Scholars@Duke
Ashraf Samir Habib

Ashraf Samir Habib

Professor of Anesthesiology
Anesthesiology, Women's
habib001@mc.duke.edu
Box 3094 Med Ctr, Durham, NC 27710
2301 Erwin Road, 5666 HAFS Building, Durham, NC 27710

Selected Publications

Mode of Anesthesia for Patients with Placenta Accreta Spectrum Undergoing Cesarean Hysterectomy: A Report from the Multicenter Perioperative Outcomes Group Database.

Journal Article Anesthesiology · December 16, 2025 BACKGROUND: Placenta accreta spectrum is a highly morbid obstetric condition, often necessitating cesarean hysterectomy and requiring specialist anesthesia care. There are few hospital-level data describing anesthetic management of these cases. The authors ... Full text Link to item Cite

Hypertensive Disorders of Pregnancy in Patients With Cardiac Disease: Risk and Impact on Delivery Timing.

Journal Article JACC Adv · October 2025 BACKGROUND: Pregnant patients with cardiovascular disease (CVD) face increased risk of hypertensive disorders of pregnancy (HDP) and preterm delivery, yet data are limited regarding the degree of risk and impact of HDP on gestational age at delivery. OBJEC ... Full text Link to item Cite

Development and Validation of a Predictive Model for Maternal Cardiovascular Morbidity Events in Patients With Hypertensive Disorders of Pregnancy.

Journal Article Anesth Analg · August 1, 2025 BACKGROUND: Hypertensive disorders of pregnancy (HDP) are a major contributor to maternal morbidity, mortality, and accelerated cardiovascular (CV) disease. Comorbid conditions are likely important predictors of CV risk in pregnant people. Currently, there ... Full text Link to item Cite

Prophylactic strategies for prevention of postpartum haemorrhage in caesarean delivery: a systematic review and Bayesian network meta-analysis of randomised controlled trials.

Journal Article Lancet Glob Health · August 2025 BACKGROUND: Postpartum haemorrhage is a leading cause of maternal mortality, particularly in low-income and middle-income countries. Several pharmacological agents, such as oxytocin, ergot alkaloids, prostaglandins, and tranexamic acid, have been used prop ... Full text Link to item Cite

Erector spinae plane block with liposomal bupivacaine for post-cesarean analgesia.

Journal Article Int J Gynaecol Obstet · July 2025 PURPOSE: The aim of the current study was to assess the analgesic efficacy of erector spinae plane block with liposomal bupivacaine in women undergoing cesarean delivery. METHODS: We prospectively enrolled patients undergoing elective cesarean delivery und ... Full text Link to item Cite

Cerebrospinal fluid proteome of patients with persistent pain and/or postpartum depression after elective cesarean delivery: An exploratory prospective cohort study.

Journal Article J Clin Anesth · June 2025 BACKGROUND: Persistent pain (>2 months) after cesarean delivery (CD) can affect up to 20 % of patients, and is associated with increased risk for postpartum depression (PPD). Preoperative identification of patients at risk for persistent pain and PPD remai ... Full text Link to item Cite

Intrathecal morphine 100 µg versus 150 µg for post-cesarean delivery analgesia: a retrospective cohort study (2020-2022).

Journal Article Int J Obstet Anesth · May 2025 BACKGROUND: In the context of multimodal analgesia, the optimal dose of intrathecal morphine (ITM) for post-cesarean analgesia remains unclear. In January 2022, the dose of ITM was reduced from 150 µg to 100 µg without other changes in our analgesic regime ... Full text Link to item Cite

Risk of Hypertensive Disorders of Pregnancy in Patients With Cardiac Disease.

Journal Article medRxiv · January 5, 2025 BACKGROUND: Pregnant patients with cardiovascular disease (CVD) face increased risk of preeclampsia and preterm delivery, yet data is limited data regarding degree of risk and impact of hypertensive disorders of pregnancy (HDP) on gestational age at delive ... Full text Link to item Cite

Combined spinal-epidural vs. dural puncture epidural techniques for labour analgesia: a randomised controlled trial.

Journal Article Anaesthesia · January 2025 BACKGROUND: The dural puncture epidural technique is a modification of the combined spinal-epidural technique. Data comparing the two techniques are limited. We performed this randomised study to compare the quality of labour analgesia following initiation ... Full text Link to item Cite

The Role of Sleep Apnea in Postoperative Neurocognitive Disorders Among Older Noncardiac Surgery Patients: A Prospective Cohort Study.

Journal Article Anesth Analg · January 1, 2025 BACKGROUND: Obstructive sleep apnea is associated with increased dementia risk, yet its role in postoperative neurocognitive disorders is unclear. Here, we studied whether the severity of untreated obstructive sleep apnea is associated with the severity of ... Full text Link to item Cite

In Response.

Journal Article Anesth Analg · December 1, 2024 Full text Link to item Cite

The Association of Guideline-Directed Prophylaxis With Postoperative Nausea and Vomiting in Adult Patients: A Single-Center, Retrospective Cohort Study.

Journal Article Anesth Analg · November 1, 2024 BACKGROUND: Consensus guidelines for postoperative nausea and vomiting (PONV) prophylaxis recommend a risk-based approach in which the number of antiemetics administered is based on a preoperative estimate of PONV risk. These guidelines have been adapted b ... Full text Link to item Cite

Postoperative analgesic consumption for primary versus first repeat Cesarean delivery: a historical cohort study.

Journal Article Can J Anaesth · November 2024 PURPOSE: It is unclear if postoperative pain experience and opioid consumption differ in patients undergoing primary vs repeat Cesarean delivery (CD) as prior studies have yielded conflicting results and none used the same patients as their own controls. W ... Full text Link to item Cite

The evaluation of the performance of ChatGPT in the management of labor analgesia.

Journal Article J Clin Anesth · November 2024 UNLABELLED: ChatGPT4 is a leading large language model (LLM) chatbot released by OpenAI in 2023. ChatGPT4 can respond to free-text queries, answer questions and make suggestions regarding virtually any topic. ChatGPT4 has successfully answered anesthesia a ... Full text Link to item Cite

VX-548 in the treatment of acute pain.

Journal Article Pain Manag · September 2024 Acute pain management requires balancing analgesia with adverse effects risk. The voltage-gated sodium channel NaV1.8 plays an important role in pain physiology, and its inhibition was shown to have analgesic effects. VX-548 is a new oral NaV1.8-specific i ... Full text Link to item Cite

The Association of Guideline-Directed Prophylaxis with Postoperative Nausea and Vomiting in Pediatric Patients: A Single-Center, Retrospective Cohort Study.

Journal Article Anesth Analg · July 1, 2024 BACKGROUND: Guidelines for postoperative nausea and vomiting (PONV) prophylaxis in pediatric patients recommend escalation of the number of antiemetics based on a preoperative estimate of PONV risk. These recommendations have been translated into performan ... Full text Link to item Cite

Cognitive and Cerebrospinal Fluid Alzheimer's Disease-related Biomarker Trajectories in Older Surgical Patients and Matched Nonsurgical Controls.

Conference Anesthesiology · May 1, 2024 BACKGROUND: Anesthesia and/or surgery accelerate Alzheimer's disease pathology and cause memory deficits in animal models, yet there is a lack of prospective data comparing cerebrospinal fluid (CSF) Alzheimer's disease-related biomarker and cognitive traje ... Full text Link to item Cite

Maternal Morbidity According to Mode of Delivery Among Pregnant Patients With Pulmonary Hypertension.

Journal Article Anesth Analg · May 1, 2024 BACKGROUND: Patients with pulmonary hypertension have a high risk of maternal morbidity and mortality. It is unknown if a trial of labor carries a lower risk of morbidity in these patients compared to a planned cesarean delivery. The objective of this stud ... Full text Link to item Cite

The 90% effective dose of intrathecal hyperbaric bupivacaine for Cesarean delivery under combined spinal-epidural anesthesia in parturients with super obesity: an up-down sequential allocation study.

Journal Article Can J Anaesth · May 2024 PURPOSE: To determine the 90% effective dose (ED90) of intrathecal hyperbaric bupivacaine for Cesarean delivery under combined spinal-epidural anesthesia (CSE) in parturients with super obesity (body mass index [BMI] ≥ 50 kg·m-2). METHODS: We enrolled part ... Full text Link to item Cite

Comparison of the Efficacy of HSK3486 and Propofol for Induction of General Anesthesia in Adults: A Multicenter, Randomized, Double-blind, Controlled, Phase 3 Noninferiority Trial.

Journal Article Anesthesiology · April 1, 2024 BACKGROUND: Propofol is an intravenous anesthetic associated with hypotension, respiratory depression, and injection-site pain. HSK3486 injectable emulsion (ciprofol) is a 2,6-disubstituted phenol derivative with fast onset and quick, stable recovery. Prev ... Full text Link to item Cite

Placenta accreta spectrum care infrastructure: an evidence-based review of needed resources supporting placenta accreta spectrum care.

Journal Article Am J Obstet Gynecol MFM · January 2024 The incidence of placenta accreta spectrum, the deeply adherent placenta with associated increased risk of maternal morbidity and mortality, has seen a significant rise in recent years. Therefore, there has been a rise in clinical and research focus on thi ... Full text Link to item Cite

Considerations for anesthesiology in robotic-assisted surgeries

Chapter · January 1, 2024 Adoption of robotic-assisted surgery has increased recently, which can be attributed to its advantages over conventional laparoscopic techniques. These include increased instrument dexterity and precision, improved surgeon ergonomics, three-dimensional cam ... Full text Cite

Inflammatory changes in the plasma and cerebrospinal fluid of patients with persistent pain and postpartum depression after elective Cesarean delivery: an exploratory prospective cohort study.

Journal Article Can J Anaesth · December 2023 PURPOSE: Severe acute pain after Cesarean delivery increases the risk of developing persistent pain (~20% incidence) and postpartum depression (PPD) (~15% incidence). Both conditions contribute to maternal morbidity and mortality, yet early risk stratifica ... Full text Link to item Cite

Severe Maternal Morbidity According to Mode of Delivery Among Pregnant Patients With Cardiomyopathies.

Journal Article JACC Heart Fail · December 2023 BACKGROUND: Women with cardiomyopathies are at risk for pregnancy complications. The optimal mode of delivery in these patients is guided by expert opinion and limited small studies. OBJECTIVES: The objective of this study is to examine the association of ... Full text Link to item Cite

Procalcitonin levels in pregnancy: A systematic review and meta-analysis of observational studies.

Conference Int J Gynaecol Obstet · November 2023 BACKGROUND: The utility of procalcitonin to identify obstetric sepsis is unknown. OBJECTIVE: To calculate the mean (range) procalcitonin in pregnancy among healthy women not in labor (group 1), healthy women in labor (group 2), and women with preterm prela ... Full text Link to item Cite

Role of cosyntropin in the management of postpartum post-dural puncture headache: a two-center retrospective cohort study.

Journal Article Int J Obstet Anesth · November 2023 BACKGROUND: Research suggests that postpartum post-dural puncture headache (PDPH) might be prevented or treated by administering intravenous cosyntropin. METHODS: In this retrospective cohort study, we questioned whether prophylactic (1 mg) and therapeutic ... Full text Link to item Cite

Neurokinin-1 receptor antagonists for the prevention of postoperative nausea and vomiting.

Journal Article Pharmacotherapy · September 2023 Despite the availability of several classes of antiemetics, postoperative nausea and vomiting (PONV) remains a substantial burden for patients following surgery, resulting in patient dissatisfaction and prolonged stays in post-anesthesia care units and ult ... Full text Link to item Cite

Selective Inhibition of NaV1.8 with VX-548 for Acute Pain.

Journal Article N Engl J Med · August 3, 2023 BACKGROUND: The NaV1.8 voltage-gated sodium channel, expressed in peripheral nociceptive neurons, plays a role in transmitting nociceptive signals. The effect of VX-548, an oral, highly selective inhibitor of NaV1.8, on control of acute pain is being studi ... Full text Link to item Cite

Opioid-Sparing Multimodal Analgesia Use After Cesarean Delivery Under General Anesthesia: A Retrospective Cohort Study in 729 US Hospitals.

