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S K Weeks

Publications and source records attributed to S K Weeks.

At least 19 recordsLinked to original sources
PubMed1998

Epidural analgesia in early labour blocks the stress response but uterine contractions remain unchanged.

PURPOSE: To determine the effect of epidural analgesia on biochemical markers of stress, plasma oxytocin concentrations and frequency of uterine contractions during the first stage of labour. METHODS: Nine nulliparous women, in spontaneous labour, with a singleton fetus and cervical dilatation < or = 5 cm were enrolled. Epidural bupivacaine 0.25% (range 10-14 ml) was administered and bilateral sensory blockade to ice (T8-L4) achieved. Blood samples were collected before the epidermal block and every 10 min for one hour after the block was achieved for the measurement of plasma beta-endorphin, cortical, glucose, lactate and oxytocin concentrations. No exogenous oxytocin was given. Intensity of pain was assessed at the time of the blood sampling using a 10 cm visual analogue scale (VAS). The frequency of uterine contractions was recorded for 60 min before and after the epidural block. RESULTS: There was a decrease in plasma beta-endorphin and cortisol concentrations after epidural block (P < 0.01). There were no changes in plasma glucose and lactate concentrations. The mean VAS for pain decreased 10 min after epidural block was achieved and remained < 2 throughout the study period (P < 0.001). Mean plasma oxytocin concentrations did not change. The frequency of uterine contractions before and after the epidural block was similar. CONCLUSIONS: The metabolic stress response to the pain of labour was attenuated by epidural analgesia. In contrast, plasma oxytocin concentration and frequency of uterine contractions were unaffected by the attenuation of metabolic stress response.

Adult↗
PubMed1997

Is epidural anesthesia in labor associated with chronic low back pain? A prospective cohort study.

UNLABELLED: The association between epidural anesthesia during labor and subsequent postpartum low back pain remains unclear. The objective of this follow-up cohort study was to determine whether epidural anesthesia was associated with chronic back pain 1 yr after delivery. We contacted 329 women by telephone and asked them to complete a standardized questionnaire 1 yr (+/-1 mo) after delivery. One hundred sixty-four women had received epidural analgesia for labor and delivery, and 165 had not. Subjects were asked to quantify their back pain (yes/no, numeric rating score, and interference with daily activities). Differences between the two groups were tested by using the chi2 test and the Mann-Whitney U-test, and logistic regression was used to control for confounding variables. The response rate was 244 of 329 (74%). Responders and nonresponders were similar in their demographic and clinical characteristics. There was no difference in the prevalence of back pain between women who had received epidural anesthesia (12 of 121, 10%) and those who had not (17 of 123, 14%). The adjusted relative risk of low back pain at 1 yr (epidural versus nonepidural) was 0.63 (95% confidence interval 0.25, 1.56). There were also no differences between the two groups on numeric rating scores or level of interference with activities. This prospective follow-up study demonstrated no association between epidural anesthesia for labor and delivery and chronic back pain 1 yr after delivery. IMPLICATIONS: We evaluated the presence of low back pain 1 yr after delivery in two groups of women-those who chose epidural analgesia for labor and those who did not. There was no increased risk of back pain in women who had used epidural analgesia. This finding is consistent with those of other North American studies.

Adult↗
PubMed1994

Repeat epidural analgesia and unilateral block.

The use of epidural analgesia has become so widespread in recent years that many women are now requesting repeat epidural analgesia for their second or subsequent labour. This study examines the incidence of problems at insertion and of inadequate block in 71 multiparae having second epidurals compared with 150 primiparae having their first epidural. Unilateral block occurred in 6.66% of primiparae and 18.3% of multiparae (P < 0.02). There was no association between difficulty of insertion of catheter, blood in needle/catheter or paraesthesia and unilateral blockade. Epidurals were inserted at a greater dilatation (P < 0.05) and there was a shorter time to delivery (P < 0.01) in the multiparous group. We conclude that unilateral block is thus more common in women receiving repeat epidurals.

Adult↗
PubMed1992

Antepartum uterine relaxation with nitroglycerin at caesarean delivery.

In this case report, NTG provided sufficient uterine relaxation to allow difficult twin extraction at Caesarean delivery. Administration of NTG in this situation was controversial, and if it had not been effective, time may have been lost before general anaesthesia could have been induced. Nitroglycerin merits further evaluation as an antepartum uterine relaxant, but the initial experience is encouraging.

Adult↗
PubMed1992

Headache after spinal anesthesia for cesarean section: a comparison of the 27-gauge Quincke and 24-gauge Sprotte needles.

