The effect of epidural analgesia on maternal-neonatal outcomes: a retrospective study

Objectives: Epidural analgesia is commonly used for relieving labor pain in contemporary clinical practice. The rate of pregnant women who request epidural analgesia during labor has been increasing annually, leading to a debate on the effect of epidural analgesia on maternal or neonatal outcomes.Material and methods: The medical records of nulliparous women with a term singleton pregnancy from January to December 2019 at the Affiliated Hospital of Zunyi Medical University were retrospectively reviewed. The women were divided into those who received epidural analgesia during delivery and those who did not receive it. Maternal and neonatal outcomes were assessed.Results: A total of 528 women met the inclusion criteria. The overall labor analgesia rate was 43.0% (227). Women with epidural analgesia had a significantly longer second stage [34.5 (22.8–65.3) vs 27.0 (18.0–41.3) min, p < 0.001] and total duration of labor [698.5 (493.5–875.0) vs 489.5 (344.0-676.3) min, p < 0.001] compared with those without epidural. There were no significant relationships between epidural analgesia and the normal vaginal delivery rate, the incidence of episiotomy, and other adverse maternal or neonatal outcomes (p > 0.05).Conclusions: Epidural analgesia can prolong the second stage of labor, but this is no increased risk for both mother and neonate

Copper-Catalyzed Cyanation of Aryl Iodides with Malononitrile: An Unusual Cyano Group Transfer Process from C(sp3) to C(sp2)

Natural Science Foundation of China [21072132]; Sichuan Provincial Foundation [08ZQ026-041]; Ministry of Education [NCET-10-0581]An unusual copper-catalyzed cyanation of aryl iodides to form aryl nitriles by cyano group transfer from C(sp3) to C(sp2) carbon atoms is reported and proceeds to give yields of up to 86%

Comparison of the Efficacy and Safety of Adamgammadex with Sugammadex for Reversal of Rocuronium-Induced Neuromuscular Block: Results of a Phase II Clinical Trial

This current phase II clinical trial was to compare the effect and safety of adamgammadex, a new cyclodextrin-based selective relaxant binding agent, with sugammadex to reverse rocuronium-induced neuromuscular block. Patients were randomised to receive adamgammadex (4 or 6 mg kg−1) or sugammadex (2 mg kg−1, as a positive control group) at the reappearance of the second twitch (T2) in response to TOF stimulation. The standard safety data were collected. The 4 mg kg−1 (n = 16) and 6 mg kg−1 (n = 20) adamgammadex- and 2 mg kg−1 (n = 20) sugammadex-induced recovery time of TOF ratio to 0.9 were 2.3, 1.6, and 1.5 min, respectively (p = 0.49). The 4 mg kg −1 adamgammadex-induced median recovery time was longer than that of 2 mg kg−1 sugammadex (p = 0.01), and there was no difference between the 6 mg kg −1 adamgammadex group and 2 mg kg−1 sugammadex group (p = 0.32). Then, the number of patients who experienced adverse events (AEs) was 6, 11, and 14 for adamgammadex at 4, 6 mg kg−1 and sugammadex at 2 mg kg−1, respectively. The treatment emergent AEs that occurred more than twice were detailed as follows: incision site pain, hypotension, emesis, fever, throat pain, blood bilirubin increase, abnormal T-wave of ECG, dizziness, incision site swelling, postoperative fever, expectoration, and nausea. For drug-related AEs, the increased urine acetone bodies and first-degree atrioventricular block were observed in two patients from sugammadex group. Then, the previously reported AEs were not observed in this study, including anaphylaxis, haemorrhage, recurarization, abnormal basic vital signs, or lengthened QRS intervals and QT intervals. Adamgammadex was found to be effective for reversal of rocuronium-induced neuromuscular block as sugammadex