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Book contents

Chapter 64 - Neuraxial Analgesia and Anesthesia in Obstetrics

from Section 6 - Late Prenatal – Obstetric Problems

Published online by Cambridge University Press:  15 November 2017

David James
University of Nottingham
Philip Steer
Imperial College London
Carl Weiner
University of Kansas
Bernard Gonik
Wayne State University, Detroit
Stephen Robson
University of Newcastle
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In 1847, the obstetrician James Young Simpson reported the use of diethyl ether to provide peripartum pain relief in a woman with a deformed pelvis. From this beginning, an evolution in the agents and techniques used to provide obstetric analgesia and anesthesia has occurred.

High-Risk Pregnancy
Management Options
, pp. 1810 - 1841
Publisher: Cambridge University Press
First published in: 2017

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American Society of Anesthesiologists. Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Anesthesiology 2007; 106: 843–63.Google Scholar
Arendt, KW, Segal, BS. The association between epidural labor analgesia and maternal fever. Clin Perinatol 2013; 40: 385–98.CrossRefGoogle ScholarPubMed
Bamber, JH, Kinsella, SM. MBBRACE-UK-the new home for the confidential enquiries into maternal deaths-reports for the first time. Anaesthesia 2015; 1: 59.CrossRefGoogle Scholar
Bucklin, BA, Hawkins, JL, Anderson, JR, Ullrich, FA. Obstetric anesthesia workforce survey: twenty-year update. Anesthesiology 2005; 103: 645–53.CrossRefGoogle ScholarPubMed
Dyer, RA, Piercy, JL, Reed, AR, et al. Hemodynamic changes associated with spinal anesthesia for cesarean delivery in severe preeclampsia. Anesthesiology 2008; 108: 802–11.CrossRefGoogle ScholarPubMed
Hawkins, JL, Chang, J, Palmer, SK, et al. Anesthesia-related maternal mortality in the United States, 1997–2002. Obstet Gynecol 2011; 117: 6974.CrossRefGoogle Scholar
Lee, A, Ngan Kee, WD, Gin, T. A quantitative, systematic review of randomized controlled trials of ephedrine versus phenylephrine for the management of hypotension during spinal anesthesia for cesarean delivery. Anesth Analg 2002; 94: 920–6.CrossRefGoogle ScholarPubMed
Turnbull, DK, Shepherd, DB. Post-dural puncture headache: Pathogenesis, prevention and treatment. Br J Anaesth 2003; 91: 718–29.CrossRefGoogle Scholar
Ueyama, H, He, YL, Tanigami, H, et al. Effects of crystalloid and colloid preload on blood volume in the parturient undergoing spinal anesthesia for elective cesarean section. Anesthesiology 1999; 91: 1571–6.CrossRefGoogle ScholarPubMed
Wong, CA, Scavone, BM, Peaceman, AM, et al. The risk of cesarean delivery with neuraxial analgesia given early versus late in labor. N Engl J Med 2005; 352: 655–65.CrossRefGoogle ScholarPubMed
Cook, TM. Combined spinal–epidural techniques. Anaesthesia 2000; 55: 4264.CrossRefGoogle ScholarPubMed
Palot, M, Chale, JJ, Colladon, B, et al. Anesthesia and analgesia practice patterns in French obstetrical patients. Ann Fr Anesth Reanim 1998; 17: 210–19.Google Scholar
Bucklin, BA, Hawkins, JL, Anderson, JR, Ullrich, FA. Obstetric anesthesia workforce survey: twenty-year update. Anesthesiology 2005; 103: 645–53.CrossRefGoogle ScholarPubMed
Tsen, LC, Pitner, R, Camann, WR. General anesthesia at a tertiary care hospital 1990–1995: indications and implications. Int J Obstet Anesth 1998; 7: 147–52.CrossRefGoogle Scholar
Eltzschig, HK, Lieberman, ES, Camann, WR. Regional anesthesia and analgesia for labor and delivery. N Engl J Med 2003; 348: 319–32.CrossRefGoogle ScholarPubMed
Birnbach, DJ, Ojea, LS. Combined spinal–epidural (CSE) for labor and delivery. Int Anesthesiol Clin 2002; 40: 2748.CrossRefGoogle ScholarPubMed
Mhyre, JM, Riesner, MN, Polley, LS, Naughton, NN. A series of anesthesia-related maternal deaths in Michigan, 1985–2003. Anesthesiology 2007; 106: 1096–104.CrossRefGoogle Scholar
Carvalho, B Respiratory depression after neuraxial opioids in the obstetric setting. Anesth Analg 2008; 107: 956–61.CrossRefGoogle ScholarPubMed
Hawkins, JL, Koonin, LM, Palmer, SK, Gibbs, CP. Anesthesia-related deaths during obstetric delivery in the United States, 1979–1990. Anesthesiology 1997; 86: 277–84.CrossRefGoogle ScholarPubMed
Hawkins, JL, Chang, J, Palmer, SK, et al. Anesthesia-related maternal mortality in the United States, 1997–2002. Obstet Gynecol 2011; 117: 6974.CrossRefGoogle Scholar
American Society of Anesthesiologists. Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Anesthesiology 2007; 106: 843–63.Google Scholar
Kodali, BS, Chandrasekhar, S, Bulich, LN, et al. Airway changes during labor and delivery. Anesthesiology 2008; 108: 357–62.CrossRefGoogle ScholarPubMed
Soens, MA, Birnbach, DJ, Ranasinghe, JS, van Zundert, A. Obstetric anesthesia for the obese and morbidly obese patient: an ounce of prevention is worth more than a pound of treatment. Acta Anaesthesiol Scand 2008; 52: 619.CrossRefGoogle ScholarPubMed
Rodgers, A, Walker, N, Schug, S, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: Results from overview of randomised trials. BMJ 2000; 321: 1493.CrossRefGoogle ScholarPubMed