Journal Article Anesth Analg · August 1, 2023 BACKGROUND: Optimizing analgesia after cesarean delivery is essential to quality of patient recovery. The American Society of Anesthesiologists and the Society for Obstetric Anesthesia and Perinatology recommend multimodal analgesia (MMA). However, little ... Full text Link to item Cite

Society of Anesthesia and Sleep Medicine and the Society for Obstetric Anesthesia and Perinatology Consensus Guideline on the Screening, Diagnosis, and Treatment of Obstructive Sleep Apnea in Pregnancy.

Journal Article Obstet Gynecol · August 1, 2023 The Society of Anesthesia and Sleep Medicine and the Society for Obstetric Anesthesia and Perinatology tasked an expert group to review existing evidence and to generate recommendations on the screening, diagnosis, and treatment of patients with obstructiv ... Full text Link to item Cite

Peri-operative anaesthetic management of women with obesity.

Journal Article Best Pract Res Clin Obstet Gynaecol · July 2023 Obesity in women is prevalent and growing at an alarming pace worldwide, resulting in significant healthcare and socioeconomic consequences. Obesity is a multisystemic disease that is associated with numerous comorbidities, particularly sleep-disordered br ... Full text Link to item Cite

Risk factors for persistent pain after breast cancer surgery: a multicentre prospective cohort study.

Journal Article Anaesthesia · April 2023 Identifying factors associated with persistent pain after breast cancer surgery may facilitate risk stratification and individualised management. Single-population studies have limited generalisability as socio-economic and genetic factors contribute to pe ... Full text Link to item Cite

Maternal Cardiovascular Morbidity Events Following Preeclampsia: A Retrospective Cohort Study.

Journal Article Anesth Analg · April 1, 2023 BACKGROUND: Patients with preeclampsia are at high risk for long-term cardiovascular events, yet the short-term, acute cardiovascular complications that follow preeclampsia are understudied. The objective of this study was to compare the short-term, acute ... Full text Link to item Cite

Obstructive Sleep Apnea Among Gravidas With Chronic Hypertension Compared to Matched Controls: A Prospective Cohort Study.

Journal Article Anesth Analg · February 1, 2023 BACKGROUND: Previous studies of obstructive sleep apnea (OSA) risk in gravidas with chronic hypertension (cHTN) did not control for obesity as a risk factor for OSA. We therefore performed this study to evaluate whether OSA is more prevalent among gravidas ... Full text Link to item Cite

A pharmacological overview of aprepitant for the prevention of postoperative nausea and vomiting.

Journal Article Expert Rev Clin Pharmacol · 2023 INTRODUCTION: Post-operative nausea and vomiting (PONV) affects 30% of all patients undergoing surgery and up to 80% of high-risk patients. Antiemetics for PONV prophylaxis target a variety of receptor systems, with varying degrees of efficacy and side eff ... Full text Link to item Cite

Impact of a multimodal analgesic protocol modification on opioid consumption after cesarean delivery: a retrospective cohort study.

Journal Article J Matern Fetal Neonatal Med · December 2022 INTRODUCTION: Adequate pain control is a mainstay in enhanced recovery after surgery (ERAS) protocols. ERAS protocols are widely accepted in colorectal and gynecologic surgeries and are increasingly implemented in the obstetric setting. Multimodal analgesi ... Full text Link to item Cite

Anesthesia and Analgesia for the Obese Parturient.

Journal Article Adv Anesth · December 2022 Obesity is a worldwide epidemic and is associated with an increased risk of hypertension, diabetes, and obstructive sleep apnea. Pregnant patients with obesity experience a higher risk of maternal and fetal complications. Anesthesia also poses higher risks ... Full text Link to item Cite

The association between intravenous iron for antenatal anemia and postnatal depression: a retrospective cohort study.

Journal Article Arch Gynecol Obstet · November 2022 PURPOSE: Determine if intravenous iron for antenatal anemia is associated with reduced incidence of postnatal depression (PND) within 12 months. METHODS: This retrospective cohort study included adult women with antenatal anemia (hemoglobin value of < 11.0 ... Full text Link to item Cite

Dural Puncture Epidural in Obese Parturients: Reply.

Journal Article Anesthesiology · November 1, 2022 Full text Link to item Cite

Respiratory depression after administration of single-dose neuraxial morphine for post-cesarean delivery analgesia: a retrospective cohort study.

Journal Article Int J Obstet Anesth · November 2022 BACKGROUND: Neuraxial administration of long-acting opioid is the "gold standard" for the management of postoperative pain following cesarean delivery. Respiratory depression, however, remains a concerning complication. METHODS: This retrospective single-c ... Full text Link to item Cite

Transfusion Requirements with Hybrid Management of Placenta Accreta Spectrum Incorporating Targeted Embolization and a Selective Use of Delayed Hysterectomy.

Journal Article Am J Perinatol · October 2022 OBJECTIVE: This study compares the number of units of red blood cells (RBCs) transfused in patients with placenta accreta spectrum (PAS) treated with or without a multidisciplinary algorithm that includes placental uterine arterial embolization (P-UAE) and ... Full text Link to item Cite

Long-term morbidities following unintentional dural puncture in obstetric patients: A systematic review and meta-analysis.

Journal Article J Clin Anesth · August 2022 STUDY OBJECTIVE: To investigate the association of unintentional dural puncture (UDP) and postdural puncture headache (PDPH) with the risk of chronic headache, backache, neckache and depression. We also investigated if epidural blood patch (EBP) is associa ... Full text Link to item Cite

Expert Consensus Regarding Core Outcomes for Enhanced Recovery after Cesarean Delivery Studies: A Delphi Study.

Journal Article Anesthesiology · August 1, 2022 BACKGROUND: Heterogeneity among reported outcomes from enhanced recovery after cesarean delivery impact studies is high. This study aimed to develop a standardized enhanced recovery core outcome set for use in future enhanced recovery after cesarean delive ... Full text Link to item Cite

Development and Validation of a Model for Opioid Prescribing Following Gynecological Surgery.

Journal Article JAMA Netw Open · July 1, 2022 IMPORTANCE: Overprescription of opioid medications following surgery is well documented. Current prescribing models have been proposed in narrow patient populations, which limits their generalizability. OBJECTIVE: To develop and validate a model for predic ... Full text Open Access Link to item Cite

Anesthetic management of placenta accreta spectrum at an academic center and a comparison of the combined spinal epidural with the double catheter technique: A retrospective study.

Journal Article J Clin Anesth · May 2022 STUDY OBJECTIVES: To describe the anesthetic management and outcomes of placenta accreta spectrum (PAS) cases at our institution over a 19 year period and to compare outcomes associated with the lumbar combined spinal epidural (CSE) technique versus the do ... Full text Link to item Cite

Intrathecal bupivacaine versus chloroprocaine for transvaginal cervical cerclage placement: a retrospective cohort study.

Journal Article Int J Obstet Anesth · May 2022 BACKGROUND: Bupivacaine is commonly used in spinal anesthesia for cervical cerclage placement, but its long duration of action can delay hospital discharge. Chloroprocaine has a short duration of action and has re-emerged as an agent for ambulatory neuraxi ... Full text Link to item Cite

Quality of Labor Analgesia with Dural Puncture Epidural versus Standard Epidural Technique in Obese Parturients: A Double-blind Randomized Controlled Study.

Journal Article Anesthesiology · May 1, 2022 BACKGROUND: The dural puncture epidural technique may improve analgesia quality by confirming midline placement and increasing intrathecal translocation of epidural medications. This would be advantageous in obese parturients with increased risk of block f ... Full text Link to item Cite

ED 90 of Intrathecal Chloroprocaine With Fentanyl for Prophylactic Cervical Cerclage: A Sequential Allocation Biased-Coin Design.

Journal Article Anesth Analg · April 1, 2022 BACKGROUND: Chloroprocaine is a short-acting local anesthetic that has been used for spinal anesthesia in outpatient surgery. There is limited experience with spinal chloroprocaine for prophylactic cervical cerclage placement. We sought to determine the ef ... Full text Link to item Cite

Obstructive sleep apnea in pregnant women.

Journal Article Int Anesthesiol Clin · April 1, 2022 The prevalence of OSA in the low-risk obstetric population is thought to be low; best estimates have been extrapolated from the one available large prospective study and likely range between 3–8%. OSA prevalence in high-risk pregnant women such as those wi ... Full text Link to item Cite

Uterine exteriorization versus in situ repair in Cesarean delivery: a systematic review and meta-analysis.

Journal Article Can J Anaesth · February 2022 PURPOSE: We conducted an updated systematic review and meta-analysis on maternal outcomes associated with uterine exteriorization compared with in situ repair in women undergoing Cesarean delivery. METHODS: We searched for randomized controlled trials comp ... Full text Link to item Cite

Postoperative changes in cognition and cerebrospinal fluid neurodegenerative disease biomarkers.

Journal Article Ann Clin Transl Neurol · February 2022 OBJECTIVE: Numerous investigators have theorized that postoperative changes in Alzheimer's disease neuropathology may underlie postoperative neurocognitive disorders. Thus, we determined the relationship between postoperative changes in cognition and cereb ... Full text Open Access Link to item Cite

What Is the Best Strategy for Prevention of Postoperative Nausea and Vomiting?

Chapter · January 1, 2022 Postoperative nausea and vomiting (PONV) are among the most common side effects associated with anesthesia and surgery. The overall incidence of PONV for all surgeries and patient populations is estimated to be 25% to 30%. PONV can lead to a delay in posta ... Full text Cite

Analgesia After Cesarean Delivery in the United States 2008-2018: A Retrospective Cohort Study.

Journal Article Anesth Analg · December 1, 2021 BACKGROUND: Optimizing analgesia after cesarean delivery is a priority and requires balancing adequate pain relief with the risk of analgesics-associated adverse effects. Current recommendations are for use of a multimodal, opioid-sparing analgesic regimen ... Full text Link to item Cite

Perioperative neurocognitive and functional neuroimaging trajectories in older APOE4 carriers compared with non-carriers: secondary analysis of a prospective cohort study.

Journal Article Br J Anaesth · December 2021 BACKGROUND: Cognitive dysfunction after surgery is a major issue in older adults. Here, we determined the effect of APOE4 on perioperative neurocognitive function in older patients. METHODS: We enrolled 140 English-speaking patients ≥60 yr old scheduled fo ... Full text Open Access Link to item Cite

Randomized trial of transversus abdominis plane block with liposomal bupivacaine after cesarean delivery with or without intrathecal morphine.

Journal Article J Clin Anesth · December 2021 STUDY OBJECTIVE: To investigate efficacy and safety of liposomal bupivacaine (LB) transversus abdominis plane (TAP) block with or without intrathecal morphine (ITM) compared with ITM alone for postsurgical analgesia after cesarean delivery (CD). DESIGN: Mu ... Full text Link to item Cite

Safety evaluation of oliceridine for the management of postoperative moderate-to-severe acute pain.

Journal Article Expert Opin Drug Saf · November 2021 INTRODUCTION: Opioids for managing postoperative pain are associated with side effects including opioid-induced respiratory depression (OIRD) and gastrointestinal complications. Opioids induce analgesia via G-protein signaling, while adverse effects are me ... Full text Link to item Cite

Impact of enhanced recovery after cesarean delivery on maternal outcomes: A systematic review and meta-analysis.

Journal Article Anaesth Crit Care Pain Med · October 2021 BACKGROUND: This meta-analysis explores the impact of enhanced recovery after cesarean delivery (ERAC) on maternal outcomes. METHODS: We searched 4 databases (Web of Science, Embase, PubMed and CINAHL) in October 2020 without date limiters, for studies qua ... Full text Link to item Cite

The Society for Obstetric Anesthesia and Perinatology Coronavirus Disease 2019 Registry: An Analysis of Outcomes Among Pregnant Women Delivering During the Initial Severe Acute Respiratory Syndrome Coronavirus-2 Outbreak in the United States.

