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21 results on '"Kumaraswami, Sangeeta"'

3. Multimodal Acute Pain Management in the Parturient with Opioid Use Disorder: A Review

Author

Koltenyuk,Victor, Mrad,Ismat, Choe,Ian, Ayoub,Mohamad, Kumaraswami,Sangeeta, Xu,Jeff, Koltenyuk,Victor, Mrad,Ismat, Choe,Ian, Ayoub,Mohamad, Kumaraswami,Sangeeta, and Xu,Jeff

Abstract

Victor Koltenyuk,1 Ismat Mrad,2 Ian Choe,1 Mohamad Ibrahim Ayoub,3 Sangeeta Kumaraswami,4 Jeff L Xu4 1School of Medicine, New York Medical College, Valhalla, NY, USA; 2Anesthesiology and Perioperative Medicine, University of Rochester, Rochester, NY, USA; 3Department of Anesthesiology, New York University Grossman School of Medicine, New York, NY, USA; 4Department of Anesthesiology, Westchester Medical Center/New York Medical College, Valhalla, NY, USACorrespondence: Jeff L Xu, Department of Anesthesiology, Westchester Medical Center/New York Medical College, 100 Woods Road, Valhalla, NY, 10595, USA, Tel +1 914 493 7693, Fax +1 914 493 7927, Email jeff.xu@wmchealth.orgAbstract: The opioid epidemic in the United States has led to an increasing number of pregnant patients with opioid use disorder (OUD) presenting to obstetric units. Caring for this complex patient population requires an interdisciplinary approach involving obstetricians, anesthesiologists, addiction medicine physicians, psychiatrists, and social workers. The management of acute pain in the parturient with OUD can be challenging due to several factors, including respiratory depression, opioid tolerance, and opioid-induced hyperalgesia. Patients with a history of OUD can present in one of three categories: 1) those with untreated OUD; 2) those who are currently abstinent from opioids; 3) those being treated with medications to prevent withdrawal. A patient-centered, multimodal approach is essential for optimal peripartum pain relief and prevention of adverse maternal and neonatal outcomes. Medications for opioid use disorder (MOUD), previously referred to as medication-assisted therapy (MAT), include opioids like methadone, buprenorphine, and naltrexone. These are prescribed for pregnant patients with OUD, but appropriate dosing and administration of these medications are critical to avoid withdrawal in the mother. Non-opioid analgesics such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSA

Published
2024

12. Pushing the Envelope in Obstetric Care: A Case Report of Cesarean Delivery in a Parturient with a BMI >100 kg m−2

Author

Kumaraswami, Sangeeta, Futterman, Itamar, Pothula, Suryanarayana, Rajendran, Geetha P., and Kaul, Ashutosh

Subjects
Article Subject
Abstract

An increasing number of women with a body mass index (BMI) ≥ 60 kg m−2, referred to as super-super obesity, are requiring anesthetic care for labor and delivery. Management of these patients presents obstetric, anesthetic, and logistical challenges. We report our experience in the management of cesarean delivery in a parturient with a BMI of 112 kg m−2. Use of epidural anesthesia and performance of a supraumbilical transverse surgical incision with caudal placement of the panniculus resulted in optimal hemodynamic and ventilatory parameters. Effective multidisciplinary planning and communication is key. We present this case to highlight decision-making strategies and elucidate our approach in the management of this complex obstetric case.

Published
2020
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14. Management of a Parturient with Mast Cell Activation Syndrome: An Anesthesiologist’s Experience

Author

Kumaraswami, Sangeeta and Farkas, Gabriel

Subjects
Article Subject
Abstract

Mast cell activation syndrome (MCAS) is a disorder in which patients experience symptoms and signs attributable to inappropriate mast cell activation and mediator release. Multiorgan involvement in patients can result in significant morbidity and possible mortality. Limited literature exists regarding anesthetic management of patients with MCAS. We report a case of vaginal delivery with neuraxial labor analgesia in a parturient with this condition and highlight the importance of multidisciplinary planning for uneventful outcomes. Stress can trigger life-threatening symptoms, and counseling is important to allay patients’ fears. Optimum medical control, adequate premedication, avoidance of triggers, and preparedness to treat serious mediator effects are key. We review MCAS and discuss anesthetic considerations for patients with this mast cell disorder.

Published
2018
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16. Pushing the Envelope in Obstetric Care: A Case Report of Cesarean Delivery in a Parturient with a BMI >100 kg m−2.

Author

Kumaraswami, Sangeeta, Futterman, Itamar, Pothula, Suryanarayana, Rajendran, Geetha P., and Kaul, Ashutosh

Subjects
*CESAREAN section, *SURGICAL site, *BODY mass index, *HEMODYNAMICS, *EPIDURAL anesthesia
Abstract

An increasing number of women with a body mass index (BMI) ≥ 60 kg m−2, referred to as super-super obesity, are requiring anesthetic care for labor and delivery. Management of these patients presents obstetric, anesthetic, and logistical challenges. We report our experience in the management of cesarean delivery in a parturient with a BMI of 112 kg m−2. Use of epidural anesthesia and performance of a supraumbilical transverse surgical incision with caudal placement of the panniculus resulted in optimal hemodynamic and ventilatory parameters. Effective multidisciplinary planning and communication is key. We present this case to highlight decision-making strategies and elucidate our approach in the management of this complex obstetric case. [ABSTRACT FROM AUTHOR]

Published
2020
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17. Pushing the Envelope in Obstetric Care: A Case Report of Cesarean Delivery in a Parturient with a BMI >100 kg m−2.