Dresner, M, Brocklesby, J, Bamber, J. Audit of the influence of body mass index on the performance of epidural analgesia in labour and the subsequent mode of delivery. BJOG 2006; 113: 1178–81.CrossRefGoogle ScholarPubMed
Hetherington, SE. A controlled study of the effect of prepared childbirth classes on obstetric outcomes. Birth 1990; 17: 8690.CrossRefGoogle ScholarPubMed
Scott, JR, Rose, NB. Effect of psychoprophylaxis (Lamaze preparation) on labor and delivery in primiparas. N Engl J Med 1976; 294: 1205–7.CrossRefGoogle ScholarPubMed
Motoyama, EK, Rivard, G, Acheson, F, Cook, CD. Adverse effect of maternal hyperventilation on the foetus. Lancet 1966; 1: 286–8.Google ScholarPubMed
Stewart, DE. Psychiatric symptoms following attempted natural childbirth. Can Med Assoc J 1982; 127: 713–16.Google ScholarPubMed
Smith, CA, Collins, CT, Cyna, AM, Crowther, CA. Complementary and alternative therapies for pain management in labour. Cochrane Database Syst Rev 2003; (2): CD003521.CrossRefGoogle Scholar
Scott, KD, Berkowitz, G, Klaus, M. A comparison of intermittent and continuous support during labor: a meta-analysis. Am J Obstet Gynecol 1999; 180: 1054–9.CrossRefGoogle ScholarPubMed
Carroll, D, Tramer, M, McQuay, H, et al. Transcutaneous electrical nerve stimulation in labour pain: a systematic review. Br J Obstet Gynaecol 1997; 104: 169–75.CrossRefGoogle ScholarPubMed
Tsen, LC, Thomas, J, Segal, S, et al. Transcutaneous electrical nerve stimulation does not augment combined spinal epidural labour analgesia. Can J Anaesth 2000; 47: 3842.CrossRefGoogle Scholar
Tsen, LC, Thomas, J, Segal, S, et al. Transcutaneous electrical nerve stimulation does not augment epidural labor analgesia. J Clin Anesth 2001; 13: 571–5.CrossRefGoogle Scholar
Fger, El. Atropine, scopolamine, and related compounds. Anesthesiology 1962; 23: 365–83.Google Scholar
Hinova, A, Fernando, R. Systemic remifentanil for labor analgesia. Anesth Analg 2009; 109: 1925–9.CrossRefGoogle ScholarPubMed
Way, WL, Costley, EC, Leongway, E. Respiratory sensitivity of the newborn infant to meperidine and morphine. Clin Pharmacol Ther 1965; 11: 454461.CrossRefGoogle Scholar
Shnider, SM, Moya, F. Effects of meperidine on the newborn infant. Am J Obstet Gynecol 1964; 89: 1009.CrossRefGoogle ScholarPubMed
Coalson, DW, Glosten, B. Alternatives to epidural analgesia. Semin Perinatol 1991; 15: 375–85.Google ScholarPubMed
Hodgkinson, R, Huff, RW, Hayashi, RH, Husain, FJ. Double-blind comparison of maternal analgesia and neonatal neurobehaviour following intravenous butorphanol and meperidine. J Int Med Res 1979; 7: 224–30.CrossRefGoogle ScholarPubMed
Whitelaw, AG, Cummings, AJ, McFadyen, IR. Effect of maternal lorazepam on the neonate. Br Med J 1981; 282: 1106–8.Google ScholarPubMed
Busacca, M, Gementi, P, Gambini, E, et al. Neonatal effects of the administration of meperidine and promethazine to the mother in labor. Double blind study. J Perinat Med 1982; 10: 4853.CrossRefGoogle ScholarPubMed
Clark, RB, Seifen, AB. Systemic medication during labor and delivery. Obstet Gynecol Annu 1983; 12: 165–97.Google ScholarPubMed
Brazelton, TB. Effect of prenatal drugs on the behavior of the neonate. Am J Psychiatry 1970; 126: 1261–6.CrossRefGoogle ScholarPubMed
Akamatsu, TJ, Bonica, JJ, Rehmet, R, et al. Experiences with the use of ketamine for parturition. I. Primary anesthetic for vaginal delivery. Anesth Analg 1974; 53: 284–7.CrossRefGoogle ScholarPubMed
Likis, FE, Andrews, JC, Collins, MR, et al. Nitrous oxide for the management of labor pain: a systemic review. Anesth Analg 2014; 118: 153–67.Google Scholar
Rosen, AL. Recent advances in pain relief in childbirth. I. Inhalation and systemic analgesia. Br J Anaesth 1971; 43: 837–48.CrossRefGoogle ScholarPubMed
Munson, ES, Embro, WJ. Enflurane, isoflurane, and halothane and isolated human uterine muscle. Anesthesiology 1977; 46: 1114.CrossRefGoogle ScholarPubMed
Marx, GF, Kim, YL, Lin, CC, et al. Postpartum uterine pressures under halothane or enflurance anesthesia. Obstet Gynecol 1978; 51: 695–8.Google ScholarPubMed
Asling, JH, Shnider, SM, Margolis, AJ, et al. Paracervical block anesthesia in obstetrics. II. Etiology of fetal bradycardia following paracervical block anesthesia. Am J Obstet Gynecol 1970; 107: 626–34.Google ScholarPubMed
Leighton, BL, Halpern, SH, Wilson, DB. Lumbar sympathetic blocks speed early and second stage induced labor in nulliparous women. Anesthesiology 1999; 90: 1039–46.CrossRefGoogle ScholarPubMed
Hutchins, CJ. Spinal analgesia for instrumental delivery: a comparison with pudendal nerve block. Anaesthesia 1980; 35: 376–7.CrossRefGoogle ScholarPubMed
Merkow, AJ, McGuinness, GA, Erenberg, A, Kennedy, RL. The neonatal neurobehavioral effects of bupivacaine, mepivacaine, and 2-chloroprocaine used for pudendal block. Anesthesiology 1980; 52: 309–12.CrossRefGoogle ScholarPubMed
Philipson, EH, Kuhnert, BR, Syracuse, CD. 2-Chloroprocaine for local perineal infiltration. Am J Obstet Gynecol 1987; 157: 1275–8.CrossRefGoogle ScholarPubMed
Goetzinger, KR, Harper, LM, Tuuli, MG, et al. Effect of regional anesthesia on the success rate of external cephalic version: a systematic review and meta-analysis. Obstet Gynecol 2011; 118: 1137–44.CrossRefGoogle ScholarPubMed
