Epidural Analgesia

Epidural analgesia is a form of pain relief administered through the space surrounding the dural sheath either by direct injection or via catheter. The agent, when administered, can cause both a loss of sensation (anesthesia) and a loss of pain (analgesia), by reversibly interrupting the transmission of signals through nerves in or near the spinal cord. This form of pain relief has been found useful in many clinical situations. This book intends to provide an in-depth review of the current knowledge on epidural analgesia. The use of this form of analgesia is explored by contributors from different perspectives, including labor and delivery, postoperative analgesia in both pediatric and geriatric patients, and its role during anesthesia and surgery. In order to provide a balanced medical view this book was edited by an obstetric anesthesiologist.

This book examines the future of birthing practices, particularly by focusing on epidural analgesia in childbirth. It describes historical and cultural trajectories that have shaped the way in which birth is understood in Western, developed nations. In setting out the nature of epidural history, knowledge and practice, the book delves into related birth practices within the hospital setting. By critically examining these practices, which are embedded in a scientific discourse that rationalises and relies upon technology use, the authors argue that epidural analgesia has been positioned as a safe technology in contemporary maternity culture, despite it carrying particular risks. In examining alternative research the book proposes that increasing epidural rates are not only due to greater pain relief requirements or access but are influenced by technocratic values and a fragmented maternity system. The authors outline the way in which this epidural discourse influences how information is presented to women and how this affects their choices around the use of pain relief in labour.

Epidurals are increasingly popular and have become more versatile, with applications in adult surgery, trauma, obstetrics and paediatric practice. This book of best practice guidelines aims to help develop and improve patient care, stimulate learning and highlight ideas for nursing research. It can be used as a quick reference guide for clinical practice or as a framework for developing individual local epidural services and practice guidelines. outlines the specific responsibilities of the multidisciplinary healthcare team in relation to epidural practice reviews the issues of risk benefit analysis and informed consent provides an overview of the physiology of acute pain, epidural catheter insertion procedure and the pharmacodynamics and pharmacokinetics of the commonest classes of drugs describes the equipment required to ensure safe and effective delivery of epidural solution to patients An overview of the nature and frequency of the observations required for close monitoring of patients and a practical guide to the removal of the catheter are also provided. Clinical governance and competency-based training are also addressed, and a framework provided to fit the training into the Agenda for Change Knowledge and Skills framework.

This book represents a unique and substantial guide, and will bring anesthesiologists up-to-date on advances in the neuraxial technique and its applications in obstetrics. Today the epidural block is almost exclusively of interest to obstetric anesthesiologists, and how it is taught increasingly coincides with its applications in obstetrics. Since the classical, seminal textbooks by Bonica, Moore and Bromage, published in the 1950s and 60s, textbooks devoted solely to the epidural technique have become quite rare. Among more recent books, there are many excellent texts on epidural anesthesia or analgesia in obstetrics, but none are fully dedicated to the epidural technique, which is usually described in a few paragraphs or, at most, in a chapter. This highly detailed book, including videoclip on epidural technique, offers comprehensive coverage on epidurals; as such, it will appeal to all anesthesiologists, especially obstetric anesthesiologists.

Epidural Anaesthesia: Images, Problems and Solutions brings together the most comprehensive collection of post-block epidurograms in the world into a single volume. With accompanying X-rays and contrast injection images, it clearly explains why an epidural block has failed and provides practical advice on how to avoid complications in the future. Key features: Contains over 180 clearly labelled X-rays and contrast injection images to help you learn using these examples Uses X-rays and contrast injection images rather than more complex imaging technologies, to allow quick assessment of blocks in the most basic radiology department Written by a world-renowned expert, providing consistency of style and approach throughout Companion website contains downloadable images as well as moving X-rays of contrast injection, 3D reconstructions and explanatory cartoons This unique book for specialist and trainee anaesthetists demonstrates, with simple X-rays and contrast injection, why epidurals are occasionally imperfect. Epidural Anaesthesia: Images, Problems and Solutions will enable you to refine your technique and avoid adverse outcomes in practice.

This book offers an in-depth examination of labor pain and analgesia with the aim of promoting natural childbirth without pain. All aspects of the subject are covered, including the latest techniques of delivering labor analgesia. Importantly, emphasis is placed on a holistic approach, detailed attention being paid to the humanization of childbirth and behavioral aspects in addition to evidence-based medicine. Potential future developments are also addressed, with discussion of opportunities that have yet to be realized. In order to ensure that the text is easily readable for trainees as well as established practitioners, chapters have been restricted to a manageable length and information is presented clearly and succinctly. Step-by-step tutorials and boxes highlighting practical points are used to clarify technical aspects. The authors include both well-established experts and young emerging professionals from various European countries, ensuring an intercultural perspective.

The single most comprehensive hands-on guide to the practice of Regional Anesthesia and Pain Management -- in full color! 4 STAR DOODY'S REVIEW! "This is an enormous book. It weighs in at just under eight and a half pounds with a list price that makes it comparable to an equal quantity of sushi grade tuna! It is a beautiful and powerful text/reference book. The composition corresponds particularly well with the subject. The wealth of detail, the high quality photos and drawings, the well composed text, and the engaging layout are enticing. Handling and reading such an exceptional book brings great pleasure. Forget the fish. Buy the book."--Doody's Review Service Here at last is a reference that covers the practice of Regional Anesthesia in its entirety, providing practitioners and students with both the physiologic principles and specific, state-of-the-art patient-management protocols and techniques. Recognized leaders in the specialty have filled this richly illustrated volume with authoritative, completely practical help. You'll find algorithms for managing or avoiding a wide range of common clinical dilemmas or complications. You'll get time-saving tools such as intravenous-to-oral opioid conversion tables and PCA setup guides as well as no-nonsense selection of nerve block techniques and advice on their strengths and pitfalls. This handy reference helps you make wise choices about anesthetics, dosing intervals, equipment, and perioperative management of patients receiving single-injection or continuous nerve blocks or spinal or epidural anesthesia. It tells you how to successfully manage patients with suspected epidural hematoma or neurologic injuries -- and much more. Filled with full-color, high-quality, detailed illustrations and clinical images of actual patients Covers the entire field of regional anesthesia, including nerve stimulator and ultrasound-guided peripheral nerve blocks, from imaging and instrumentation to step-by-step instructions for employing them in adults and children Details how to achieve reliable anesthesia and analgesia for surgical interventions on the face and upper and lower extremities Provides information on the advantages and disadvantages of using regional anesthesia in patients with coexisting diseases Offers guidance on acute pain management of adults and children in the perioperative period and in the ER Features up-to-date information on the etiology, prevention, and management of a wide range of complications