Journal Article Anesth Analg · August 1, 2021 BACKGROUND: Early reports associating severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with adverse pregnancy outcomes were biased by including only women with severe disease without controls. The Society for Obstetric Anesthesia and ... Full text Link to item Cite

Placental uterine artery embolization followed by delayed hysterectomy for placenta percreta: A case series.

Journal Article Gynecol Oncol Rep · August 2021 We describe outcomes of patients with suspected placenta percreta treated with placental uterine artery embolization (P-UAE) followed by delayed hysterectomy. This is a prospective case series of subjects from 2005 to 2018 with suspected placenta percreta ... Full text Link to item Cite

Postoperative analgesia after cesarean delivery.

Journal Article Int Anesthesiol Clin · July 1, 2021 Full text Link to item Cite

A quality improvement initiative to reduce venous thromboembolism on a gynecologic oncology service.

Journal Article Gynecol Oncol · July 2021 OBJECTIVE: To describe and evaluate the effects of implementation of a venous thromboembolism (VTE) prophylaxis quality improvement (QI) initiative on a gynecologic oncology service at a single institution. METHODS: Prior to 2018, no consensus gynecologic ... Full text Link to item Cite

Oliceridine is Associated with Reduced Risk of Vomiting and Need for Rescue Antiemetics Compared to Morphine: Exploratory Analysis from Two Phase 3 Randomized Placebo and Active Controlled Trials.

Journal Article Pain Ther · June 2021 INTRODUCTION: Use of parenteral opioids is a major risk factor for postoperative nausea and vomiting. Conventional opioids bind to µ-opioid receptors (MOR), stimulate both the G-protein signaling (achieving analgesia); and the β-arrestin pathway (associate ... Full text Link to item Cite

Low Incidence of Opioid-Induced Respiratory Depression Observed with Oliceridine Regardless of Age or Body Mass Index: Exploratory Analysis from a Phase 3 Open-Label Trial in Postsurgical Pain.

Journal Article Pain Ther · June 2021 INTRODUCTION: Advanced age and obesity are reported to increase the risk of opioid-induced respiratory depression (OIRD). Oliceridine, an intravenous opioid, is a G-protein-biased agonist at the µ-opioid receptor that may provide improved safety. The recen ... Full text Link to item Cite

Anesthetic management for robotic hysterectomy in obese women.

Journal Article Curr Opin Anaesthesiol · June 1, 2021 PURPOSE OF REVIEW: Obesity is a major health epidemic, with the prevalence reaching ∼40% in the United States in recent years. It is associated with increased risk of hypertension, diabetes, heart disease, stroke, obstructive sleep apnea (OSA), and gynecol ... Full text Link to item Cite

Society for Obstetric Anesthesia and Perinatology: Consensus Statement and Recommendations for Enhanced Recovery After Cesarean.

Journal Article Anesth Analg · May 1, 2021 The purpose of this article is to provide a summary of the Enhanced Recovery After Cesarean delivery (ERAC) protocol written by a Society for Obstetric Anesthesia and Perinatology (SOAP) committee and approved by the SOAP Board of Directors in May 2019. Th ... Full text Link to item Cite

Oliceridine in the treatment of moderate to severe acute pain.

Journal Article Pain Manag · May 2021 Intravenous opioids are a mainstay for the management of moderate to severe acute pain. Opioid administration provides effective pain control at the cost of significant side effects. Commonly used opioids like morphine are nonselective μ-receptor agonists, ... Full text Link to item Cite

Association of gabapentinoid utilization with postoperative pulmonary complications in gynecologic surgery: a retrospective cohort study.

Journal Article Curr Med Res Opin · May 2021 OBJECTIVE: To investigate gabapentinoid utilization and association with postoperative pulmonary complications after gynecologic surgery. METHODS: After Institutional Review Board approval, we performed this retrospective cohort study using the Premier Hea ... Full text Link to item Cite

Obesity in women: anaesthetic implications for peri-operative and peripartum management.

Journal Article Anaesthesia · April 2021 The prevalence, healthcare and socio-economic impact of obesity (defined as having a body mass index of ≥ 30 kg.m-2 ) are disproportionately higher in women than men. A combination of biological and social factors, including the adaptation of energy homeos ... Full text Link to item Cite

Immunomodulatory lipid mediator profiling of cerebrospinal fluid following surgery in older adults.

Journal Article Sci Rep · February 4, 2021 Arachidonic acid (AA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA) derived lipids play key roles in initiating and resolving inflammation. Neuro-inflammation is thought to play a causal role in perioperative neurocognitive disorders, yet th ... Full text Open Access Link to item Cite

In Response.

Journal Article Anesth Analg · February 1, 2021 Full text Link to item Cite

772 Pulmonary hypertension and pregnancy: a preliminary report of 25 pregnancies

Conference American Journal of Obstetrics and Gynecology · February 2021 Full text Cite

Cerebrospinal Fluid Proteome Changes in Older Non-Cardiac Surgical Patients with Postoperative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2021 BACKGROUND: Postoperative cognitive dysfunction (POCD), a syndrome of cognitive deficits occurring 1-12 months after surgery primarily in older patients, is associated with poor postoperative outcomes. POCD is hypothesized to result from neuroinflammation; ... Full text Open Access Link to item Cite

Oliceridine: A Novel Drug for the Management of Moderate to Severe Acute Pain - A Review of Current Evidence.

Journal Article J Pain Res · 2021 Optimal pain relief requires a balance between adequate analgesia and risk of adverse effects. Opioids remain the cornerstone for managing moderate to severe pain, but are associated with opioid-induced respiratory depression (OIRD) and gastrointestinal co ... Full text Link to item Cite

Dexamethasone as an Analgesic Adjunct for Postcesarean Delivery Pain: A Randomized Controlled Trial.

Journal Article Anesthesiol Res Pract · 2021 OBJECTIVES: Dexamethasone has been shown to have analgesic properties in the general surgical population. However, the analgesic effects for women that undergo cesarean deliveries under spinal anesthesia remain unclear and may be related to the timing of d ... Full text Link to item Cite

The optimum management of nausea and vomiting during and after cesarean delivery.

Journal Article Best Pract Res Clin Anaesthesiol · December 2020 Intraoperative and postoperative nausea and vomiting (IONV and PONV) afflict up to 80% of parturients undergoing cesarean delivery with neuraxial anesthesia. Preventing nausea and emesis is a top priority for women undergoing cesarean delivery and is inclu ... Full text Link to item Cite

Quadratus lumborum block for postoperative analgesia after cesarean delivery: A systematic review with meta-analysis and trial-sequential analysis.

Journal Article J Clin Anesth · December 2020 STUDY OBJECTIVE: The aim of this study was to investigate the analgesic efficacy of Quadratus lumborum block (QLB) versus controls, transversus abdominis plane (TAP) block and neuraxial morphine, or when added to neuraxial morphine in women undergoing cesa ... Full text Link to item Cite

Transversus Abdominis Plane Block With Liposomal Bupivacaine for Pain After Cesarean Delivery in a Multicenter, Randomized, Double-Blind, Controlled Trial.

Journal Article Anesth Analg · December 2020 BACKGROUND: In women undergoing cesarean delivery under spinal anesthesia with intrathecal morphine, transversus abdominis plane (TAP) block with bupivacaine hydrochloride (HCl) may not improve postsurgical analgesia. This lack of benefit could be related ... Full text Link to item Cite

Postoperative nausea and vomiting: State of the art.

Journal Article Best Pract Res Clin Anaesthesiol · December 2020 Full text Link to item Cite

The next generation of antiemetics for the management of postoperative nausea and vomiting.

Journal Article Best Pract Res Clin Anaesthesiol · December 2020 Postoperative nausea and vomiting (PONV) afflict approximately 30% of patients overall and up to 80% of high-risk patients after surgery. Optimal pharmacological prophylaxis of PONV is challenging as it necessitates the consideration of PONV risk, drug eff ... Full text Link to item Cite

Patient and procedural risk factors for increased postoperative pain after cesarean delivery under neuraxial anesthesia: a retrospective study.

Journal Article Int J Obstet Anesth · November 2020 BACKGROUND: There is significant interindividual variability in pain experienced after cesarean delivery. The goal of this study was to identify risk factors for increased postoperative pain in women undergoing cesarean delivery under neuraxial anesthesia ... Full text Link to item Cite

Tonic-clonic seizure after unrecognized unintentional dural puncture.

Journal Article Int J Obstet Anesth · November 2020 Patients who suffer an unintentional dural puncture have a high risk of developing a post-dural puncture headache. Other neurologic complications have been reported, but seizure is rarely seen. We present a case of a 21-year-old primigravida who experience ... Full text Link to item Cite

Intra-operative ketorolac 15 mg versus 30 mg for analgesia following cesarean delivery: a retrospective study.

Journal Article Int J Obstet Anesth · November 2020 BACKGROUND: Ketorolac is a nonsteroidal anti-inflammatory drug used as part of multimodal analgesia in women undergoing cesarean delivery. The lowest effective dose of ketorolac that best optimizes analgesia without increasing side effects is unclear. We p ... Full text Link to item Cite

A risk score for postoperative nausea and/or vomiting in women undergoing cesarean delivery with intrathecal morphine.

Journal Article Int J Obstet Anesth · November 2020 BACKGROUND: Postoperative nausea and/or vomiting affects up to 80% of parturients undergoing cesarean delivery, but there is a lack of obstetric-specific risk-prediction models. We performed this study to identify postoperative nausea/vomiting risk factors ... Full text Link to item Cite

Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting.

Journal Article Anesth Analg · August 2020 This consensus statement presents a comprehensive and evidence-based set of guidelines for the care of postoperative nausea and vomiting (PONV) in both adult and pediatric populations. The guidelines are established by an international panel of experts und ... Full text Link to item Cite

A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults.

Journal Article J Neurol · July 2020 OBJECTIVE: Lumbar punctures (LPs) are important for obtaining CSF in neurology studies but are associated with adverse events and feared by many patients. We determined adverse event rates and pain scores in patients prospectively enrolled in two cohort st ... Full text Link to item Cite

Analgesic use after vaginal delivery in women with perineal lacerations: a retrospective cohort study.

Journal Article Curr Med Res Opin · June 2020 Objective: To evaluate opioid consumption among parturients with varying degrees of perineal lacerations.Methods: This was a retrospective analysis of women who delivered vaginally at our institution from 1 January 2014 to 12 April 2015. We collected infor ... Full text Link to item Cite

Comparison of Programmed Intermittent Epidural Boluses With Continuous Epidural Infusion for the Maintenance of Labor Analgesia: A Randomized, Controlled, Double-Blind Study.

Journal Article Anesth Analg · February 2020 BACKGROUND: Programmed intermittent epidural boluses may improve the spread of local anesthetics compared to continuous epidural infusion, improving labor analgesia and obstetric outcomes. However, there are limited data from studies using commercially ava ... Full text Link to item Cite

Supplemental peri-operative intravenous crystalloids for postoperative nausea and vomiting: an abridged Cochrane systematic review.

Journal Article Anaesthesia · February 2020 We conducted a Cochrane systematic review on the effectiveness of supplemental intravenous crystalloid administration in preventing postoperative nausea and vomiting. We included randomised controlled trials of patients undergoing surgery under general ana ... Full text Link to item Cite

Ropivacaine and Ketorolac Wound Infusion for Post-Cesarean Delivery Analgesia: A Randomized Controlled Trial.

Journal Article Obstet Gynecol · February 2020 OBJECTIVE: To evaluate the efficacy of wound infusion with ropivacaine plus ketorolac compared with placebo for post-cesarean delivery analgesia in women who received a multimodal analgesic regimen including intrathecal morphine. METHODS: In a randomized d ... Full text Link to item Cite

The MARBLE Study Protocol: Modulating ApoE Signaling to Reduce Brain Inflammation, DeLirium, and PostopErative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2020 BACKGROUND: Perioperative neurocognitive disorders (PND) are common complications in older adults associated with increased 1-year mortality and long-term cognitive decline. One risk factor for worsened long-term postoperative cognitive trajectory is the A ... Full text Open Access Link to item Cite

Risk Factors Associated with Development of Acute and Sub-Acute Post-Cesarean Pain: A Prospective Cohort Study.