Schorr, SJ, Speights, SE, Ross, EL, et al. A randomized trial of epidural anesthesia to improve external cephalic version success. Am J Obstet Gynecol 1997; 177: 1133–7.CrossRefGoogle ScholarPubMed
Dugoff, L, Stamm, CA, Jones, OW, et al. The effect of spinal anesthesia on the success rate of external cephalic version: a randomized trial. Obstet Gynecol 1999; 93: 345–9.Google ScholarPubMed
Birnbach, DJ, Matut, J, Stein, DJ, et al. The effect of intrathecal analgesia on the success of external cephalic version. Anesth Analg 2001; 93: 410–13.Google ScholarPubMed
Lavoie, A, Guay, J. Anesthetic dose neuraxial blockade increases the success rate of external fetal version: a meta-analysis. Can J Anaesth 2010; 57: 408–14.CrossRefGoogle ScholarPubMed
Cherayil, G, Feinberg, B, Robinson, J, Tsen, LC. Central neuraxial blockade promotes external cephalic version success after a failed attempt. Anesth Analg 2002; 94: 1589–92.Google ScholarPubMed
Weiniger, CF, Spencer, PS, Weiss, Y, et al. Reducing the cesarean delivery rates for breech presentations: administration of spinal anesthesia facilitates manipulation to cephalic presentation, but is it cost saving? Isr J Health Policy Res 2014; 3: 5.CrossRefGoogle ScholarPubMed
Arkoosh, VA. Continuous spinal analgesia and anesthesia in obstetrics. Reg Anesth 1993; 18: 402–5.Google ScholarPubMed
Lambert, DH, Hurley, RJ. Cauda equina syndrome and continuous spinal anesthesia. Anesth Analg 1991; 72: 817–19.CrossRefGoogle ScholarPubMed
Arkoosh, VA, Palmer, CM, Yun, EM, et al. A randomized, double-masked, multicenter comparison of the safety of continuous intrathecal labor analgesia using a 28-gauge catheter versus continuous epidural labor analgesia. Anesthesiology 2008; 108: 286–98.CrossRefGoogle ScholarPubMed
Tsen, LC, Boosalis, P, Segal, S, et al. Hemodynamic effects of simultaneous administration of intravenous ephedrine and spinal anesthesia for cesarean delivery. J Clin Anesth 2000; 12: 378–82.CrossRefGoogle ScholarPubMed
Mercier, FJ. Fluid loading for cesarean delivery under spinal anesthesia: have we studied all the options? Anesth Analg 2011; 113: 677–80.CrossRefGoogle ScholarPubMed
Datta, S, Alper, MH, Ostheimer, GW, Weiss, JB. Method of ephedrine administration and nausea and hypotension during spinal anesthesia for cesarean section. Anesthesiology 1982; 56: 6870.CrossRefGoogle ScholarPubMed
Turnbull, DK, Shepherd, DB. Post-dural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth 2003; 91: 718–29.CrossRefGoogle Scholar
Paech, MJ, Doherty, DA, Christmas, T, et al. The volume of blood for epidural blood patch in obstetrics: a randomized, blinded clinical trial. Anesth Analg 2011; 113: 126133.CrossRefGoogle ScholarPubMed
Abouleish, E, Vega, S, Blendinger, I, Tio, TO. Long-term follow-up of epidural blood patch. Anesth Analg 1975; 54: 459–63.Google ScholarPubMed
Santos, AC, DeArmas, PI. Systemic toxicity of levobupivacaine, bupivacaine, and ropivacaine during continuous intravenous infusion to nonpregnant and pregnant ewes. Anesthesiology 2001; 95: 1256–64.CrossRefGoogle ScholarPubMed
Ohmura, S, Kawada, M, Ohta, T, et al. Systemic toxicity and resuscitation in bupivacaine-, levobupivacaine-, or ropivacaine-infused rats. Anesth Analg 2001; 93: 743–8.CrossRefGoogle ScholarPubMed
Booker, PD, Wilkes, RG, Bryson, TH, Beddard, J. Obstetric pain relief using epidural morphine. Anaesthesia 1980; 35: 377–9.CrossRefGoogle ScholarPubMed
Camann, WR, Denney, RA, Holby, ED, Datta, S. A comparison of intrathecal, epidural, and intravenous sufentanil for labor analgesia. Anesthesiology 1992; 77: 884–7.CrossRefGoogle ScholarPubMed
Celleno, D, Capogna, G. Epidural fentanyl plus bupivacaine 0.125 per cent for labour: Analgesic effects. Can J Anaesth 1988; 35: 375–8.CrossRefGoogle ScholarPubMed
van der Vyver, M, Halpern, S, Joseph, G. Patient-controlled epidural analgesia versus continuous infusion for labour analgesia: a meta-analysis. Br J Anaesth 2002; 89: 459–65.CrossRefGoogle ScholarPubMed
George, RB, Allen, TK, Habib, AS. Intermittent epidural bolus compared with continuous epidural infusions for labor analgesia: a systematic review and meta-analysis. Anesth Analg 2013; 116: 133–44.CrossRefGoogle ScholarPubMed
Tsen, LC, Thue, B, Datta, S, Segal, S. Is combined spinal–epidural analgesia associated with more rapid cervical dilation in nulliparous patients when compared with conventional epidural analgesia? Anesthesiology 1999; 91: 920–5.CrossRefGoogle ScholarPubMed
Wong, CA, Scavone, BM, Peaceman, AM, et al. The risk of cesarean delivery with neuraxial analgesia given early versus late in labor. N Engl J Med 2005; 352: 655–65.CrossRefGoogle ScholarPubMed
Holmstrom, B, Rawal, N, Axelsson, K, Nydahl, PA. Risk of catheter migration during combined spinal epidural block: percutaneous epiduroscopy study. Anesth Analg 1995; 80: 747–53.Google ScholarPubMed
Albright, GA, Forster, RM. The safety and efficacy of combined spinal and epidural analgesia/anesthesia (6,002 blocks) in a community hospital. Reg Anesth Pain Med 1999; 24: 117–25.Google Scholar