A high incidence of postdural puncture headache (PDPH) occurs after spinal anesthesia for cesarean section. To examine this problem, a study was conducted with the recently developed 24-gauge Sprotte and 27-gauge Quincke needles in patients undergoing elective and emergency cesarean section (n = 298). The needle to be used was assigned in a random manner: group I, 27-gauge Quincke (n = 147); group II, 24-gauge Sprotte (n = 151). During the postoperative period, patients were visited daily and asked specifically about the presence and severity of headache. The overall incidence of PDPH was 2% (n = 6), five in the Quincke group (3.5%) and one in the Sprotte group (0.7%). There was no significant difference in the incidence of PDPH between the two groups. Five headaches were classified as mild, and only one was moderate to severe. All headaches resolved quickly with conservative management and without blood patch. The authors conclude that the choice between a 27-gauge Quincke and a 24-gauge Sprotte needle does not influence the incidence of PDPH after spinal anesthesia for cesarean section.

Adult↗
PubMed1988

Intravenous meperidine for control of shivering during caesarean section under epidural anaesthesia.

To determine the efficacy of meperidine in controlling shivering during epidural anaesthesia for Caesarean section, forty-six parturients were studied. After delivery of the infant, shivering patients received either a single dose of intravenous meperidine 50 mg, or saline in a randomized double-blind fashion. Shivering was classified on a scale of 0 to 3 (grade 0 = none, grade 3 = severe shivering that was distressing to the patient and interfered with monitoring). Shivering and other variables were recorded at epidural placement, skin incision, delivery, and 2, 5, 15, 30 and 60 minutes following injection. Administration of meperidine resulted in a significant decrease in both the overall incidence of shivering (87 to 35 per cent, p less than 0.01) and severity of shivering (grade 3:57 to 0 per cent, p less than 0.01), compared with saline (incidence: 87 to 83 per cent, grade 3:57 per cent, no change). This effect was apparent within two minutes of drug injection and persisted throughout the study period. There were no differences in vital signs, oxygen saturation or temperature between groups. The incidence of nausea was similar, although patients receiving meperidine were more drowsy at two and five minutes following injection (p less than 0.01) compared with patients in the saline group. There were no differences in level of consciousness at the later intervals. The mechanism of action of meperidine on shivering remains to be elucidated.

Adult↗
PubMed1983

Neonatal pattern of breathing following cesarean section: epidural versus general anesthesia.

We tested the hypothesis that different anesthetic techniques for elective cesarean section would be reflected in the pattern of breathing and its control after birth. The pattern of breathing, including tidal volume, total breath duration (TTOT), minute ventilation, inspiratory (TI) and expiratory times, TI/TTOT ratio, and mouth occlusion pressure, was measured in 27 infants delivered by elective cesarean section during maternal epidural (lidocaine-carbon dioxide-epinephrine, n = 19) or general anesthesia (66% oxygen in N2O and 0.5% halothane, n = 8) at 10, 60, and 90 min and 3-5 days of age. Neonatal acid-base values and Apgar scores were within normal limits in both groups of infants. In general, at any given age the values of the respiratory parameters measured and their variability were similar between the two groups of infants. These findings indicate that the pattern of breathing after birth is not different following epidural or general anesthesia, and on the basis of our measurements, both epidural or general anesthesia appeared equally suitable for elective cesarean section.

Anesthesia, Epidural↗
PubMedDate not supplied

Concept analysis of family+health = a new definition of family health.

In this article, the authors explore references to family and health in the nursing literature and compare them with their own perceptions to propose a new definition of family health. Focusing on connectedness, energy, and hope for the future, this definition and its conceptual model can help nurses care for families in the rehabilitation setting.

Family Health↗
PubMedDate not supplied

What are the educational needs of prospective family caregivers of newly disabled adults?

What are the needs of family caregivers of newly disabled adults? Research to date has focused on the needs of family members of patients in critical care units and of family members who have been in the caregiver role at home for some time. No studies could be found on the perceptions of individuals facing the decision to assume the family caregiver role for a newly disabled adult anticipating discharge from a physical rehabilitation or medical-surgical nursing unit. Watson's philosophy of science and caring provided the theoretical basis for this study. The Elaine Matthis Educational Wants of Family Caregivers of Disabled Adults Questionnaire was used to assess the perceptions of prospective family caregivers visiting newly disabled adults in an urban medical center. The results of this research are offered to help nurses understand the feelings of uncertainty about the new and unexpected role that family caregivers face and to help nurses meet the needs of families preparing to take disabled adult relatives home.

Adult↗
PubMedDate not supplied

Save our skin (SOS).

Explore the source record for details and available documents.

Emblems and Insignia↗
PubMedDate not supplied

The FAMTOOL family health assessment tool.

The purpose of this study was to design and validate a family health assessment tool (FAMTOOL) based on a concept analysis of family and health. Preliminary testing of this instrument by a convenience sample of 80 adults resulted in an internal consistency coefficient of .90. A retest 2 weeks later produced a stability coefficient of .96. The FAMTOOL provides rehabilitation nurses with a quick, positive assessment instrument for helping patients and their family members assess their own family's health, compare responses with each other, and see strengths they might not have considered otherwise. As the family health system should be included in the initial assessment of everyone entering the healthcare system, the FAMTOOL may prove helpful to nurses in a wide variety of primary, secondary, and tertiary settings.

Adult↗