Yale Anesthesiology

In this episode, Dr. Lawrence Tsen discusses the findings of his paper on Labor Analgesia Initiation with Dural Puncture Epidural (DPE) Versus Conventional Epidural Techniques. The paper presents a randomized biased-coin sequential allocation trial to determine the effective dose for 90% of patients of Bupivacaine. We explore the benefits of using the DPE technique, if any, along with criticisms from some experts. Additionally, we delve into whether DPE techniques can improve analgesia and the mechanisms behind it. These are just a few of the topics covered in this podcast.

Labor Analgesia Initiation With Dural Puncture Epidural Versus Conventional Epidural Techniques: A Randomized Biased-Coin Sequential Allocation Trial to Determine the Effective Dose for 90% of Patients of Bupivacaine

https://pubmed.ncbi.nlm.nih.gov/37526934/

https://pubmed.ncbi.nlm.nih.gov/36030558/

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

Sacral sensory blockade from 27-gauge pencil-point dural puncture epidural analgesia or epidural analgesia in laboring nulliparous parturients: a randomized controlled trial

Determination of the Optimal Volume of Programmed Intermittent Epidural Bolus When Combined With the Dural Puncture Epidural Technique for Labor Analgesia: A Random-Allocation Graded Dose-Response Study

https://pubmed.ncbi.nlm.nih.gov/37010955/

https://pubmed.ncbi.nlm.nih.gov/35320341/

In this episode, Dr. Holly Ende discusses her article, Implementation of an Epidural Rounding Reminder in the Electronic Medical Record Improves Performance of Standardized Patient Assessments during Labor.

Implementation of an Epidural Rounding Reminder in the Electronic Medical Record Improves Performance of Standardized Patient Assessments during Labor

In this episode, Dr. Rachel Kearns discussed the findings from her study -Epidural analgesia during labour and severe maternal morbidity: population-based study. This study solidifies that anesthesiologists bring more to the table than “just” labor pain management.

Epidural analgesia during labour and severe maternal morbidity: population-based study.

In this episode, Dr. Vishal Uppal and Allana Munro discussed with us the findings from their study -The Incidence and Predictors of Failed Spinal Anesthesia After Intrathecal Injection of Local Anesthetic for Cesarean Delivery: A Single-Center, 9-Year Retrospective Review.

Anesthesia-Related Maternal Mortality in the United States: 1979–2002

Can epidurals as a quality marker

Use of Labor Neuraxial Analgesia for Vaginal Delivery and Severe Maternal Morbidity

Raising the Standards: RCOA Quality Improvement Compendium. Accessed March 1, 2023. https://rcoa.ac.uk/sites/default/files/documents/2020-08/21075%20RCoA%20Audit%20Recipe%20Book_16%20Section%20B.7_p241-268_AW.pdf

Mechanism and Management of Failed Spinal Anesthesia – NYSORA

In this episode, Dr. Allison Mootz, an obstetric anesthesiology fellow at Brigham and Women, discusses her thought-provoking article titled- The Accuracy of ChatGPT-Generated Responses in Answering Commonly Asked Patient Questions About Labor Epidurals: A Survey-Based Study.

In this episode, Dr. Ron George provides a tour de force of our past and present labor analgesia management. We discuss his recent publication, Modern Labor Epidural Analgesia: Implications for Labor Outcomes and Maternal-Fetal Health.

In this episode, Dr. David Bishop, a Specialist Anesthesiologist and Head of the Clinical Unit of Anaesthesia at Edendale Hospital in Pietermaritzburg talks about a vital topic and his recent publication, Tranexamic acid at cesarean delivery: drug-error deaths.

Tranexamic acid at cesarean delivery: drug-error deaths

https://pubmed.ncbi.nlm.nih.gov/36300729/

Spinal tranexamic acid – a new killer in town

https://pubmed.ncbi.nlm.nih.gov/30985919/

YouTube publication (Tranexamic acid during CS: Drug error warning (https://www.youtube.com/watch?v=jeFtFWeMwkw&t=184s)

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

https://pubmed.ncbi.nlm.nih.gov/28456509/

In this episode, Dr. Thomas Klumpner, whose research interests involve using technology to detect childbirth complications before they become life-threatening, discusses with us his research titled: Use of a Novel Electronic Maternal Surveillance System and the Maternal Early Warning Criteria to Detect Severe Postpartum Hemorrhage

Use of a Novel Electronic Maternal Surveillance System and the Maternal Early Warning Criteria to Detect Severe Postpartum Hemorrhage https://pubmed.ncbi.nlm.nih.gov/32022745/

Singh et al., A validation study of the CEMACH recommended modified early obstetric warning system (MEOWS) https://pubmed.ncbi.nlm.nih.gov/22066604/

Klumpner, T, stal. User Perceptions of an Electronic Maternal Alerting System. A A Pract. 2020;14(11):e01308 – https://pubmed.ncbi.nlm.nih.gov/32935951/

Use of a novel electronic maternal surveillance system to generate automated alerts on the labor and delivery unit https://pubmed.ncbi.nlm.nih.gov/29945569/

In this episode, Dr. Vishal Uppal, whose primary research interests are improving the safety and efficacy of regional anesthesia techniques in high-risk patient populations, discussed his article Consensus Practice Guidelines on Postdural Puncture Headache From a Multisociety, International Working Group: A Summary Report.

Consensus guidelines

In this episode, Dr. Tracey Vogel, an obstetric anesthesiologist who is very well-versed in a topic we should all know about, discusses trauma-informed care. What is trauma-informed care, and how can we become a trauma-informed care unit? These and many more questions are addressed during this Podcast. “A service that is not trauma-informed is trauma denied.”

Trauma-Informed Care on Labor and Delivery