Cappiello, E, O’Rourke, N, Segal, S, Tsen, LC. A randomized trial of dural puncture epidural technique compared with the standard epidural technique for labor analgesia. Anesth Analg 2008; 107: 1646–61.CrossRefGoogle ScholarPubMed
Palmer, CM, Emerson, S, Volgoropolous, D, Alves, D. Dose response relationship of intrathecal morphine for postcesarean analgesia. Anesthesiology 1999; 90: 437–44.CrossRefGoogle ScholarPubMed
Abouleish, EI. Epinephrine improves the quality of spinal hyperbaric bupivacaine for cesarean section. Anesth Analg 1987; 66: 395400.CrossRefGoogle ScholarPubMed
Park, GE, Hauch, MA, Curlin, F, et al. The effects of varying volumes of crystalloid administration before cesarean delivery on maternal hemodynamics and colloid osmotic pressure. Anesth Analg 1996; 83: 299303.CrossRefGoogle ScholarPubMed
Lee, A, Ngan Kee, WD, Gin, T. A quantitative, systematic review of randomized controlled trials of ephedrine versus phenylephrine for the management of hypotension during spinal anesthesia for cesarean delivery. Anesth Analg 2002; 94: 920–6.CrossRefGoogle ScholarPubMed
Ueyama, H, He, YL, Tanigami, H, et al. Effects of crystalloid and colloid preload on blood volume in the parturient undergoing spinal anesthesia for elective cesarean section. Anesthesiology 1999; 91: 1571–6.CrossRefGoogle ScholarPubMed
Ngan Kee, W. Phenylephrine infusions for maintaining blood pressure during spinal anesthesia for cesarean delivery: finding the shoe that fits. Anesth Analg 2014; 118: 496–8.CrossRefGoogle ScholarPubMed
Datta, S, Lambert, DH, Gregus, J, et al. Differential sensitivities of mammalian nerve fibers during pregnancy. Anesth Analg 1983; 62: 1070–2.CrossRefGoogle ScholarPubMed
Bromage, PR. Continuous lumbar epidural analgesia for obstetrics. Can Med Assoc J 1961; 85: 1136–40.Google ScholarPubMed
Philipson, EH, Kuhnert, BR, Syracuse, CD. Fetal acidosis, 2-chloroprocaine, and epidural anesthesia for cesarean section. Am J Obstet Gynecol 1985; 151: 322–4.CrossRefGoogle ScholarPubMed
Camann, WR, Hartigan, PM, Gilbertson, LI, et al. Chloroprocaine antagonism of epidural opioid analgesia: a receptor-specific phenomenon? Anesthesiology 1990; 73: 860–3.CrossRefGoogle ScholarPubMed
Stevens, RA, Urmey, WF, Urquhart, BL, Kao, TC. Back pain after epidural anesthesia with chloroprocaine. Anesthesiology 1993; 78: 492–7.CrossRefGoogle ScholarPubMed
Stevens, RA, Chester, WL, Schubert, A, et al. pH-adjustment of 2-chloroprocaine quickens the onset of epidural anaesthesia. Can J Anaesth 1989; 36: 515–18.CrossRefGoogle ScholarPubMed
Peterfreund, RA, Datta, S, Ostheimer, GW. pH adjustment of local anesthetic solutions with sodium bicarbonate: laboratory evaluation of alkalinization and precipitation. Reg Anesth 1989; 14: 265–70.Google ScholarPubMed
Bauer, ME, Kountanis, JA, Tsen, LC, et al. Risk factors for failed conversion of labor epidural analgesia to cesarean delivery anesthesia: a systematic review and meta-analysis of observational trials. Int J Obstet Anesth 2012; 21: 294309.CrossRefGoogle ScholarPubMed
Aya, AG, Vialles, N, Tanoubi, I, et al. Spinal anesthesia-induced hypotension: a risk comparison between patients with severe preeclampsia and healthy women undergoing preterm cesarean delivery. Anesth Analg 2005; 101: 869–75.CrossRefGoogle ScholarPubMed
Santos, AC, Birnbach, DJ. Spinal anesthesia in the parturient with severe preeclampsia: time for reconsideration. Anesth Analg 2003; 97: 621–2.Google ScholarPubMed
Chestnut, DH, Dewan, DM, Redick, LF, et al. Anesthetic management for obstetric hysterectomy: a multi-institutional study. Anesthesiology 1989; 70: 607–10.CrossRefGoogle ScholarPubMed
Bamber, JH, Kinsella, SM. MBBRACE-UK-the new home for the confidential enquiries into maternal deaths-reports for the first time. Anaesthesia 2015; 1: 59.CrossRefGoogle Scholar
Ross, BK. ASA closed claims in obstetrics: lessons learned. Anesthesiol Clin North Am 2003; 21: 183–97.CrossRefGoogle ScholarPubMed
Palanisamy, A, Mitani, AA, Tsen, LC. General anesthesia for cesarean delivery at a tertiary care hospital from 2000 to 2005: a retrospective analysis and 10-year update. Int J Obstet Anesth 2011; 1: 1016.CrossRefGoogle Scholar
American Society of Anesthesiologists. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 2003; 98: 1269–77.Google Scholar
Han, TH, Brimacombe, J, Lee, EJ, Yang, HS. The laryngeal mask airway is effective (and probably safe) in selected healthy parturients for elective cesarean section: A prospective study of 1067 cases. Can J Anaesth 2001; 48: 1117–21.CrossRefGoogle ScholarPubMed
James, CF, Modell, JH, Gibbs, CP, et al. Pulmonary aspiration: effects of volume and pH in the rat. Anesth Analg 1984; 63: 665–8.CrossRefGoogle ScholarPubMed
Johnston, JR, Moore, J, McCaughey, W, et al. Use of cimetidine as an oral antacid in obstetric anesthesia. Anesth Analg 1983; 62: 720–6.CrossRefGoogle ScholarPubMed
Murphy, DF, Nally, B, Gardiner, J, Unwin, A. Effect of metoclopramide on gastric emptying before elective and emergency caesarean section. Br J Anaesth 1984; 56: 1113–16.CrossRefGoogle ScholarPubMed
