Position The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) believes that registered nurses (RNs) who are not licensed anesthesia care providers should monitor but not manage the delivery of analgesia and anesthesia by catheter techniques to pregnant women. These techniques include administration of analgesia and anesthesia via epidural, intrathecal, spinal and patient-co...

BACKGROUND Continuous epidural analgesia with catheterization is a useful technique, because it has a wide adaptation range and provides prolonged analgesia. Problems that may arise from long-term epidural analgesia are changes in the analgesic area, duration of analgesia and catheter-related problems. Few articles have evaluated gradual changes of long-term epidural analgesia. In the animal mo...

BACKGROUND Insulin resistance (IR) is a feature of the endocrine stress response to surgery. It is not known whether a preoperative state of IR would affect the postoperative endocrine response. We sought to characterize the preoperative state of IR in a group of patients undergoing elective hip and knee arthroplasty, and to determine to what extent perioperative epidural analgesia modifies the...

BACKGROUND Pain during childbirth is a well known cause of dissatisfaction amongst women in labor. The use of epidural analgesia in labor is becoming widespread due to its benefit in terms of pain relief. METHOD After approval of the local Ethics Committee on Research and obtaining informed written consent, 50 American Society of Anesthesiologists (ASA) class I-II consecutive multiparous wome...

The report in this issue by Wood et aL I chronicles the development of a paediatric epidural analgesia programme at Alberta Children's Hospital. In these authors' experience, epidural analgesia was associated with good analgesia and safety, though with a considerable incidence of side effects and technical difficulties. Readers should not be put off by the quoted incidence of "complications"; m...

BACKGROUND Improvement in patient outcome and reduced use of medical resources may result from using epidural anesthesia and analgesia as compared with general anesthesia and intravenous opioids, although the relative importance of intraoperative versus postoperative technique has not been studied. This prospective, double-masked, randomized clinical trial was designed to compare alternate comb...

BACKGROUND Severe preamputation pain is associated with phantom limb pain (PLP) development in limb amputees. We investigated whether optimized perioperative analgesia reduces PLP at 6-month follow-up. METHODS A total of 65 patients underwent lower-limb amputation and were assigned to five analgesic regimens: (1) Epi/Epi/Epi patients received perioperative epidural analgesia and epidural anes...

INTRODUCTION Epidural analgesia provides excellent analgesia after major surgery but it is not without adverse effects. This retrospective study aims to evaluate the efficacy of analgesia and the problems commonly encountered postoperatively. MATERIALS AND METHODS Elective surgical patients who had epidural catheters inserted perioperatively intended for postoperative analgesia over a 1-year ...