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 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Labour pain is very real to expectant mothers. Untreated it can give rise to hypocarbia, hypoxia and fetal acidosis. Pain relief during labour dates back to Queen Victoria who was given chloroform for the birth of Prince Leopold. Since then many techniques and drugs have been used. Epidural analgesia was introduced in 1942 and since then has been regarded as a very effective method for labour pain relief. This article deals with the technique of epidural catheter insertion as well as discussing some of the common complications that can occur and their management.
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PMID:Epidural analgesia for patients in labour. 239 6

The relationship between labor pain and concomitant psychological state, in terms of prenatal anxiety levels and post-partum mood, has been studied. A consecutive series of primiparae (n = 129) was assessed at intervals over the course of their pregnancy and after delivery. State anxiety was measured at recruitment (10-14 weeks of pregnancy), 10 weeks, 32 weeks and at labor. Labor pain was assessed on the McGill Pain Questionnaire (MPQ) and visual analog rating scales. Pain ratings on the MPQ were found to be high when compared to other clinical pain groups. Drug use in labor emerged as the strongest predictor of pain ratings on the MPQ total, sensory and affective scales, accounting for 11, 9 and 7% of the variance respectively. Anxiety scores at 32 weeks accounted for a further 5% of the variance and emerged as the best predictor of MPQ evaluative scores and visual analog ratings. A significant association was found between pain ratings and ratings of post-partum mood. Neither attendance at preparatory classes nor initial attitudes towards the neonate were related to pain scores.
Pain 1985 Jul
PMID:Psychosocial predictors of labor pain. 403 23

The McGill Pain Questionnaire (MPQ) was used to assess the nature and intensity of labour pain in 29 women. Subjects completed the MPQ during the first stage of labour, and again 24-48 hours post-natally, when they recalled the pain of the first and second stages of their childbirth. Labour pain was found, on average, to be severe. However, it varied greatly between subjects. In particular, one psychological factor--previous experience of pain--was found to be strongly associated with perceived levels of labour pain. Subjects who reported that they had previously experienced significant levels of pain unrelated to childbirth had low or moderate levels of labour pain. Subjects who reported little experience of pain unrelated to childbirth, had high levels of pain.
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PMID:A study of labour pain using the McGill Pain Questionnaire. 653 13

Episiotomy is one of the most commonly performed operative procedures and yet little information is available on the subjective reactions in the puerperium to this procedure. The present study was designed to furnish information on the attitudes of patients, levels of pain, and of course recovery by studying a consecutive series of 101 Caucasian primiparea who received episiotomies at delivery. Women were interviewed within 24 hours of delivery and then, at three months after delivery, completed a questionnaire. The high level of pain experienced was noteworthy. Labour pain and episiotomy pain were uncorrelated, indicating the importance of distinguishing between them. Several women were experiencing problems at the three-month follow-up, with some attributing these to the episiotomy repair. The data are presented in the framework of providing women in the postpartum period with systematic information on the nature of postepisiotomy pain and subsequent recovery to facilitate their adjustment.
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PMID:How women view postepisiotomy pain. 679 23

Labour pain was measured with the McGill Pain Questionnaire in 87 primiparas and 54 multiparas. The average intensity of labour pain ranked among the most intense pains recorded with the questionnaire. However, the pain scores had a wide range and were influenced by several medical and social variables. They were significantly higher for the primiparas than for the multiparas. Moreover, high pain levels were associated with a history of menstrual difficulties and lower socioeconomic status. The primiparas who had received prepared childbirth training had lower pain scores than those who had received no such training. Nevertheless, the effects of prepared childbirth training were relatively small, and most patients (81%) who received it requested epidural anesthesia. Because many women who received training suffered severe pain during labour, prepared childbirth training and epidural anesthesia should be regarded as compatible, complementary procedures.
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PMID:Labour is still painful after prepared childbirth training. 727 87

There was necessary to study that the magnetic application is effective to menstrual pain based on rogers theory about energy exchange. The purpose of this study was to examine the effectiveness of magnetic application in primary dysmenorrhea and so this study provide the basic information about nursing intervention of pain relief. The data was gathered from 23 student nurses at S University during the period of June 1. 1992 to October 5. 1992. This study was designed with control group pretest-posttest design to examine the effectiveness of magnetic application in primary dysmenorrhea. The subjects were experiencing self-reported dysmenorrhea above 5 scores measured by GRS during menstruation. The subjects were assigned randomly to one of two groups: 1) an experimental group (n = 11) that applied magnet (800-1299 gauss) or 2) a control group (n = 12) that applied nonmagnet. Both groups' pain level was assessed using the GRS (Graphic Rating Scale) which was developed by Scott and Huskisson (1976), and the ALPRSR (Adjective Labor Pain Rating Scale Rank) and ALPRSS (Adjective Labor Pain Rating Scale Score) which was developed by Park and Hur (1984). The pain level of experimental group was measured first 9 a.m. after beginning of dysmenorrhea, Md (3 hours after applied magnet) and 3 p.m. (3 hours after detached magnet). The pain level of control group was measured first 9 a.m. after beginning of dysmenorrhea, MD (3 hours after applied nonmagnet) and 3 p.m. (3 hours after detached nonmagnet). The both group applied magnet or nonmagnet on the suprapubic area, the bilateral lumbar 3 and above 4FB of the medial malleolus of tibial bilaterally. The research data was analyzed by SPSS/PC+. The results of this study were as follows: 1) 3 hours after applying magnet or nonmagnet (MD), The GRS mean rank was significant difference statistically (p = 0.0001). 2) 3 hours after applying magnet or nonmagnet (MD), the ALPRSR mean rank was significant difference statistically (p = 0.0106). 3) 3 hours after applying magnet or nonmagnet (MD), The ALPRSS mean rank was significant difference statistically (p = 0.0086). 4) 3 hours after detached magnet or nonmagnet (3 p.m.), the GRS mean rank was significant difference statistically (p = 0.0070). 5) 3 hours after detached magnet or nonmagnet (3 p.m.), the ALPRSR mean rank was significant difference statistically (p = 0.0317). 6) 3 hours after detached magnet or nonmagnet (3 p.m.), The ALPRSS mean rank was significant difference statistically (p = 0.0374).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The effect of magnetic application for primary dysmenorrhea]. 795 79