Norris, MC, Dewan, DM. Preoxygenation for cesarean section: a comparison of two techniques. Anesthesiology 1985; 62: 827–9.CrossRefGoogle ScholarPubMed
Palahniuk, RJ, Shnider, SM, Eger, EI. Pregnancy decreases the requirement for inhaled anesthetic agents. Anesthesiology 1974; 41: 82–3.CrossRefGoogle ScholarPubMed
Dogru, K, Yildiz, K, Dalgic, H, et al. Inhibitory effects of desflurane and sevoflurane on contractions of isolated gravid rat myometrium under oxytocin stimulation. Acta Anaesthesiol Scand 2003; 47: 472–4.CrossRefGoogle ScholarPubMed
Zand, F, Hadavi, SM, Chohedri, A, Sabetian, P. Survey on the adequacy of depth of anaesthesia with bispectral index and isolated forearm technique in elective Caesarean section under general anaesthesia with sevoflurane. Br J Anaesth 2014; 112: 871–8.CrossRefGoogle ScholarPubMed
Mattingly, JE, D’Alessio, J, Ramanathan, J. Effects of obstetric analgesics and anesthetics on the neonate: a review. Paediatr Drugs 2003; 5: 615–27.CrossRefGoogle ScholarPubMed
Datta, S, Ostheimer, GW, Weiss, JB, et al. Neonatal effect of prolonged anesthetic induction for cesarean section. Obstet Gynecol 1981; 58: 331–5.Google ScholarPubMed
Maayan-Metzger, A, Schushan-Eisen, I, Todris, L, Etchin, A, Kuint, J. The effect of time intervals on neonatal outcome in elective cesarean delivery at term under regional anesthesia. Int J Gynaecol Obstet 2010; 111: 224–8.CrossRefGoogle ScholarPubMed
Spain, JE, Tuuli, M, Stout, MJ, et al. Time from uterine incision to delivery and hypoxic neonatal outcomes. Am J Perinatol 2015; 32: 497502.Google ScholarPubMed
Wang, JK, Nauss, LA, Thomas, JE. Pain relief by intrathecally applied morphine in man. Anesthesiology 1979; 50: 149–51.CrossRefGoogle ScholarPubMed
Cousins, MJ, Mather, LE. Intrathecal and epidural administration of opioids. Anesthesiology 1984; 61: 276310.Google ScholarPubMed
Pan, PH, James, CF. Anesthetic-postoperative morphine regimens for cesarean section and postoperative oxygen saturation monitored by a telemetric pulse oximetry network for 24 continuous hours. J Clin Anesth 1994; 6: 124–8.CrossRefGoogle ScholarPubMed
Harrison, DM, Sinatra, R, Morgese, L, Chung, JH. Epidural narcotic and patient-controlled analgesia for post-cesarean section pain relief. Anesthesiology 1988; 68: 454–7.CrossRefGoogle ScholarPubMed
Rosen, MA, Hughes, SC, Shnider, SM, et al. Epidural morphine for the relief of postoperative pain after cesarean delivery. Anesth Analg 1983; 62: 666–72.CrossRefGoogle ScholarPubMed
Carmichael, FJ, Rolbin, SH, Hew, EM. Epidural morphine for analgesia after caesarean section. Can Anaesth Soc J 1982; 29: 359–63.CrossRefGoogle ScholarPubMed
Fuller, JG, McMorland, GH, Douglas, MJ, Palmer, L. Epidural morphine for analgesia after caesarean section: a report of 4880 patients. Can J Anaesth 1990; 37: 636–40.CrossRefGoogle ScholarPubMed
Palmer, CM, Nogami, WM, Van Maren, G, Alves, DM. Postcesarean epidural morphine: A dose-response study. Anesth Analg 2000; 90: 887–91.CrossRefGoogle ScholarPubMed
Thind, GS, Wells, JC, Wilkes, RG. The effects of continuous intravenous naloxone on epidural morphine analgesia. Anaesthesia 1986; 41: 582–5.CrossRefGoogle ScholarPubMed
Kotelko, DM, Dailey, PA, Shnider, SM, et al. Epidural morphine analgesia after cesarean delivery. Obstet Gynecol 1984; 63: 409–13.Google ScholarPubMed
Sharar, SR, Ready, LB, Ross, BK, et al. A comparison of postcesarean epidural morphine analgesia by single injection and by continuous infusion. Reg Anesth 1991; 16: 232–5.Google ScholarPubMed
Fischer, RL, Lubenow, TR, Liceaga, A, et al. Comparison of continuous epidural infusion of fentanyl-bupivacaine and morphine-bupivacaine in management of postoperative pain. Anesth Analg 1988; 67: 559–63.CrossRefGoogle ScholarPubMed
Chadwick, HS, Ready, LB. Intrathecal and epidural morphine sulfate for post-cesarean analgesia: a clinical comparison. Anesthesiology 1988; 68: 925–9.CrossRefGoogle ScholarPubMed
Fusco, P, Scimia, P, Paladini, G, et al. Transversus abdominis plane block for analgesia after cesarean delivery: a systematic review. Minerva Anestesiol 2015; 81: 195204.Google ScholarPubMed
Clinical competence in hemodynamic monitoring. A statement for physicians from the ACP/ACC/AHA Task Force on Clinical Privileges in Cardiology. Circulation 1990; 81: 2036–40.CrossRefGoogle Scholar
Sibbald, WJ, Keenan, SP. Show me the evidence: a critical appraisal of the Pulmonary Artery Catheter Consensus Conference and other musings on how critical care practitioners need to improve the way we conduct business. Crit Care Med 1997; 25: 2060–3.CrossRefGoogle ScholarPubMed
Connors, AF, Speroff, T, Dawson, NV, et al. The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators. JAMA 1996; 276: 889–97.Google ScholarPubMed
Newsome, LR, Bramwell, RS, Curling, PE. Severe preeclampsia: Hemodynamic effects of lumbar epidural anesthesia. Anesth Analg 1986; 65: 31–6.CrossRefGoogle ScholarPubMed
Sise, MJ, Hollingsworth, P, Brimm, JE, et al. Complications of the flow-directed pulmonary artery catheter: a prospective analysis in 219 patients. Crit Care Med 1981; 9: 315–18.CrossRefGoogle ScholarPubMed