Author

Kumaraswami, Sangeeta, Futterman, Itamar, Pothula, Suryanarayana, Rajendran, Geetha P., and Kaul, Ashutosh

Subjects
CESAREAN section, SURGICAL site, BODY mass index, HEMODYNAMICS, EPIDURAL anesthesia
Abstract

An increasing number of women with a body mass index (BMI) ≥ 60 kg m−2, referred to as super-super obesity, are requiring anesthetic care for labor and delivery. Management of these patients presents obstetric, anesthetic, and logistical challenges. We report our experience in the management of cesarean delivery in a parturient with a BMI of 112 kg m−2. Use of epidural anesthesia and performance of a supraumbilical transverse surgical incision with caudal placement of the panniculus resulted in optimal hemodynamic and ventilatory parameters. Effective multidisciplinary planning and communication is key. We present this case to highlight decision-making strategies and elucidate our approach in the management of this complex obstetric case. [ABSTRACT FROM AUTHOR]

Published
2020
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18. Pushing the Envelope in Obstetric Care: A Case Report of Cesarean Delivery in a Parturient with a BMI >100 kg m−2.

Author

Kumaraswami, Sangeeta, Futterman, Itamar, Pothula, Suryanarayana, Rajendran, Geetha P., and Kaul, Ashutosh

Subjects
*CESAREAN section, *SURGICAL site, *BODY mass index, *HEMODYNAMICS, *EPIDURAL anesthesia
Abstract

An increasing number of women with a body mass index (BMI) ≥ 60 kg m−2, referred to as super-super obesity, are requiring anesthetic care for labor and delivery. Management of these patients presents obstetric, anesthetic, and logistical challenges. We report our experience in the management of cesarean delivery in a parturient with a BMI of 112 kg m−2. Use of epidural anesthesia and performance of a supraumbilical transverse surgical incision with caudal placement of the panniculus resulted in optimal hemodynamic and ventilatory parameters. Effective multidisciplinary planning and communication is key. We present this case to highlight decision-making strategies and elucidate our approach in the management of this complex obstetric case. [ABSTRACT FROM AUTHOR]

Published
2020
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19. Pushing the Envelope in Obstetric Care: A Case Report of Cesarean Delivery in a Parturient with a BMI >100 kg m−2.

Author

Kumaraswami, Sangeeta, Futterman, Itamar, Pothula, Suryanarayana, Rajendran, Geetha P., and Kaul, Ashutosh

Subjects
CESAREAN section, SURGICAL site, BODY mass index, HEMODYNAMICS, EPIDURAL anesthesia
Abstract

An increasing number of women with a body mass index (BMI) ≥ 60 kg m−2, referred to as super-super obesity, are requiring anesthetic care for labor and delivery. Management of these patients presents obstetric, anesthetic, and logistical challenges. We report our experience in the management of cesarean delivery in a parturient with a BMI of 112 kg m−2. Use of epidural anesthesia and performance of a supraumbilical transverse surgical incision with caudal placement of the panniculus resulted in optimal hemodynamic and ventilatory parameters. Effective multidisciplinary planning and communication is key. We present this case to highlight decision-making strategies and elucidate our approach in the management of this complex obstetric case. [ABSTRACT FROM AUTHOR]

Published
2020
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21. Response of an Obstetric Unit during the Coronavirus Disease of 2019 (COVID-19) Pandemic: Experiences from a Tertiary Care Center.

Author

Kumaraswami S, Pradhan TS, Vrabie-Wolf S, Lodhi S, Rajendran GP, Tedjarati SS, and Grimes CL

Abstract

Objective  To describe our experiences in preparing our obstetric unit in Westchester County, New York, during the COVID-19 (coronavirus disease of 2019) pandemic. We focus on describing our timeline, continuously evolving actions, observations, and challenges. Methods  With guidance from the New York State Department of Health (NYSDOH), our institutional epidemiologist, and key multidisciplinary faculty members, we evaluated emerging national data as well as expert opinions to identify issues and challenges to create action plans. Results  We created and modified policies for our patients presenting for obstetrical care on the labor and delivery unit to accommodate their unique needs during this pandemic. Conclusion  The COVID-19 pandemic has posed many unique challenges. Balancing communication, risks of infection to providers, patient autonomy and rights, and resources for testing and personal protective equipment were among the valuable lessons learnt. We have shared our experiences and described our observations and challenges in Westchester County, New York., Competing Interests: Conflict of Interest None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Published
2020
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