Journal Article J Pain Res · 2020 BACKGROUND: Although cesarean delivery is one of the most commonly performed surgical procedures, robust data regarding post-cesarean pain is still lacking. Recent studies showed an association between pain upon local anesthetic (LA) injection for spinal a ... Full text Link to item Cite

Low Incidence of Postoperative Respiratory Depression with Oliceridine Compared to Morphine: A Retrospective Chart Analysis.

Journal Article Pain Res Manag · 2020 BACKGROUND: Oliceridine, an investigational IV opioid, is a first-in-class G-protein selective agonist at the μ-opioid receptor. The G-protein selectivity results in potent analgesia with less recruitment of β-arrestin, a signaling pathway associated with ... Full text Link to item Cite

Antibiotic Prophylaxis for Cesarean Delivery: A Survey of Anesthesiologists.

Journal Article Anesthesiol Res Pract · 2020 BACKGROUND: The most common complication after cesarean delivery is surgical site infection. Antibiotic prophylaxis reduces infectious morbidity and current anesthetic quality metrics include preincision antibiotic prophylaxis. Recently, studies suggest re ... Full text Link to item Cite

Flow Cytometry Characterization of Cerebrospinal Fluid Monocytes in Patients With Postoperative Cognitive Dysfunction: A Pilot Study.

Journal Article Anesth Analg · November 2019 Animal models suggest postoperative cognitive dysfunction may be caused by brain monocyte influx. To study this in humans, we developed a flow cytometry panel to profile cerebrospinal fluid (CSF) samples collected before and after major noncardiac surgery ... Full text Open Access Link to item Cite

Personalized analgesic management for cesarean delivery.

Journal Article Int J Obstet Anesth · November 2019 Current pain and analgesic management strategies apply a standardized one-size-fits-all approach to women undergoing cesarean delivery. These standardized protocols do not account for significant variability in women's pain and may lead to under-treatment ... Full text Link to item Cite

The role of gabapentinoids in acute and chronic pain after surgery.

Journal Article Curr Opin Anaesthesiol · October 2019 PURPOSE OF REVIEW: Gabapentinoid use has increased substantially in the past several years after initial promising data with regard to acute perioperative pain control. The purpose of this review is to critically appraise the evidence for the use of gabape ... Full text Link to item Cite

Society for Obstetric Anesthesia and Perinatology Consensus Statement: Monitoring Recommendations for Prevention and Detection of Respiratory Depression Associated With Administration of Neuraxial Morphine for Cesarean Delivery Analgesia.

Journal Article Anesth Analg · August 2019 The majority of women undergoing cesarean delivery in the United States receive neuraxial morphine, the most effective form of postoperative analgesia for this surgery. Current American Society of Anesthesiologists (ASA) and American Society of Regional An ... Full text Link to item Cite

Monitoring, prevention and treatment of side effects of long-acting neuraxial opioids for post-cesarean analgesia.

Journal Article Int J Obstet Anesth · August 2019 Long-acting neuraxial opioids such as morphine and diamorphine, administered via spinal or epidural routes, are staple components of a multimodal approach to postoperative analgesia following cesarean delivery. The widespread use of neuraxial opioids is du ... Full text Link to item Cite

What’s New in Obstetric Anesthesia? The 2018 Gerard W. Ostheimer Lecture.

Journal Article Anesth Analg · July 2019 The "What's New in Obstetric Anesthesia Lecture" is presented every year at the annual meeting of the Society for Obstetric Anesthesia and Perinatology. This lecture was established in 1975 to update the membership on the most relevant articles that were p ... Full text Link to item Cite

Reduction in opioid use and postoperative pain scores after elective laparotomy with implementation of enhanced recovery after surgery protocol on a gynecologic oncology service.

Journal Article Int J Gynecol Cancer · June 2019 OBJECTIVE: Enhanced Recovery After Surgery (ERAS) protocols are designed to mitigate the physiologic stress response created by surgery, to decrease the time to resumption of daily activities, and to improve overall recovery. This study aims to investigate ... Full text Link to item Cite

Cost-effectiveness of hyperthermic intraperitoneal chemotherapy (HIPEC) at interval debulking of epithelial ovarian cancer following neoadjuvant chemotherapy.

Journal Article Gynecol Oncol · May 2019 OBJECTIVES: A recent randomized controlled trial demonstrated an overall survival benefit to the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to neoadjuvant chemotherapy (NACT) for stage III epithelial ovarian cancer (EOC). The objective o ... Full text Link to item Cite

What's new in obstetric anesthesia in 2017?

Journal Article Int J Obstet Anesth · May 2019 The Gerard W. Ostheimer lecture is delivered every year at the annual meeting of the Society for Obstetric Anesthesia and Perinatology. The lecture aims to provide the anesthesiologist who provides obstetric anesthesia care with a review of the most releva ... Full text Link to item Cite

The INTUIT Study: Investigating Neuroinflammation Underlying Postoperative Cognitive Dysfunction.

Journal Article J Am Geriatr Soc · April 2019 BACKGROUND/OBJECTIVES: Every year, up to 40% of the more than 16 million older Americans who undergo anesthesia/surgery develop postoperative cognitive dysfunction (POCD) or delirium. Each of these distinct syndromes is associated with decreased quality of ... Full text Open Access Link to item Cite

Reply.

Journal Article Am J Obstet Gynecol · April 2019 Full text Link to item Cite

Supplemental perioperative intravenous crystalloids for postoperative nausea and vomiting.

Journal Article Cochrane Database Syst Rev · March 29, 2019 BACKGROUND: Postoperative nausea and vomiting (PONV) is a common complication following general anaesthesia. It may be associated with patient dissatisfaction, increased costs of treatment, and unintended admission to hospital.Supplemental intravenous crys ... Full text Link to item Cite

Anesthetic management of parturients with Arnold Chiari malformation-I: a multicenter retrospective study.

Journal Article Int J Obstet Anesth · February 2019 BACKGROUND: Consensus regarding the safest mode of delivery and anesthetic management for parturients with Arnold Chiari malformation-I (ACM-I) remains controversial. This study assessed their anesthetic management and reported anesthetic complications dur ... Full text Link to item Cite

Amisulpride for the Rescue Treatment of Postoperative Nausea or Vomiting in Patients Failing Prophylaxis: A Randomized, Placebo-controlled Phase III Trial.

Journal Article Anesthesiology · February 2019 BACKGROUND: Although antiemetics are commonly used to prevent postoperative nausea or vomiting, the failure rate is appreciable and there is currently no generally accepted standard for rescue treatment of postoperative nausea or vomiting after failed prop ... Full text Link to item Cite

Risk factors for severe acute pain and persistent pain after surgery for breast cancer: a prospective observational study.

Journal Article Reg Anesth Pain Med · February 2019 BACKGROUND AND OBJECTIVES: There are few prospective studies providing comprehensive assessment of risk factors for acute and persistent pain after breast surgery. This prospective observational study assessed patient-related, perioperative, and genetic ri ... Full text Link to item Cite

Opioid-related respiratory and gastrointestinal adverse events in patients with acute postoperative pain: prevalence, predictors, and burden.

Journal Article J Pain Palliat Care Pharmacother · 2019 Opioid-induced respiratory depression (OIRD) and postoperative nausea and vomiting (PONV) are challenging, resource-intensive, and costly opioid-related adverse events (ORAEs). Utilizing the Premier Healthcare Database, we identified patients > 18 years ol ... Full text Link to item Cite

ATHENA: A Phase 3, Open-Label Study Of The Safety And Effectiveness Of Oliceridine (TRV130), A G-Protein Selective Agonist At The µ-Opioid Receptor, In Patients With Moderate To Severe Acute Pain Requiring Parenteral Opioid Therapy.

Journal Article J Pain Res · 2019 BACKGROUND: Pain management with conventional opioids can be challenging due to dose-limiting adverse events (AEs), some of which may be related to the simultaneous activation of β-arrestin (a signaling pathway associated with opioid-related AEs) and G-pro ... Full text Link to item Cite

Obesity And Obstetric Anesthesia: Current Insights.

Journal Article Local Reg Anesth · 2019 Obesity is a significant global health problem. It results in a higher incidence of complications for pregnant women and their neonates. Cesarean deliveries are more common in obese parturients as well. The increased burden of comorbidities seen in this po ... Full text Link to item Cite

A review of the associations between obstructive sleep apnea and hypertensive disorders of pregnancy and possible mechanisms of disease.

Journal Article Sleep Med Rev · December 2018 Obesity is prevalent among pregnant women in the United States; 15-20% of obese pregnant women have obstructive sleep apnea. The prevalence of obstructive sleep apnea increases along with body mass index, age and in the presence of other co-morbidities. Un ... Full text Link to item Cite

A Systematic Review Evaluating Neuraxial Morphine and Diamorphine-Associated Respiratory Depression After Cesarean Delivery.

Journal Article Anesth Analg · December 2018 The prevalence of neuraxial opioid-induced clinically significant respiratory depression (CSRD) after cesarean delivery is unknown. We sought to review reported cases of author-reported respiratory depression (ARD) to calculate CSRD prevalence. A 6-databas ... Full text Link to item Cite

Screening extremely obese pregnant women for obstructive sleep apnea.

Journal Article Am J Obstet Gynecol · December 2018 BACKGROUND: Obesity is prevalent among pregnant women in the United States; obstructive sleep apnea is highly comorbid with obesity and is associated with adverse pregnancy outcomes. Screening for obstructive sleep apnea in pregnant women has remained a ch ... Full text Link to item Cite

Obstructive Sleep Apnea in Pregnant Women: A Review of Pregnancy Outcomes and an Approach to Management.

Journal Article Anesth Analg · November 2018 Among obese pregnant women, 15%-20% have obstructive sleep apnea (OSA) and this prevalence increases along with body mass index and in the presence of other comorbidities. Prepregnancy obesity and pregnancy-related weight gain are certainly risk factors fo ... Full text Link to item Cite

Amisulpride Prevents Postoperative Nausea and Vomiting in Patients at High Risk: A Randomized, Double-blind, Placebo-controlled Trial.

Journal Article Anesthesiology · June 2018 BACKGROUND: Postoperative nausea and vomiting causes distress for patients and can prolong care requirements. Consensus guidelines recommend use of multiple antiemetics from different mechanistic classes as prophylaxis in patients at high risk of postopera ... Full text Link to item Cite

Predicting Severity of Acute Pain After Cesarean Delivery: A Narrative Review.

Journal Article Anesth Analg · May 2018 Cesarean delivery is one of the most common surgical procedures in the United States, with over 1.3 million performed annually. One-fifth of women who undergo cesarean delivery will experience severe pain in the acute postoperative period, increasing their ... Full text Link to item Cite

A randomized trial of phenylephrine infusion versus bolus dosing for nausea and vomiting during Cesarean delivery in obese women.

Journal Article Can J Anaesth · March 2018 PURPOSE: Hypotension is common after spinal anesthesia for Cesarean delivery. It is associated with nausea, vomiting, and fetal acidosis. Previous research on phenylephrine excluded obese subjects. We compared the incidence of intraoperative nausea and vom ... Full text Link to item Cite

The Effect of Glycopyrrolate on the Incidence of Hypotension and Vasopressor Requirement During Spinal Anesthesia for Cesarean Delivery: A Meta-analysis.

Journal Article Anesth Analg · February 2018 BACKGROUND: The objective of this meta-analysis was to determine the efficacy of glycopyrrolate at reducing spinal hypotension during cesarean delivery. METHODS: A literature search was performed to identify randomized controlled trials investigating the e ... Full text Link to item Cite

The impact of neuraxial clonidine on postoperative analgesia and perioperative adverse effects in women having elective Caesarean section-a systematic review and meta-analysis.