Benedetti, TJ, Kates, R, Williams, V. Hemodynamic observations in severe preeclampsia complicated by pulmonary edema. Am J Obstet Gynecol 1985; 152: 330–4.CrossRefGoogle ScholarPubMed
Clark, SL, Cotton, DB. Clinical indications for pulmonary artery catheterization in the patient with severe preeclampsia. Am J Obstet Gynecol 1988; 158: 453–8.CrossRefGoogle ScholarPubMed
Bray, JK, Fernando, R, Patel, NP, Columb, MO. Suprasternal Doppler estimation of cardiac output: standard versus sequential combined spinal epidural anesthesia for cesarean delivery. Anesth Analg 2006; 103: 959–64.CrossRefGoogle ScholarPubMed
Dennis, AT, Castro, JM. Echocardiographic differences between preeclampsia and peripartum cardiomyopathy. Int J Obstet Anesth 2014; 23: 260–6.CrossRefGoogle ScholarPubMed
Jouppila, P, Jouppila, R, Hollmen, A, Koivula, A. Lumbar epidural analgesia to improve intervillous blood flow during labor in severe preeclampsia. Obstet Gynecol 1982; 59: 158–61.Google ScholarPubMed
VanWijk, MJ, Boer, K, Berckmans, RJ, et al. Enhanced coagulation activation in preeclampsia: the role of APC resistance, microparticles and other plasma constituents. Thromb Haemost 2002; 88: 415–20.Google ScholarPubMed
Kelton, JG, Hunter, DJ, Neame, PB. A platelet function defect in preeclampsia. Obstet Gynecol 1985; 65: 107–09.Google ScholarPubMed
Wallace, D II, Leveno, KJ, Cunningham, FG, et al. Randomized comparison of general and regional anesthesia for cesarean delivery in pregnancies complicated by severe preeclampsia. Obstet Gynecol 1995; 86: 193–9.CrossRefGoogle ScholarPubMed
Hepner, D, Tsen, LC. Fluid management in obstetrics. In Hahn, R, Prough, DS, Svensen, CH (eds). Perioperative Fluid Therapy. New York, NY: Informa Healthcare, 2007, pp. 405–22.Google Scholar
Pant, M, Fong, R, Scavone, B. Prevention of peri-induction hypertension in preeclamptic patients: a focused review. Anesth Analg 2014; 119: 1350–6.CrossRefGoogle ScholarPubMed
Brickner, ME. Cardiovascular management in pregnancy: congenital heart disease. Circulation 2014; 130: 273–82.CrossRefGoogle ScholarPubMed
Knotts, RJ, Garan, H. Cardiac arrhythmias in pregnancy. Semin Perinatol 2014; 38: 285–8.CrossRefGoogle ScholarPubMed
Rees, GA, Willis, BA. Resuscitation in late pregnancy. Anaesthesia 1988; 33: 347–9.Google Scholar
Lipman, S, Cohen, S, Einav, S, et al. The Society for Obstetric Anesthesia and Perinatology consensus statement on the management of cardiac arrest in pregnancy. Anesth Analg 2014; 118: 1003–16.CrossRefGoogle Scholar
Kebed, KY, Bishu, K, Al Adham, RI, et al. Pregnancy and postpartum infective endocarditis: a systematic review. Mayo Clin Proc 2014; 89: 1143–52.CrossRefGoogle ScholarPubMed
Khanlou, H, Khanlou, N, Eiger, G. Relationship between mitral valve regurgitant flow and peripartum change in systemic vascular resistance. South Med J 2003; 96: 308–9.CrossRefGoogle ScholarPubMed
Tsen, LC. Anesthetic management of the parturient with cardiac and diabetic diseases. Clin Obstet Gynecol 2003; 46: 700–10.CrossRefGoogle ScholarPubMed
Naulty, JS, Ostheimer, GW, Datta, S, et al. Incidence of venous air embolism during epidural catheter insertion. Anesthesiology 1982; 57: 410–12.CrossRefGoogle ScholarPubMed
Daliento, L, Somerville, J, Presbitero, P, et al. Eisenmenger syndrome: factors relating to deterioration and death. Eur Heart J 1998; 19: 1845–55.CrossRefGoogle ScholarPubMed
Datta, S, Brown, WU. Acid–base status in diabetic mothers and their infants following general or spinal anesthesia for cesarean section. Anesthesiology 1977; 47: 272–6.CrossRefGoogle ScholarPubMed
Datta, S, Kitzmiller, JL, Naulty, JS, et al. Acid–base status of diabetic mothers and their infants following spinal anesthesia for cesarean section. Anesth Analg 1982; 61: 662–5.CrossRefGoogle ScholarPubMed
Greisen, J, Juhl, CB, Grofte, T, et al. Acute pain induces insulin resistance in humans. Anesthesiology 2001; 95: 578–84.CrossRefGoogle ScholarPubMed
Lattermann, R, Carli, F, Wykes, L, Schricker, T. Epidural blockade modifies perioperative glucose production without affecting protein catabolism. Anesthesiology 2002; 97: 374–81.CrossRefGoogle ScholarPubMed
Jones, TW, Porter, P, Sherwin, RS, et al. Decreased epinephrine responses to hypoglycemia during sleep. N Engl J Med 1998; 338: 1657–62.CrossRefGoogle ScholarPubMed
Friedman, EA. Primigravid labor: a graphicostatistical analysis. Obstet Gynecol 1955; 6: 567–89.CrossRefGoogle ScholarPubMed
Zhang, J, Troendle, JF, Yancey, MK. Reassessing the labor curve in nulliparous women. Am J Obstet Gynecol 2002; 187: 824–8.CrossRefGoogle ScholarPubMed
Floberg, J, Belfrage, P, Ohlsen, H. Influence of the pelvic outlet capacity on fetal head presentation at delivery. Acta Obstet Gynecol Scand 1987; 66: 127–30.CrossRefGoogle ScholarPubMed
Wuitchik, M, Bakal, D, Lipshitz, J. The clinical significance of pain and cognitive activity in latent labor. Obstet Gynecol 1989; 73: 3542.Google ScholarPubMed
Hess, PE, Pratt, SD, Lucas, TP, et al. Predictors of breakthrough pain during labor epidural analgesia. Anesth Analg 2001; 93: 414–18.Google ScholarPubMed
Hess, PE, Pratt, SD, Soni, AK, et al. An association between severe labor pain and cesarean delivery. Anesth Analg 2000; 90: 881–6.CrossRefGoogle ScholarPubMed
