of obstetric care. This narrative review seeks to critically examine and synthesize existing literature on strategies for improving labor analgesia with a primary focus on their implications for neonatal neurological health. English studies from various databases were included, using keywords such as "childbirth analgesia", "labor pain management", "obstetric analgesia", and "neonatal outcomes", combined with "neonatal neurology" and "neonatal outcomes"...

Large hiatal hernias, besides being more prevalent in the elderly, have a different clinical presentation: less reflux, more mechanical symptoms, and a greater possibility of acute, life-threatening complications such as gastric volvulus, ischemia, and visceral mediastinal perforation. Thus, surgical indications are distinct from gastroesophageal reflux disease-related sliding hiatal hernias. Heartburn tends to be less intense, while symptoms of chest pain, cough, discomfort, and tiredness are reported more frequently...

INTRODUCTION: Research shows that Somali women are less likely to receive epidural analgesia for labor pain compared to non-immigrant women in Norway. It is unclear why. This study aimed to explore the perceptions and experiences of Somali women regarding pain relief during childbirth. METHODS: In January 2023, semi-structured interviews were conducted with 10 Somali women who had lived in Norway for at least ten years and given birth within the past 12 months. Data were analyzed using thematic content analysis as described by Graneheim and Lundman...

BACKGROUND: Labor pain is considered the worst pain in a woman's life. Hence, pain control should be essential to labor management at any level. There is scarce information, and there are gaps regarding the knowledge, attitude, and barriers to the utilization of nonpharmacological approaches for pain relief in Saudi Arabia. Therefore, the current study aims to evaluate nonpharmacological pain relief (NPPR)-related knowledge, attitudes, and barriers among obstetric care providers in Najran, Saudi Arabia...

INTRODUCTION: To investigate the clinical features, pregnancy care, timing, and approaches of pregnancy termination as well as the perinatal management of pregnant women with ectopic pheochromocytomas (EPCC) (paragangliomas, PGL). METHODS: We report the diagnosis and treatment of a pregnant women with EPCC which was confirmed in the third trimester in our hospital. Literature in relation to EPCC during pregnancy both in and outside China was searched for data analysis such as maternal clinical features and maternal and fetal prognosis...

BACKGROUND: Epidural analgesia is resource and labor intense and may limit postoperative management options and delay discharge. This study compared postoperative outcomes after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) with epidural analgesia versus continuous wound infusion system (CWIS) with/without intraoperative methadone. METHODS: A single-institution, retrospective chart review was performed including all patients undergoing open CRS/HIPEC from 2018 to 2021...

INTRODUCTION: A significant number of women who undergo neuraxial labor analgesia experience breakthrough pain. Prompt mitigation of breakthrough pain is essential to improve maternal and fetal outcomes. We evaluated epidural chloroprocaine compared with ropivacaine in alleviating labor breakthrough pain. METHODS: We performed a double-blind randomized controlled clinical trial between May and July 2023. Eligible parturients received epidural analgesia with ropivacaine and sufentanil...

INTRODUCTION: Traditional parathyroid registries are labor-intensive and do not always capture long-term follow-up data. This study aimed to develop a patient-driven international parathyroid registry and leverage community connections to improve patient-centered care for hyperparathyroidism. METHODS: An anonymous voluntary online survey was developed using Qualtrics and posted in an international patient and advocate-run social media group affiliated with over 11,700 members...