Journal Article Br J Anaesth · February 2018 Neuraxial clonidine improves postoperative analgesia in the general surgical population. The efficacy and safety of neuraxial clonidine as a postoperative analgesic adjunct in the Caesarean section population still remains unclear. This systematic review a ... Full text Link to item Cite

High-dose versus low-dose local anaesthetic for transversus abdominis plane block post-Caesarean delivery analgesia: a meta-analysis.

Journal Article Br J Anaesth · February 2018 BACKGROUND: The optimal local-anaesthetic (LA) dose for transversus-abdominis-plane (TAP) block is unclear. In this meta-analysis, we aimed to determine whether TAP blocks for Caesarean delivery (CD) with low-dose (LD) LA demonstrated non-inferiority in te ... Full text Link to item Cite

Enhanced recovery after cesarean delivery.

Journal Article F1000Res · 2018 Enhanced recovery after surgery is a concept initially developed for patients undergoing colorectal surgery but has been adopted by other surgical specialties with similar positive outcomes. The adoption of enhanced recovery after surgery in the obstetric ... Full text Link to item Cite

Prevalence of difficult intubation and failed intubation in a diverse obstetric community-based population.

Journal Article Curr Med Res Opin · December 2017 OBJECTIVE: To describe the incidence of difficult and failed intubations in obstetric patients during a 6 year period monitored by a quality assurance program together with American Society of Anesthesiologists Physical Status (ASA PS) scores, and obesity ... Full text Link to item Cite

The impact of body mass index on the risk of high spinal block in parturients undergoing cesarean delivery: a retrospective cohort study.

Journal Article J Anesth · August 2017 PURPOSE: To investigate the hypothesis that the risk of high spinal block is not increased in obese parturients undergoing cesarean delivery compared to non-obese parturients. METHODS: This is a retrospective study at an academic center. We searched the pe ... Full text Link to item Cite

Establishing Obstetric Anesthesiology Practice Guidelines in the Republic of Armenia: A Global Health Collaboration.

Journal Article Anesthesiology · August 2017 BACKGROUND: Disparity exists in anesthesia practices between high- and low-to-middle income countries, and awareness has been raised within the global health community to improve the standards of anesthesia care and patient safety. The establishment of int ... Full text Link to item Cite

Spinal-induced hypotension: Incidence, mechanisms, prophylaxis, and management: Summarizing 20 years of research.

Journal Article Best Pract Res Clin Anaesthesiol · March 2017 Hypotension commonly occurs in parturients undergoing cesarean delivery under spinal anesthesia. This leads to maternal and neonatal adverse outcomes, including maternal nausea and vomiting and fetal acidosis, and might even lead to cardiovascular collapse ... Full text Link to item Cite

The effect of second-stage pushing and body mass index on postdural puncture headache.

Journal Article J Clin Anesth · February 2017 STUDY OBJECTIVE: To explore how pushing during labor and body mass index affect the development of postdural puncture headache in parturients who experienced dural puncture with Tuohy needles. DESIGN: Retrospective cohort. SETTING: Obstetric ward and opera ... Full text Link to item Cite

Intraoperative Frontal Alpha-Band Power Correlates with Preoperative Neurocognitive Function in Older Adults.

Journal Article Front Syst Neurosci · 2017 Each year over 16 million older Americans undergo general anesthesia for surgery, and up to 40% develop postoperative delirium and/or cognitive dysfunction (POCD). Delirium and POCD are each associated with decreased quality of life, early retirement, incr ... Full text Open Access Link to item Cite

Reply.

Journal Article Br J Anaesth · November 2016 Full text Link to item Cite

Local anaesthetic wound infiltration for postcaesarean section analgesia: A systematic review and meta-analysis.

Journal Article Eur J Anaesthesiol · October 2016 BACKGROUND: Wound infiltration with local anaesthetics has been investigated as a potentially useful method for providing analgesia after caesarean delivery, but the literature is inconclusive. OBJECTIVE: The objective is to assess the efficacy of local an ... Full text Link to item Cite

Evaluation of failed and high blocks associated with spinal anesthesia for Cesarean delivery following inadequate labour epidural: a retrospective cohort study.

Journal Article Can J Anaesth · October 2016 PURPOSE: The purpose of this retrospective cohort study was to investigate factors associated with failed and high spinal blocks in patients who received spinal anesthesia for Cesarean delivery following a labour epidural that was inadequate for surgical a ... Full text Link to item Cite

The effect of anti-emetic doses of dexamethasone on postoperative blood glucose levels in non-diabetic and diabetic patients: a prospective randomised controlled study.

Journal Article Anaesthesia · September 2016 There are few data regarding postoperative hyperglycaemia in non-diabetic compared with diabetic patients following postoperative nausea and vomiting prophylaxis with dexamethasone. Eighty-five non-diabetic patients and patients with type-2 diabetes were r ... Full text Link to item Cite

A retrospective comparison of programmed intermittent epidural bolus with continuous epidural infusion for maintenance of labor analgesia.

Journal Article Curr Med Res Opin · August 2016 OBJECTIVE: To assess whether maintenance of labor epidural analgesia using programmed intermittent epidural bolus (PIEB) is associated with reduced local anesthetic (LA) consumption, patient-controlled epidural analgesia (PCEA) use, and rescue analgesia re ... Full text Link to item Cite

Retrospective comparison of ephedrine and phenylephrine for the treatment of spinal anesthesia induced hypotension in pre-eclamptic patients.

Journal Article Curr Med Res Opin · June 2016 OBJECTIVE: To compare neonatal acid base status in parturients who underwent cesarean delivery and received either ephedrine or phenylephrine boluses for the treatment of spinal anesthesia induced hypotension. RESEARCH DESIGN AND METHODS: After institution ... Full text Link to item Cite

Supplemental perioperative intravenous crystalloids for postoperative nausea and vomiting

Journal Article Cochrane Database of Systematic Reviews · June 1, 2016 This is the protocol for a review and there is no abstract. The objectives are as follows: The objective of this review is to assess the effect of supplemental perioperative intravenous (IV) crystalloids on the risk of postoperative nausea and vomiting (PO ... Full text Cite

Failure rate and complications associated with the use of spinal catheters for the management of inadvertent dural puncture in the parturient: a retrospective comparison with re-sited epidural catheters.

Journal Article Curr Med Res Opin · May 2016 Objective To report on the failure rate of spinal catheters placed following inadvertent dural puncture (IDP) compared with re-sited epidural catheters in the obstetric population. Research design and methods Patients who experienced IDP during epidural or ... Full text Link to item Cite

The impact of gestational age and fetal weight on the risk of failure of spinal anesthesia for cesarean delivery.

Journal Article Int J Obstet Anesth · May 2016 BACKGROUND: There are limited data about spinal dosing for cesarean delivery in preterm parturients. We investigated the hypothesis that preterm gestation is associated with an increased incidence of inadequate spinal anesthesia for cesarean delivery compa ... Full text Open Access Link to item Cite

Combination antiemetics

Chapter · March 29, 2016 Full text Cite

Blood-Conservation Strategies in a Blood-Refusal Parturient with Placenta Previa and Placenta Percreta.

Journal Article A A Case Rep · March 1, 2016 Abnormal placentation can be associated with significant blood loss and massive blood transfusions. Caring for parturients with abnormal placentation who refuse blood transfusion is very challenging. We present a 35-year-old, gravida 3, para 1, Jehovah's W ... Full text Link to item Cite

Impact of postoperative nausea and vomiting prophylaxis with dexamethasone on the risk of recurrence of endometrial cancer.

Journal Article Curr Med Res Opin · 2016 OBJECTIVE: To assess whether antiemetic doses of dexamethasone are associated with an increased risk of cancer recurrence in women who underwent surgery for endometrial cancer. RESEARCH DESIGN AND METHODS: This is a retrospective study at an academic unive ... Full text Link to item Cite

Managing anesthesia for cesarean section in obese patients: current perspectives.

Journal Article Local Reg Anesth · 2016 Obesity is a worldwide epidemic. It is associated with increased comorbidities and increased maternal, fetal, and neonatal complications. The risk of cesarean delivery is also increased in obese parturients. Anesthetic management of the obese parturient is ... Full text Link to item Cite

Postoperative hyperglycemia after 4- vs 8-10-mg dexamethasone for postoperative nausea and vomiting prophylaxis in patients with type II diabetes mellitus: a retrospective database analysis.

Journal Article J Clin Anesth · November 2015 STUDY OBJECTIVE: The study objective is to compare change in postoperative blood glucose from preoperative values in patients with type II diabetes mellitus receiving 4- or 8-10-mg dexamethasone for postoperative nausea and vomiting prophylaxis. DESIGN: Th ... Full text Link to item Cite

Uterine exteriorization compared with in situ repair for Cesarean delivery: a systematic review and meta-analysis.

Journal Article Can J Anaesth · November 2015 PURPOSE: To compare perioperative outcomes following uterine exteriorization vs in situ repair after Cesarean delivery. SOURCE: We searched CENTRAL, MEDLINE®, EMBASEâ„¢, CINAHL, and ClinicalTrials.gov for randomized clinical trials that included any of our p ... Full text Link to item Cite

The Effect of patient warming during Caesarean delivery on maternal and neonatal outcomes: a meta-analysis.

Journal Article Br J Anaesth · October 2015 BACKGROUND: Perioperative warming is recommended for surgery under anaesthesia, however its role during Caesarean delivery remains unclear. This meta-analysis aimed to determine the efficacy of active warming on outcomes after elective Caesarean delivery. ... Full text Link to item Cite

Anesthetic management of super-morbidly obese parturients for cesarean delivery with a double neuraxial catheter technique: a case series.

Journal Article Int J Obstet Anesth · August 2015 Parturients with super-morbid obesity, defined as body mass index greater than 50kg/m(2), represent a growing segment of patients who require anesthetic care for labor and delivery. Severe obesity and its comorbid conditions place the parturient and fetus ... Full text Link to item Cite

Anesthetic management and outcomes of parturients with dilated cardiomyopathy in an academic centre.

Journal Article Can J Anaesth · March 2015 PURPOSE: This study examines the peripartum anesthetic management and outcomes of women with dilated cardiomyopathy in a large university medical centre over a seven-year period. PRINCIPAL FINDINGS: Twenty-five women were included in this series, 18 with a ... Full text Link to item Cite

Evidence-based anesthesia for major gynecologic surgery.

Journal Article Anesthesiol Clin · March 2015 Studies on enhanced recovery after gynecological surgery are limited but seem to report outcome benefits similar to those reported after colorectal surgery. Regional anesthesia is recommended in enhanced recovery protocols. Effective regional anesthetic te ... Full text Link to item Cite

Anesthetic technique for cesarean delivery and neonatal acid-base status: a retrospective database analysis.

Journal Article Int J Obstet Anesth · February 2015 INTRODUCTION: A previous meta-analysis reported lower umbilical artery pH with spinal anesthesia for cesarean delivery compared to general or epidural anesthesia. Ephedrine was used in the majority of studies. The objective of this study was to evaluate th ... Full text Link to item Cite

Impact of pregabalin on acute and persistent postoperative pain: a systematic review and meta-analysis.

Journal Article Br J Anaesth · January 2015 We performed this systematic review to assess the analgesic efficacy of perioperative pregabalin. Subgroup analyses and meta-regression were performed to assess the impact of individual dose and frequency of pregabalin administration on analgesic efficacy. ... Full text Link to item Cite

Postoperative Pain Scores and Narcotic Use in Robotic-assisted Versus Laparoscopic Hysterectomy for Endometrial Cancer Staging.

Journal Article J Minim Invasive Gynecol · 2015 STUDY OBJECTIVE: To retrospectively evaluate perioperative pain and analgesic and antiemetic use in patients who underwent surgical staging for endometrial cancer using traditional versus robotic-assisted laparoscopy. DESIGN: We identified women in a singl ... Full text Link to item Cite

Sheehan syndrome: acute presentation with severe headache.

