2021
What’s New in Neuraxial Labor Analgesia
Toledano RD, Leffert L. What’s New in Neuraxial Labor Analgesia. Current Anesthesiology Reports 2021, 11: 340-347. PMID: 34466127, PMCID: PMC8390543, DOI: 10.1007/s40140-021-00453-6.Peer-Reviewed Original ResearchNeuraxial labor analgesiaEpidural drug deliveryLabor analgesiaObstetric patientsCesarean delivery anesthesiaNeuraxial analgesiaGeneral anesthesiaDelivery anesthesiaObstetric anesthesiaNeuraxial proceduresCOVID-19Spinal epidural hematoma formationSARS-CoV-2 infectionSerious adverse eventsEmergency cesarean deliveryCommon serious complicationEpidural labor analgesiaEpidural hematoma formationPain of childbirthAnalgesia techniquesEpidural blockadeAdverse eventsCesarean deliveryRisk/benefit decisionsAnesthetic management
2020
Pragmatic approach to neuraxial anesthesia in obstetric patients with disorders of the vertebral column, spinal cord and neuromuscular system
Walsh E, Zhang Y, Madden H, Lehrich J, Leffert L. Pragmatic approach to neuraxial anesthesia in obstetric patients with disorders of the vertebral column, spinal cord and neuromuscular system. Regional Anesthesia & Pain Medicine 2020, 46: 258-267. PMID: 33115718, DOI: 10.1136/rapm-2020-101792.Peer-Reviewed Original ResearchConceptsNeuraxial anesthesiaObstetric patientsSpinal cordCesarean delivery anesthesiaCesarean deliveryLabor analgesiaNeuraxial analgesiaVertebral columnCase seriesGeneral anesthesiaObstetrical patientsRetrospective studyDelivery anesthesiaPatient injuryAnesthesiaPatient harmPatientsNarrative reviewAvailable evidenceUnwarranted fearsNeuromuscular systemAdditional riskPresent unique challengesAnalgesiaCordStroke in Pregnancy: A Focused Update.
Miller EC, Leffert L. Stroke in Pregnancy: A Focused Update. Anesthesia & Analgesia 2020, 130: 1085-1096. PMID: 31124843, PMCID: PMC7035913, DOI: 10.1213/ane.0000000000004203.Peer-Reviewed Original ResearchConceptsHemorrhagic strokeCesarean deliveryPregnant womenIschemic strokeGeneral anesthesiaObstetric anesthesiologistHigh-risk obstetriciansLarge stroke trialsPregnancy-related strokeHigh-risk groupRisk of herniationMaternal strokeObstetric indicationsTherapeutic anticoagulationExtremity weaknessStroke neurologistsAcute strokeDevastating complicationNeuraxial analgesiaNonpregnant womenStroke subtypesIntracranial hypertensionRecent strokeVaginal deliveryStroke trials
2018
Anesthetic Treatment of Cardiac Disease During Pregnancy
Cohen KM, Minehart RD, Leffert LR. Anesthetic Treatment of Cardiac Disease During Pregnancy. Current Treatment Options In Cardiovascular Medicine 2018, 20: 66. PMID: 30019160, DOI: 10.1007/s11936-018-0657-4.Peer-Reviewed Original ResearchPhysiologic changesCardiac diseaseCardiac pathologyMaternal-fetal medicine specialistsNormal physiologic changesInterdisciplinary care teamFetal medicine specialistsHemodynamic goalsObstetric indicationsPregnant patientsCesarean deliveryNeuraxial analgesiaAnesthetic managementCoronary diseaseMedical therapyNeuraxial anesthesiaValvular diseaseAnesthetic approachVasoactive agentsPeripartum periodCare teamAnesthetic treatmentMaternal wellbeingMedicine specialistsCardiothoracic surgeonsThe Society for Obstetric Anesthesia and Perinatology Consensus Statement on the Anesthetic Management of Pregnant and Postpartum Women Receiving Thromboprophylaxis or Higher Dose Anticoagulants
Leffert L, Butwick A, Carvalho B, Arendt K, Bates SM, Friedman A, Horlocker T, Houle T, Landau R, Dubois H, Fernando R, Houle T, Kopp S, Montgomery D, Pellegrini J, Smiley R, Toledo P. The Society for Obstetric Anesthesia and Perinatology Consensus Statement on the Anesthetic Management of Pregnant and Postpartum Women Receiving Thromboprophylaxis or Higher Dose Anticoagulants. Anesthesia & Analgesia 2018, 126: 928-944. PMID: 29099429, DOI: 10.1213/ane.0000000000002530.Peer-Reviewed Original ResearchConceptsHigh-dose anticoagulantsConsensus statementMaternal deathsObstetric anesthesiaNeuraxial proceduresPerinatology Consensus StatementPharmacodynamics of anticoagulantsUse of thromboprophylaxisRisk-benefit discussionsKey preventive measuresObstetric populationObstetric surgeryCesarean deliveryNeuraxial analgesiaVenous thromboembolismAnesthetic managementObstetric patientsDifficult airwayNeuraxial anesthesiaGeneral anesthesiaPostpartum womenPregnant womenFetal harmPostpartum periodLeading cause