Labour pain is the result of many complex interactions. Although not fully determined, the pain arises from distension of the lower uterine segment and cervical dilatation. The neural mechanism of labour has some features similar to other forms of acute pain; nociceptive information is relayed in small A delta and C afferent fibres to the dorsal horn of the spinal cord, mediated by neurotransmitters; from there it may be involved in the initiation of segmental spinal reflexes or pass through the spinothalamic tract to the brain. Many factors are activated during labour which may modify the nociceptive impulse at different stages of its passage. Some of these factors act synergistically to promote anti-nociception that peaks at delivery.
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PMID:Physiology of pain in labour. 1002 25

The objective of this study was to measure the relationship between women's ratings of partners' participation during labour and maternal outcomes as measured by anxiety level, pain perception, dosage of pain-relieving drug used and length of labour. A convenience sample of 45 primigravid women was selected from the postpartum unit of a public hospital in Hong Kong. They were all first-time Chinese mothers, aged 18 or over, who had attended antenatal classes and had their partners present during labour. The State Scale of the State-Trait Anxiety Inventory was used to measure maternal anxiety during labour. Labour pain was measured by the Visual Analogue Scale. A series of scales were developed to measure partners' participation during labour. Women's ratings of partners' practical support were significantly lower than their ratings of partners' emotional support. There were no significant associations between level of emotional support and maternal outcome measures. However, perceived practical support was positively related to the dosage of pain-relieving drug used and total length of labour. Positive relationships between the duration of partners' presence and women's ratings of perceived support provided by partners during labour were also found.
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PMID:Relationships between partner's support during labour and maternal outcomes. 1111 18

We examined the relationship of labor pain relief medications with neonatal suckling and breastfeeding duration in 129 mothers delivering vaginally. Suckling was measured using the Infant Breastfeeding Assessment Tool (IBFAT). Controlling for infant age, birthweight, and gender, infants of unmedicated mothers had higher IBFAT suckling scores than those of medicated mothers (x = 11.1 vs. x = 8.2 respectively, P = .001). IBFAT suckling scores for intravenous and epidural groups were similar (x = 8.5) while those who received a combination of both intravenous and epidural medications were lower (x = 6.4 +/- 2.96, P = .001). Mothers evaluated their breastfeeding similarly to nurse evaluators (Z = 9.39, P = .001). Breastfeeding duration did not differ between unmedicated and medicated groups; however, dyads with low IBFAT scores weaned earlier than those with medium or high scores. Labor pain relief medications diminish early suckling but are not associated with duration of breastfeeding through 6 weeks postpartum.
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PMID:The effect of labor pain relief medication on neonatal suckling and breastfeeding duration. 1113 28

Epidural analgesia and intravenous analgesia with opioids are two techniques for providing pain relief for women in labour. Labour pain is comparable to surgical pain in its severity, and epidural analgesia provides better relief from this pain than intravenous analgesia; a meta-analysis quantified this improvement to be 40 mm on a 100mm pain scale during the first stage of labour. Epidural analgesia also has fewer adverse effects. However, providing epidural analgesia for labour pain costs more. The full cost of providing epidural analgesia can be divided into two components: a baseline-cost component, which captures the costs of hospital care to parturients receiving intravenous analgesia for labour pain; and an incremental-cost component, which estimates the costs arising from incremental care specific to epidural analgesia. The baseline component may be constructed using hospital cost-accounting data pertaining to actual obstetric patients. The incremental component is constructed from a set of recognised complications of epidural and intravenous analgesia, associated incidence rates and estimates of the costs involved, from society's perspective. The incremental expected cost per patient to society of providing epidural analgesia was calculated to be approximately $US338 (1998 values). This cost difference results primarily from increased professional costs (and is particularly sensitive to the method used to estimate the cost of anaesthesia professional services) and increased complication costs associated with epidural analgesia. A rational social policy for providing labour analgesia must weigh the value of improved pain relief from epidural analgesia against the increased cost of epidural analgesia.
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PMID:Economic considerations related to providing adequate pain relief for women in labour: comparison of epidural and intravenous analgesia. 1199 40


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