Journal Article Int J Obstet Anesth · November 2014 Postpartum headache is a common occurrence with a broad differential diagnosis. Sheehan syndrome, or postpartum pituitary necrosis, is not typically recognized as a cause of postpartum headache. We present a case of Sheehan syndrome that initially presente ... Full text Link to item Cite

Nicotine for postoperative analgesia: a systematic review and meta-analysis.

Journal Article Anesth Analg · August 2014 BACKGROUND: The perioperative adminstration of nicotine has been investigated as an analgesic adjunct and a possible modality to prevent postoperative nausea and vomiting (PONV). We performed this systematic review to assess the impact of perioperative adm ... Full text Link to item Cite

A prospective evaluation of the incidence of adverse events in nurse-administered moderate sedation guided by sedation scores or Bispectral Index.

Journal Article Anesth Analg · July 2014 BACKGROUND: Moderate sedation is routinely performed in patients undergoing minor therapeutic and diagnostic procedures outside the operating room. The level of sedation is often monitored by sedation nurses using clinical criteria, such as sedation scores ... Full text Link to item Cite

A randomized placebo-controlled trial of two doses of pregabalin for postoperative analgesia in patients undergoing abdominal hysterectomy.

Journal Article Can J Anaesth · June 2014 PURPOSE: Acute pain after open abdominal hysterectomy limits the function of patients in the postoperative period, but data regarding the analgesic efficacy of a low dose of pregabalin (75 or 150 mg) have been conflicting. This study was performed to deter ... Full text Link to item Cite

Low central venous pressure versus acute normovolemic hemodilution versus conventional fluid management for reducing blood loss in radical retropubic prostatectomy: a randomized controlled trial.

Journal Article Curr Med Res Opin · May 2014 OBJECTIVE: To compare acute normovolemic hemodilution versus low central venous pressure strategy versus conventional fluid management in reducing intraoperative estimated blood loss, hematocrit drop and need for blood transfusion in patients undergoing ra ... Full text Link to item Cite

Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey.

Journal Article Curr Med Res Opin · January 2014 OBJECTIVE: During the past two decades, professional associations, accrediting bodies, and payors have made post-surgical pain treatment a high priority. In light of the disappointing findings in previous surveys, a survey was conducted to assess patient p ... Full text Open Access Link to item Cite

Consensus guidelines for the management of postoperative nausea and vomiting.

Journal Article Anesth Analg · January 2014 The present guidelines are the most recent data on postoperative nausea and vomiting (PONV) and an update on the 2 previous sets of guidelines published in 2003 and 2007. These guidelines were compiled by a multidisciplinary international panel of individu ... Full text Link to item Cite

A retrospective assessment of the incidence of respiratory depression after neuraxial morphine administration for postcesarean delivery analgesia.

Journal Article Anesth Analg · December 2013 Respiratory depression can occur after neuraxial morphine administration. In the obstetric population, there are little data on respiratory depression after neuraxial morphine administration in women undergoing cesarean delivery. In this single-center, ret ... Full text Link to item Cite

Prophylaxis and treatment of the side-effects of neuraxial morphine analgesia following cesarean delivery.

Journal Article Curr Opin Anaesthesiol · June 2013 PURPOSE OF REVIEW: Neuraxial morphine is commonly used for analgesia after cesarean delivery, but is frequently associated with postoperative nausea and vomiting (PONV) and pruritus. This review describes the recent advances in the management of those side ... Full text Link to item Cite

The impact of postoperative nausea and vomiting prophylaxis with dexamethasone on postoperative wound complications in patients undergoing laparotomy for endometrial cancer.

Journal Article Anesth Analg · May 2013 Featured Publication BACKGROUND: Dexamethasone is widely used for postoperative nausea and vomiting (PONV) prophylaxis. However, there are limited data on the risk of wound complications associated with single-dose dexamethasone use for this purpose. We performed this retrospe ... Full text Link to item Cite

The peripartum management of a patient with glutaric aciduria type 1.

Journal Article J Clin Anesth · March 2013 The management of cesarean delivery for a parturient with placenta previa at 36 weeks' gestation and glutaric aciduria type 1 is presented. The management goal was to prevent encephalopathic crisis by ensuring adequate caloric intake with dextrose infusion ... Full text Link to item Cite

Antiemetics added to phenylephrine infusion during cesarean delivery: a randomized controlled trial.

Journal Article Obstet Gynecol · March 2013 OBJECTIVE: To estimate whether the addition of metoclopramide or its combination with ondansetron to a prophylactic phenylephrine infusion provides improved intraoperative nausea and vomiting prophylaxis compared with phenylephrine infusion alone. METHODS: ... Full text Link to item Cite

Impact of perioperative dexamethasone on postoperative analgesia and side-effects: systematic review and meta-analysis.

Journal Article Br J Anaesth · February 2013 Featured Publication BACKGROUND: The analgesic efficacy and adverse effects of a single perioperative dose of dexamethasone are unclear. We performed a systematic review to evaluate the impact of a single i.v. dose of dexamethasone on postoperative pain and explore adverse eve ... Full text Link to item Cite

Intermittent epidural bolus compared with continuous epidural infusions for labor analgesia: a systematic review and meta-analysis.

Journal Article Anesth Analg · January 2013 Featured Publication BACKGROUND: The current standard labor epidural analgesic regimens consist of a local anesthetic in combination with an opioid delivered via continuous epidural infusion (CEI). With CEI local anesthetic, doses may be large with resulting profound motor blo ... Full text Link to item Cite

Inhaled fentanyl aerosol in healthy volunteers: pharmacokinetics and pharmacodynamics.

Journal Article Anesth Analg · November 2012 BACKGROUND: Rapid delivery of potent opioid to the systemic circulation is an important feature for the effective treatment of acute and acute-on-chronic breakthrough pain. The delivery of different opioids by the pulmonary route has been inconsistent, usu ... Full text Link to item Cite

Effects of dose ranging of adenosine infusion on electrocardiographic findings during and after general anesthesia.

Journal Article J Anesth · October 2012 PURPOSE: To assess changes in the electrocardiogram (ECG) associated with intraoperative infusion of adenosine in patients undergoing open abdominal gynecological surgery. METHODS: One hundred and sixty-six patients undergoing gynecological surgery were ra ... Full text Link to item Cite

Postoperative nausea and vomiting: then & now.

Journal Article Anesth Analg · September 2012 Full text Link to item Cite

Transversus abdominis plane block for analgesia after Cesarean delivery: a systematic review and meta-analysis.

Journal Article Can J Anaesth · August 2012 Featured Publication PURPOSE: To assess the efficacy of transversus abdominis plane (TAP) block in improving analgesia following Cesarean delivery (CD). SOURCE: We searched MEDLINE, CENTRAL, EMBASE, and CINAHL for randomized controlled trials that assessed the efficacy of TAP ... Full text Link to item Cite

Hemodynamic impact of dexmedetomidine administration in 15,656 noncardiac surgical cases.

Journal Article J Clin Anesth · May 2012 STUDY OBJECTIVE: To assess the hemodynamic impact of dexmedetomidine administration in a large cohort of patients undergoing routine noncardiac surgery. DESIGN: Retrospective database analysis. SETTING: Major academic medical center. MEASUREMENTS: A valid ... Full text Link to item Cite

Dexamethasone for the prophylaxis of postoperative nausea and vomiting associated with neuraxial morphine administration: a systematic review and meta-analysis.

Journal Article Anesth Analg · April 2012 Featured Publication BACKGROUND: We performed a systematic review to assess the efficacy of dexamethasone in reducing postoperative nausea, vomiting (PONV), pruritus, and enhancing postoperative analgesia in patients receiving neuraxial anesthesia with neuraxial morphine. METH ... Full text Link to item Cite

Metoclopramide for nausea and vomiting prophylaxis during and after Caesarean delivery: a systematic review and meta-analysis.

Journal Article Br J Anaesth · March 2012 Featured Publication Nausea and vomiting occur commonly during and after Caesarean delivery (CD) performed under neuraxial anaesthesia. Metoclopramide is a prokinetic agent reported to be safe in parturients. This meta-analysis assesses the efficacy of metoclopramide for proph ... Full text Link to item Cite

A review of the impact of phenylephrine administration on maternal hemodynamics and maternal and neonatal outcomes in women undergoing cesarean delivery under spinal anesthesia.

Journal Article Anesth Analg · February 2012 Featured Publication Phenylephrine is effective for the management of spinal anesthesia-induced hypotension in parturients undergoing cesarean delivery under spinal anesthesia. While ephedrine was previously considered the vasopressor of choice in obstetric patients, phenyleph ... Full text Link to item Cite

Peripartum management of two parturients with ornithine transcarbamylase deficiency.

Journal Article Int J Obstet Anesth · January 2012 Ornithine transcarbamylase deficiency is a rare X-linked disorder in which female carriers are usually heterozygous for the ornithine transcarbamylase deficiency gene. In pregnancy it has been associated with altered mental status, seizures, coma and death ... Full text Link to item Cite

Impact of intraoperative dexmedetomidine on postoperative analgesia following gynecologic surgery.

Journal Article Curr Med Res Opin · November 2011 OBJECTIVE: To assess the impact of intraoperative dexmedetomidine infusion on postoperative analgesia in women undergoing major open and laparoscopic gynecologic surgery under general anesthesia. RESEARCH DESIGN AND METHODS: A retrospective analysis of pat ... Full text Link to item Cite

Remifentanil for fetal immobilization and analgesia during the ex utero intrapartum treatment procedure under combined spinal-epidural anaesthesia.

Journal Article Br J Anaesth · June 2011 Remifentanil undergoes extensive placental transfer and has been used to provide fetal immobilization and anaesthesia for in utero fetal endoscopic interventions. We report three cases of the ex utero intrapartum treatment performed under neuraxial anaesth ... Full text Link to item Cite

A comparison of the combination of aprepitant and dexamethasone versus the combination of ondansetron and dexamethasone for the prevention of postoperative nausea and vomiting in patients undergoing craniotomy.

Journal Article Anesth Analg · April 2011 Featured Publication BACKGROUND: Postoperative nausea and vomiting (PONV) occur commonly after craniotomy. In patients receiving prophylaxis with ondansetron and dexamethasone, vomiting occurred in 45% of patients at 48 hours. In addition to causing patient discomfort, the phy ... Full text Link to item Cite

Rolapitant for the prevention of postoperative nausea and vomiting: a prospective, double-blinded, placebo-controlled randomized trial.

Journal Article Anesth Analg · April 2011 BACKGROUND: Postoperative nausea and vomiting (PONV) are common complications after surgery. Neurokinin-1 (NK(1)) receptor antagonists have been shown to be safe and effective for the prevention and treatment of PONV in humans. Rolapitant is a potent, sele ... Full text Link to item Cite

Analgesic and antiemetic needs following minimally invasive vs open staging for endometrial cancer.

Journal Article Am J Obstet Gynecol · January 2011 Featured Publication OBJECTIVE: We sought to assess perioperative outcomes of minimally invasive vs open endometrial cancer staging procedures. STUDY DESIGN: A total of 181 consecutive patients underwent open or minimally invasive hysterectomy with or without lymphadenectomy. ... Full text Link to item Cite

In response

Journal Article Anesthesia and Analgesia · December 1, 2010 Full text Cite

A double-blind, placebo-controlled trial of four fixed rate infusion regimens of phenylephrine for hemodynamic support during spinal anesthesia for cesarean delivery.

Journal Article Anesth Analg · November 2010 BACKGROUND: The administration of prophylactic phenylephrine infusions in combination with fluid cohydration significantly reduces the incidence of hypotension in women having cesarean delivery under spinal anesthesia. The ideal dosing regimen for this pur ... Full text Link to item Cite

Minimum effective dose of spinal ropivacaine with and without fentanyl for postpartum tubal ligation.