Panni, MK, Segal, S. Local anesthetic requirements are greater in dystocia than in normal labor. Anesthesiology 2003; 98: 957–63.CrossRefGoogle ScholarPubMed
Bofill, JA, Vincent, RD, Ross, EL, et al. Nulliparous active labor, epidural analgesia, and cesarean delivery for dystocia. Am J Obstet Gynecol 1997; 177: 1465–70.CrossRefGoogle ScholarPubMed
Kowalski, WB, Parsons, MT, Pak, SC, Wilson, L. Morphine inhibits nocturnal oxytocin secretion and uterine contractions in the pregnant baboon. Biol Reprod 1998; 58: 971–6.CrossRefGoogle ScholarPubMed
American College of Obstetricians and Gynecologists (ACOG) Task Force on Cesarean Delivery Rates. Evaluation of Cesarean Delivery. Washington, DC: ACOG, 2000.Google Scholar
Malone, FD, Geary, M, Chelmow, D, et al. Prolonged labor in nulliparas: lessons from the active management of labor. Obstet Gynecol 1996; 88: 211–15.CrossRefGoogle ScholarPubMed
Thorp, JA, Eckert, LO, Ang, MS, et al. Epidural analgesia and cesarean section for dystocia: risk factors in nulliparas. Am J Perinatol 1991; 8: 402–10.CrossRefGoogle ScholarPubMed
Lieberman, E, Lang, JM, Cohen, A, et al. Association of epidural analgesia with cesarean delivery in nulliparas. Obstet Gynecol 1996; 88: 9931000.CrossRefGoogle ScholarPubMed
Ohel, G, Harats, H. Epidural anesthesia in early compared with advanced labor. Int J Gynaecol Obstet 1994; 45: 217–19.CrossRefGoogle ScholarPubMed
Holt, RO, Diehl, SJ, Wright, JW. Station and cervical dilation at epidural placement in predicting cesarean risk. Obstet Gynecol 1999; 93: 281–4.Google ScholarPubMed
Segal, S, Su, M, Gilbert, P. The effect of a rapid change in availability of epidural analgesia on the cesarean delivery rate: a meta-analysis. Am J Obstet Gynecol 2000; 183: 974–8.CrossRefGoogle ScholarPubMed
Luxman, D, Wolman, I, Groutz, A, et al. The effect of early epidural block administration on the progression and outcome of labor. Int J Obstet Anesth 1998; 7: 161–4.CrossRefGoogle ScholarPubMed
Chestnut, DH, McGrath, JM, Vincent, RD, et al. Does early administration of epidural analgesia affect obstetric outcome in nulliparous women who are in spontaneous labor? Anesthesiology 1994; 80: 1201–8.Google ScholarPubMed
Chestnut, DH, Vincent, RD, McGrath, JM, et al. Does early administration of epidural analgesia affect obstetric outcome in nulliparous women who are receiving intravenous oxytocin? Anesthesiology 1994; 80: 1193–200.Google ScholarPubMed
Halpern, SH, Leighton, BL, Ohlsson, A, et al. Effect of epidural vs parenteral opioid analgesia on the progress of labor: a meta-analysis. JAMA 1998; 280: 2105–10.CrossRefGoogle ScholarPubMed
Wilson, MJ, Cooper, G, MacArthur, C, Shennan, A; Comparative Obstetric Mobile Epidural Trial (COMET) Study Group UK. Randomized controlled trial comparing traditional with two “mobile” epidural techniques: anesthetic and analgesic efficacy. Anesthesiology 2002; 97: 1567–75.Google ScholarPubMed
Goyert, GL, Bottoms, SF, Treadwell, MC, Nehra, PC. The physician factor in cesarean birth rates. N Engl J Med 1989; 320: 706–9.CrossRefGoogle ScholarPubMed
Socol, ML, Garcia, PM, Peaceman, AM, Dooley, SL. Reducing cesarean births at a primarily private university hospital. Am J Obstet Gynecol 1993; 168: 1748–58.CrossRefGoogle Scholar
Lagrew, DC, Morgan, MA. Decreasing the cesarean section rate in a private hospital: success without mandated clinical changes. Am J Obstet Gynecol 1996; 174: 184–91.CrossRefGoogle Scholar
Sng, BL, Leong, WL, Zeng, Y, et al. Early versus late initiation of epidural analgesia for labour. Cochrane Database Syst Rev 2014; (10): CD007238.CrossRefGoogle Scholar
Mackowiak, PA, Wasserman, SS, Levine, MM. A critical appraisal of 98.6 degrees F, the upper limit of the normal body temperature, and other legacies of Carl Reinhold August Wunderlich. JAMA 1992; 268: 1578–80.CrossRefGoogle ScholarPubMed
Resch, GE, Millington, WR. Inhibition of interleukin-1 beta and prostaglandin E(2) thermogenesis by glycyl-glutamine, a proopiomelanocortin-derived peptide. Brain Res 2001; 894: 316–20.CrossRefGoogle Scholar
Walker, DW, Wood, C. Temperature relationship of the mother and fetus during labor. Am J Obstet Gynecol 1970; 107: 83–7.CrossRefGoogle ScholarPubMed
Morishima, HO, Glaser, B, Niemann, WH, James, LS. Increased uterine activity and fetal deterioration during maternal hyperthermia. Am J Obstet Gynecol 1975; 121: 531–8.CrossRefGoogle ScholarPubMed
Cefalo, RC, Hellegers, AE. The effects of maternal hyperthermia on maternal and fetal cardiovascular and respiratory function. Am J Obstet Gynecol 1978; 131: 687–94.CrossRefGoogle ScholarPubMed
Lieberman, E, Lang, J, Richardson, DK, et al. Intrapartum maternal fever and neonatal outcome. Pediatrics 2000; 105: 813.CrossRefGoogle ScholarPubMed
Impey, L, Greenwood, C, MacQuillan, K, et al. Fever in labour and neonatal encephalopathy: A prospective cohort study. BJOG 2001; 108: 594–7.Google ScholarPubMed
Grether, JK, Nelson, KB. Maternal infection and cerebral palsy in infants of normal birth weight. JAMA 1997; 278: 207–11.CrossRefGoogle ScholarPubMed
