In this retrospective cohort study of 147,895 singleton births, epidural anesthesia was used in 74.2% of cases and the hazard ratio for the subsequent diagnosis of autism spectrum disorders was 1.37 (95% confidence interval, 1.23-1.53).
In this prospective cohort study at one large academic medical center in Colorado, 31% of women who opted for nitrous oxide for analgesia during labor did not require any other source of analgesia, such as an epidural or intravenous opioids. Risk factors for conversion to other modalities included labor induction, oxytocin augmentation, and labor after cesarean.
Procedural sedation and analgesia (PSA) is performed in the emergency department (ED) to alleviate anxiety, decrease pain, and provide amnesia to patients undergoing painful procedures or diagnostic imaging.This article will review guidelines for performing PSA in the ED, including suggested training, preprocedural assessment, and intraprocedural monitoring.
As emergency physicians, we want to ensure our patients are not suffering severe pain. But, at the same time, we clearly need to reduce the use of opioids. Balancing these two priorities is difficult but important to our patients and society as a whole.