Journal Article Int J Obstet Anesth · October 2010 BACKGROUND: Ropivacaine may be the ideal spinal anesthetic for postpartum tubal ligation due to its medium duration of action, low incidence of side effects and possibly reduced post-anesthetic care unit (PACU) stay. METHODS: Two prospective up-down sequen ... Full text Link to item Cite

Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery: a systematic review of randomized controlled trials.

Journal Article Drugs · June 18, 2010 Postoperative pain continues to be inadequately managed. While opioids remain the mainstay for postoperative analgesia, their use can be associated with adverse effects, including ileus, which can prolong hospital stay. A number of studies have investigate ... Full text Link to item Cite

Processed electroencephalogram during donation after cardiac death.

Journal Article Anesth Analg · May 1, 2010 We present a case series of increased bispectral index values during donation after cardiac death (DCD). During the DCD process, a patient was monitored with processed electroencephalogram (EEG), which showed considerable changes traditionally associated w ... Full text Link to item Cite

Up-down determination of the 90% effective dose of phenylephrine for the treatment of spinal anesthesia-induced hypotension in parturients undergoing cesarean delivery.

Journal Article Anesth Analg · January 1, 2010 INTRODUCTION: Hypotension frequently complicates spinal anesthesia for cesarean delivery, and vasopressors are the mainstay for treatment. The most effective dose of phenylephrine for the treatment of spinal anesthesia-induced hypotension has not been esti ... Full text Link to item Cite

Double-blind comparison of granisetron, promethazine, or a combination of both for the prevention of postoperative nausea and vomiting in females undergoing outpatient laparoscopies.

Journal Article Can J Anaesth · November 2009 PURPOSE: Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) are common problems after surgery. Prophylactic combination antiemetic therapy is recommended for patients at high risk for developing PONV and PDNV. Granisetron ... Full text Link to item Cite

A survey of the management of spinal-induced hypotension for scheduled cesarean delivery.

Journal Article Int J Obstet Anesth · October 2009 BACKGROUND: Intravenous fluids and vasopressors are used for managing spinal-induced hypotension during cesarean delivery, but the choice of vasopressor and the type and timing of fluid administration remain controversial. METHODS: We conducted an electron ... Full text Link to item Cite

Computerized surveillance of opioid-related adverse drug events in perioperative care: a cross-sectional study.

Journal Article Patient Saf Surg · August 11, 2009 BACKGROUND: Given the complexity of surgical care, perioperative patients are at high risk of opioid-related adverse drug events. Existing methods of detection, such as trigger tools and manual chart review, are time-intensive which makes sustainability ch ... Full text Open Access Link to item Cite

A retrospective comparison of anesthetic management of robot-assisted laparoscopic radical prostatectomy versus radical retropubic prostatectomy.

Journal Article J Clin Anesth · August 2009 STUDY OBJECTIVE: To compare anesthetic management and postoperative outcomes in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP) and radical retropubic prostatectomy (RRP) with general anesthesia. DESIGN: Retrospective database ... Full text Link to item Cite

Serotonin receptor antagonists for the prevention and treatment of pruritus, nausea, and vomiting in women undergoing cesarean delivery with intrathecal morphine: a systematic review and meta-analysis.

Journal Article Anesth Analg · July 2009 BACKGROUND: We performed a systematic review to determine the overall efficacy of serotonin (5-HT3) receptor antagonists for the prevention and treatment of pruritus, nausea, and vomiting in women receiving spinal anesthesia with intrathecal morphine for c ... Full text Link to item Cite

Comparison of postoperative pain outcomes after vertical or Pfannenstiel incision for major gynecologic surgery.

Journal Article Curr Med Res Opin · June 2009 OBJECTIVE: The Pfannenstiel incision is commonly used for gynecologic surgery. It is not known if this incision is associated with less postoperative pain compared to a vertical midline incision. Therefore, as part of a study to evaluate the postoperative ... Full text Link to item Cite

Lidocaine patch for postoperative analgesia after radical retropubic prostatectomy.

Journal Article Anesth Analg · June 2009 In a prospective, double-blind, placebo-controlled study, patients undergoing radical retropubic prostatectomy under general anesthesia were randomly assigned to receive a lidocaine patch or placebo applied on each side of the wound at the end of surgery. ... Full text Link to item Cite

Phase 2, double-blind, placebo-controlled, dose-response trial of intravenous adenosine for perioperative analgesia.

Journal Article Anesthesiology · December 2008 Featured Publication BACKGROUND: Adenosine regulates pain transmission by actions at spinal, supraspinal, and peripheral sites. A few studies have suggested that administration of adenosine might be associated with anesthetic- and analgesic-sparing effects. The primary aim of ... Full text Link to item Cite

P6 stimulation for the prevention of nausea and vomiting associated with cesarean delivery under neuraxial anesthesia: a systematic review of randomized controlled trials.

Journal Article Anesth Analg · October 2008 Featured Publication BACKGROUND: A number of studies investigated the use of P6 stimulation for the prevention of intraoperative and postoperative nausea and vomiting (IONV and PONV) in women having cesarean delivery under neuraxial anesthesia. We performed a systematic review ... Full text Link to item Cite

Transdermal nicotine for analgesia after radical retropubic prostatectomy.

Journal Article Anesth Analg · September 2008 Featured Publication BACKGROUND: Previous animal and human studies suggested that nicotine might have an antinociceptive effect. We hypothesized that the preoperative application of a 7 mg nicotine patch would result in reduced postoperative analgesic requirements in patients ... Full text Link to item Cite

Acupuncture and related techniques for postoperative pain: a systematic review of randomized controlled trials.

Journal Article Br J Anaesth · August 2008 Featured Publication Postoperative pain management remains a significant challenge for all healthcare providers. The objective of this systematic review was to quantitatively evaluate the efficacy of acupuncture and related techniques as adjunct analgesics for acute postoperat ... Full text Link to item Cite

Brief Report: A randomized controlled trial of SyneraTM versus lidocaine for epidural needle insertion in labouring parturients: [Compte-rendu court : Une etude randomisee controlee du SyneraTM vs lidocaine dans l'insertion de l'aiguille peridurale chez les parturientes en travail].

Journal Article Canadian journal of anaesthesia = Journal canadien d'anesthesie · March 2008 PURPOSE: Skin infiltration with lidocaine, although brief, can be very stressful, painful, and may perpetuate anxiety. Syneratrade mark, a local anesthetic patch, which contains an oxygen-activated heating component to enhance the delivery of a eutectic mi ... Cite

Brief report: a randomized controlled trial of Synera versus lidocaine for epidural needle insertion in labouring parturients.

Journal Article Can J Anaesth · March 2008 Featured Publication PURPOSE: Skin infiltration with lidocaine, although brief, can be very stressful, painful, and may perpetuate anxiety. Synerat, a local anesthetic patch, which contains an oxygen-activated heating component to enhance the delivery of a eutectic mixture of ... Full text Link to item Cite

Management of a parturient with an acute exacerbation of idiopathic pulmonary haemosiderosis and posterior spinal instrumentation.

Journal Article Br J Anaesth · February 2008 Featured Publication Idiopathic pulmonary haemosiderosis (IPH) is a rare condition associated with diffuse alveolar haemorrhage and pulmonary fibrosis. We describe the anaesthetic management of a parturient with a history of posterior spinal fusion presenting with an acute exa ... Full text Link to item Cite

The use of droperidol before and after the Food and Drug Administration black box warning: a survey of the members of the Society of Ambulatory Anesthesia.

Journal Article J Clin Anesth · February 2008 Featured Publication STUDY OBJECTIVE: To determine the practice of members of the Society of Ambulatory Anesthesia (SAMBA) in the management of postoperative nausea and vomiting (PONV) before and after the Food and Drug Administration (FDA) black box warning on droperidol. DES ... Full text Link to item Cite

A pilot study to compare the Episure Autodetect syringe with the glass syringe for identification of the epidural space in parturients.

Journal Article Anesth Analg · February 2008 Featured Publication The Episure AutoDetect syringe, a spring-loaded syringe, is a new loss-of-resistance syringe with an internal compression spring that applies constant pressure on the plunger. In this pilot study, we compared the spring-loaded syringe with the standard gla ... Full text Link to item Cite

Ethnicity and the Distance to the Epidural Space in Parturients

Journal Article Regional Anesthesia and Pain Medicine · January 2008 Full text Cite

Ex utero intrapartum treatment procedure in a patient with arthrogryposis multiplex congenita, using continuous spinal anesthesia and intravenous nitroglycerin for uterine relaxation.

Journal Article Int J Obstet Anesth · January 2008 Featured Publication The ex utero intrapartum treatment procedure allows for the controlled management of a potentially life-threatening difficult airway in the newborn. General anesthesia has previously been reported for the management of this procedure. We report the use of ... Full text Link to item Cite

Ethnicity and the distance to the epidural space in parturients.

Journal Article Reg Anesth Pain Med · 2008 Featured Publication BACKGROUND AND OBJECTIVES: In a pilot study, we previously demonstrated a higher average skin to lumbar epidural space distance (STLESD) in our obstetric population compared with the published literature. Furthermore, we demonstrated differences in STLESD ... Full text Link to item Cite

Society for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomiting.

Journal Article Anesth Analg · December 2007 Featured Publication The present guidelines were compiled by a multidisciplinary international panel of individuals with interest and expertise in postoperative nausea and vomiting (PONV) under the auspices of The Society of Ambulatory Anesthesia. The panel critically evaluate ... Full text Link to item Cite

How much are patients willing to pay to avoid postoperative muscle pain associated with succinylcholine?

Journal Article J Clin Anesth · December 2007 Featured Publication STUDY OBJECTIVE: To determine how much money patients are willing to pay to avoid postoperative muscle pains associated with succinylcholine. DESIGN: Observational study with survey instrument. SETTING: University-affiliated metropolitan hospital. PATIENTS ... Full text Link to item Cite

Detecting an infiltrated intravenous catheter using indigo carmine: a novel method.

Journal Article Anesth Analg · October 2007 Featured Publication An extravasated IV catheter may have serious clinical consequences. These include the inability to circulate emergency medications, cause pain on injection, infection at the site, and tissue damage. Clinical signs such as swelling, redness, and pain with i ... Full text Link to item Cite

Adenosine as a non-opioid analgesic in the perioperative setting.

Journal Article Anesth Analg · August 2007 Featured Publication Adenosine, a ubiquitous metabolic intermediate in the body, is involved in nearly every aspect of cell function, including neuromodulation and neurotransmission. Adenosine A(1) and A(2) receptors are widely distributed in the brain and spinal cord, and are ... Full text Link to item Cite

The management of Cesarean delivery in a parturient with paroxysmal nocturnal hemoglobinuria complicated by severe preeclampsia.

Journal Article Can J Anaesth · August 2007 Featured Publication PURPOSE: To describe the anesthetic and peripartum management of a parturient with paroxysmal nocturnal hemoglobinuria complicated by severe preeclampsia, review the pathophysiology of this condition, rationale for thromboembolic prophylaxis, and its impli ... Full text Link to item Cite

A randomized, double-blind comparison of the NK1 antagonist, aprepitant, versus ondansetron for the prevention of postoperative nausea and vomiting.

Journal Article Anesth Analg · May 2007 Featured Publication BACKGROUND: Antiemetics currently in use are not totally effective. Neurokinin-1 receptor antagonists are a new class of antiemetic that have shown promise for chemotherapy-induced nausea and vomiting. This is the first study evaluating the efficacy and to ... Full text Link to item Cite

A comparison of ondansetron with promethazine for treating postoperative nausea and vomiting in patients who received prophylaxis with ondansetron: a retrospective database analysis.

Journal Article Anesth Analg · March 2007 Featured Publication BACKGROUND: There are little data on the efficacy of antiemetics for treating postoperative nausea and vomiting (PONV) in patients who received prior PONV prophylaxis. METHODS: In this retrospective database analysis, we compared the efficacy of ondansetro ... Full text Link to item Cite

Case series: Combined spinal epidural anesthesia for Cesarean delivery and ex utero intrapartum treatment procedure.