Dammann, O, Drescher, J, Veelken, N. Maternal fever at birth and non-verbal intelligence at age 9 years in preterm infants. Dev Med Child Neurol 2003; 45: 148–51.CrossRefGoogle ScholarPubMed
Lieberman, E, Cohen, A, Lang, J, et al. Maternal intrapartum temperature elevation as a risk factor for cesarean delivery and assisted vaginal delivery. Am J Public Health 1999; 89: 506–10.CrossRefGoogle ScholarPubMed
Shipp, TD, Zelop, C, Cohen, A, et al. Post-cesarean delivery fever and uterine rupture in a subsequent trial of labor. Obstet Gynecol 2003; 101: 136–9.Google Scholar
Herbst, A, Wolner-Hanssen, P, Ingemarsson, I. Risk factors for fever in labor. Obstet Gynecol 1995; 86: 790–4.CrossRefGoogle ScholarPubMed
Vinson, DC, Thomas, R, Kiser, T. Association between epidural analgesia during labor and fever. J Fam Pract 1993; 36: 617–22.Google ScholarPubMed
Camann, WR, Hortvet, LA, Hughes, N, et al. Maternal temperature regulation during extradural analgesia for labour. Br J Anaesth 1991; 67: 565–8.CrossRefGoogle ScholarPubMed
Vallejo, MC, Kaul, B, Adler, LJ, et al. Chorioamnionitis, not epidural analgesia, is associated with maternal fever during labour. Can J Anaesth 2001; 48: 1122–6.CrossRefGoogle Scholar
Dolak, JA, Brown, RE. Epidural analgesia and neonatal fever. Pediatrics 1998; 101: 492.Google ScholarPubMed
Dashe, JS, Rogers, BB, McIntire, DD, Leveno, KJ. Epidural analgesia and intrapartum fever: Placental findings. Obstet Gynecol 1999; 93: 341–4.Google ScholarPubMed
Glosten, B, Sessler, DI, Faure, EA, et al. Central temperature changes are poorly perceived during epidural anesthesia. Anesthesiology 1992; 77: 1016.CrossRefGoogle ScholarPubMed
Fusi, L, Steer, PJ, Maresh, MJ, Beard, RW. Maternal pyrexia associated with the use of epidural analgesia in labour. Lancet 1989; 1: 1250–2.Google ScholarPubMed
Macaulay, JH, Bond, K, Steer, PJ. Epidural analgesia in labor and fetal hyperthermia. Obstet Gynecol 1992; 80: 6659.Google ScholarPubMed
Mantha, VR, Vallejo, MC, Ramesh, V, et al. The incidence of maternal fever during labor is less with intermittent than with continuous epidural analgesia: a randomized controlled trial. Int J Obstet Anesth 2008; 17: 123–9.CrossRefGoogle ScholarPubMed
Lieberman, E, Lang, JM, Frigoletto, F, et al. Epidural analgesia, intrapartum fever, and neonatal sepsis evaluation. Pediatrics 1997; 99: 415–19.CrossRefGoogle ScholarPubMed
Ploeckinger, B, Ulm, MR, Chalubinski, K, Gruber, W. Epidural anaesthesia in labour: influence on surgical delivery rates, intrapartum fever and blood loss. Gynecol Obstet Invest 1995; 39: 24–7.CrossRefGoogle ScholarPubMed
Glosten, B, Savage, M, Rooke, GA, Brengelmann, GL. Epidural anesthesia and the thermoregulatory responses to hyperthermia: preliminary observations in volunteer subjects. Acta Anaesthesiol Scand 1998; 42: 442–6.CrossRefGoogle ScholarPubMed
Goodlin, RC, Chapin, JW. Determinants of maternal temperature during labor. Am J Obstet Gynecol 1982; 143: 97103.CrossRefGoogle ScholarPubMed
Hagerdal, M, Morgan, CW, Sumner, AE, Gutsche, BB. Minute ventilation and oxygen consumption during labor with epidural analgesia. Anesthesiology 1983; 59: 425–7.CrossRefGoogle ScholarPubMed
Gleeson, NC, Nolan, KM, Ford, MR. Temperature, labour, and epidural analgesia. Lancet 1989; 2: 861–2.Google ScholarPubMed
Oka, T. 5-HT and narcotic-induced hypothermia. Gen Pharmacol 1978; 9: 151–4.CrossRefGoogle ScholarPubMed
Gross, JB, Cohen, AP, Lang, JM, et al. Differences in systemic opioid use do not explain increased fever incidence in parturients receiving epidural analgesia. Anesthesiology 2002; 97: 157–61.CrossRefGoogle Scholar
Mayer, DC, Chescheir, NC, Spielman, FJ. Increased intrapartum antibiotic administration associated with epidural analgesia in labor. Am J Perinatol 1997; 14: 83–6.CrossRefGoogle ScholarPubMed
Goetzl, L, Cohen, A, Frigoletto, F, et al. Maternal epidural use and neonatal sepsis evaluation in afebrile mothers. Pediatrics 2001; 108: 1099–102.CrossRefGoogle ScholarPubMed
Yancey, MK, Zhang, J, Schwarz, J, et al. Labor epidural analgesia and intrapartum maternal hyperthermia. Obstet Gynecol 2001; 98: 763–70.Google ScholarPubMed
Kaul, B, Vallejo, M, Ramanathan, S, Mandell, G. Epidural labor analgesia and neonatal sepsis evaluation rate: a quality improvement study. Anesth Analg 2001; 93: 986–90.CrossRefGoogle ScholarPubMed
Goetzl, L, Evans, T, Rivers, J, et al. Elevated maternal and fetal serum interleukin-6 levels are associated with epidural fever. Am J Obstet Gynecol 2002; 187: 834–8.CrossRefGoogle ScholarPubMed
Goetzl, L, Zighelboim, I, Badell, M, et al. Maternal corticosteroids to prevent intrauterine exposure to hyperthermia and inflammation: a randomized, double-blind, placebo-controlled trial. Am J Obstet Gynecol 2006; 195: 1031–7.CrossRefGoogle ScholarPubMed
Sharma, SK, Rogers, BB, Alexander, JM, et al. A randomized trial of the effects of antibiotic prophylaxis on epidural-related fever in labor. Anesth Analg 2014; 118: 604–10.CrossRefGoogle ScholarPubMed
Windle, ML, Booker, LA, Rayburn, WF. Postpartum pain after vaginal delivery: a review of comparative analgesic trials. J Reprod Med 1989; 34: 891–5Google ScholarPubMed