Journal Article Can J Anaesth · March 2007 Featured Publication PURPOSE: To report the use of regional anesthesia and iv nitroglycerin to provide anesthesia and uterine relaxation for three Cesarean deliveries (CD) involving ex utero intrapartum treatment (EXIT) of potentially life-threatening airway obstruction in the ... Full text Link to item Cite

Postoperative nausea and vomiting following the use of fentanyl or remifentanil in ambulatory gynecologic laparoscopic surgery: A prospective randomized trial

Journal Article Ambulatory Surgery · March 1, 2007 Purpose: To test the hypothesis that using remifentanil during nitrous oxide-sevoflurane anesthetic would be associated with less postoperative nausea and vomiting (PONV) compared to a similar technique with fentanyl. Scope: Sixty patients undergoing outpa ... Cite

Motor blocking minimum local anesthetic concentrations of bupivacaine, levobupivacaine, and ropivacaine in labor.

Journal Article Reg Anesth Pain Med · 2007 Featured Publication BACKGROUND AND OBJECTIVES: Adequate comparison of blocking capabilities of local anesthetics should be done with some knowledge of their relative potencies. The objective of this clinical trial was to simultaneously determine the motor blocking minimum loc ... Full text Link to item Cite

Gabapentin and postoperative pain--a systematic review of randomized controlled trials.

Journal Article Pain · December 15, 2006 Featured Publication The objective of this systematic review was to evaluate the efficacy and tolerability of perioperative gabapentin administration for the control of acute postoperative pain. We searched Medline (1966-2006), the Cochrane Library (2006), Scopus, CINAHL and b ... Full text Link to item Cite

Mid-calf position--an improved technique to place neuraxial anaesthesia.

Journal Article Br J Anaesth · October 2006 Featured Publication Full text Link to item Cite

Anaesthetic management of a parturient with the postural orthostatic tachycardia syndrome: a case report.

Journal Article Br J Anaesth · August 2006 Featured Publication Postural orthostatic tachycardia syndrome encompasses a group of disorders characterized by orthostatic intolerance. We describe the anaesthetic management of analgesia for labour and of Caesarean section in a parturient suffering from this disorder. Worse ... Full text Link to item Cite

Postoperative nausea and vomiting following inpatient surgeries in a teaching hospital: a retrospective database analysis.

Journal Article Curr Med Res Opin · June 2006 Featured Publication OBJECTIVE: To report the incidence of postoperative nausea and vomiting (PONV), to describe the use of anti-emetics both for the prophylaxis and treatment of PONV, and to assess resource utilization and duration of post-anesthesia care unit (PACU) stay. RE ... Full text Link to item Cite

A randomized, prospective double-blind comparison of the efficacy of generic propofol (sulphite additive) with diprivan.

Journal Article Eur J Anaesthesiol · April 2006 Featured Publication BACKGROUND AND OBJECTIVE: We compared the dose requirement and side effect profile of total intravenous anaesthesia using Diprivan to generic propofol at a specific anaesthetic target level utilizing the bispectral index monitor to determine efficacy diffe ... Full text Link to item Cite

Transcutaneous acupoint electrical stimulation with the ReliefBand for the prevention of nausea and vomiting during and after cesarean delivery under spinal anesthesia.

Journal Article Anesth Analg · February 2006 Featured Publication We randomized 94 patients undergoing cesarean delivery with spinal anesthesia to receive transcutaneous acupoint electrical stimulation using the ReliefBand at the P6 point (active group) or an active ReliefBand applied to the dorsum of the wrist (sham con ... Full text Link to item Cite

Use of neostigmine in the management of acute postoperative pain and labour pain: a review.

Journal Article CNS Drugs · 2006 Neostigmine is a parasympathomimetic agent that has been recently investigated for use as an adjunct analgesic agent in the perioperative and peripartum period. A number of studies have investigated the intrathecal, epidural, caudal and intra-articular rou ... Full text Link to item Cite

A randomized, double-blind study of granisetron plus dexamethasone versus ondansetron plus dexamethasone to prevent postoperative nausea and vomiting in patients undergoing abdominal hysterectomy.

Journal Article Anesth Analg · November 2005 In this randomized, double-blind study, we evaluated whether small-dose granisetron (0.1 mg) plus dexamethasone 8 mg (G+D) was as effective as ondansetron 4 mg plus dexamethasone 8 mg (O+D) for preventing vomiting during the 0 to 2 h after tracheal extubat ... Full text Link to item Cite

Chronobiology of motor block during labor

Conference ANESTHESIOLOGY · May 1, 2005 Link to item Cite

Dural ectasia: a likely cause of inadequate spinal anaesthesia in two parturients with Marfan's syndrome.

Journal Article Br J Anaesth · April 2005 Featured Publication We report two cases of Caesarean section in patients with Marfan's syndrome where continuous subarachnoid anaesthesia failed to provide an adequate surgical block. This was possibly because of dural ectasia, which was confirmed by a computed tomography sca ... Full text Link to item Cite

Role of analgesic adjuncts in postoperative pain management.

Journal Article Anesthesiol Clin North Am · March 2005 Featured Publication Postoperative pain remains a major problem. A multi-modal analgesic approach is recommended to optimize pain management and reduce opiate-related adverse effects. Several analgesic adjuncts have been investigated, and many have proved to have a useful anal ... Full text Link to item Cite

The effectiveness of rescue antiemetics after failure of prophylaxis with ondansetron or droperidol: a preliminary report.

Journal Article J Clin Anesth · February 2005 Featured Publication STUDY OBJECTIVES: To compare the effectiveness of treating established postoperative nausea and vomiting (PONV) with an antiemetic acting at a different receptor with that of treating PONV with the antiemetic used for prophylaxis. DESIGN: Analysis of data ... Full text Link to item Cite

Intrathecal morphine for analgesia after postpartum bilateral tubal ligation.

Journal Article Anesth Analg · January 2005 Featured Publication Postpartum bilateral tubal ligation (PPBTL) causes postoperative pain. We designed this study to determine the efficacy of 50 microg intrathecal morphine for analgesia after PPBTL. Sixty-five women received spinal anesthesia with 12.75 mg hyperbaric bupiva ... Full text Link to item Cite

Perioperative anesthetic management for Cesarean section of a parturient with gestational diabetes insipidus.

Journal Article Can J Anaesth · 2005 Featured Publication PURPOSE: Gestational diabetes insipidus (GDI) is a rare endocrinopathy complicating about 4:100,000 deliveries. We present the case of a preterm parturient with GDI and severe hypernatremia (serum sodium concentration = 174 mmol.L(-1)) presenting for an ur ... Full text Link to item Cite

Intrathecal morphine for postpartum bilateral tubal ligation - Reply

Journal Article ANESTHESIA AND ANALGESIA · 2005 Cite

Apparent arterial desaturation due a nerve stimulator.

Journal Article Anaesthesia · September 2004 Featured Publication Full text Link to item Cite

A randomized comparison of a multimodal management strategy versus combination antiemetics for the prevention of postoperative nausea and vomiting.

Journal Article Anesth Analg · July 2004 Featured Publication A multimodal management strategy for the prevention of postoperative nausea and vomiting (PONV) appears to be superior to single-drug prophylaxis. We tested the hypothesis that a multimodal PONV prophylaxis regimen incorporating total IV anesthesia (TIVA) ... Full text Link to item Cite

Anesthesia for cesarean section in a patient with spinal muscular atrophy.

Journal Article J Clin Anesth · May 2004 Featured Publication We describe the anesthetic management for cesarean section and tubal ligation of a 23-year-old primipara with type II spinal muscular atrophy (benign Werdnig Hoffmann). She was wheelchair-bound, had severe restrictive lung disease, and severe kyphoscoliosi ... Full text Link to item Cite

Evidence-based management of postoperative nausea and vomiting: a review.

Journal Article Can J Anaesth · April 2004 Featured Publication PURPOSE: To provide evidence-based guidelines for the prophylaxis and treatment of postoperative nausea and vomiting (PONV). SOURCE: Literature from randomized controlled trials, systematic reviews, logistic regression analyses and expert opinion in the ma ... Full text Link to item Cite

The efficacy of the 5-HT3 receptor antagonists combined with droperidol for PONV prophylaxis is similar to their combination with dexamethasone. A meta-analysis of randomized controlled trials.

Journal Article Can J Anaesth · April 2004 Featured Publication PURPOSE: The aim of this quantitative systematic review is to compare the efficacy and side effects of combining one of the 5-HT(3) receptor antagonists (5-HT) with droperidol or dexamethasone for postoperative nausea and vomiting (PONV) prophylaxis. METHO ... Full text Link to item Cite

Safety of patients reason for FDA black box warning on droperidol - Response

Journal Article ANESTHESIA AND ANALGESIA · February 1, 2004 Link to item Cite

Pharmacodynamic interactions between cisatracurium and rocuronium.

Journal Article Anesth Analg · January 2004 UNLABELLED: The onset and duration of maintenance doses of neuromuscular blocking drugs may be influenced by the original neuromuscular blocking drug used. We assessed the effect of the interaction between steroidal and benzo-isoquinolinium compounds on th ... Full text Link to item Cite

Pharmacotherapy of postoperative nausea and vomiting.

Journal Article Expert Opin Pharmacother · April 2003 Postoperative nausea and vomiting (PONV) are two of the most common and unpleasant side effects following anaesthesia and surgery. Despite the development of new anti-emetics and a vast amount of published research, PONV continues to be a problem, especial ... Full text Link to item Cite

Pharmacotherapy of postoperative nausea and vomiting

Journal Article Expert Opinion on Pharmacotherapy · 2003 Full text Cite

Anesthetic management of a ventilator-dependent parturient with the King-Denborough syndrome.

Journal Article Can J Anaesth · 2003 PURPOSE: The King-Denborough syndrome (KDS) is a rare disorder that is associated with myopathy, susceptibility to malignant hyperthermia (MH) as well as congenital skeletal and facial anomalies. We report the anesthetic management of a parturient with KDS ... Full text Link to item Cite

Combination antiemetics: what is the evidence?

Journal Article Int Anesthesiol Clin · 2003 Full text Link to item Cite

Randomized controlled trial investigating the effect of transcervical papaverine and bupivacaine on postoperative analgesia following laparoscopic sterilization.

Journal Article Eur J Anaesthesiol · November 2002 BACKGROUND AND OBJECTIVE: A critical factor that delays patient discharge following day-surgery is severe postoperative pain and the requirement for strong analgesics. Laparoscopic sterilization is a day case procedure and is associated with additional pos ... Full text Link to item Cite

Midazolam--an anti-emetic?

Journal Article Anaesthesia · July 2002 Full text Link to item Cite

ASA physical, status classification - A pregnant pause

Journal Article ANESTHESIOLOGY · April 1, 2002 Link to item Cite

Effects of remifentanil and alfentanil on the cardiovascular responses to induction of anaesthesia and tracheal intubation in the elderly.

Journal Article Br J Anaesth · March 2002 BACKGROUND: We compared the effects of remifentanil and alfentanil on arterial pressure and heart rate at induction of anaesthesia and tracheal intubation in 40 ASA I-III patients aged greater than 65 yr, in a randomized double-blind study. METHODS: Patien ... Full text Link to item Cite

Combination therapy for postoperative nausea and vomiting - a more effective prophylaxis?

Journal Article Ambul Surg · July 2001 The problem of postoperative nausea and vomiting (PONV) remains far from being resolved. Despite the introduction of new classes of antiemetics and a vast amount of published research, there is a general impression that there has been little progress in th ... Full text Link to item Cite

Buscopan for the treatment of pain after laparoscopic sterilisation.

Journal Article Anaesthesia · February 2001 We investigated the effect of Buscopan 20 mg, given at the end of surgery, on analgesic requirements in 44 ASA I and II patients presenting as day cases for laparoscopic sterilisation using Filshie clips. Patients were randomly allocated to receive either ... Full text Link to item Cite