Journal of perinatology : official journal of the California Perinatal Association
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Randomized Controlled Trial Comparative Study Clinical Trial
Double-blind, randomized comparison of the effect of carbetocin and oxytocin on intraoperative blood loss and uterine tone of patients undergoing cesarean section.
A double-blind randomized study involving pregnant women undergoing cesarean section was conducted to compare the effectiveness of a single 100 micrograms intravenous injection of the long-acting oxytocin analog, carbetocin, with that of a standard infusion of oxytocin with respect to intraoperative blood loss. The two treatments also were compared for safety and ability to maintain adequate uterine tone. ⋯ A single 100 micrograms intravenous injection of carbetocin is as effective and more reliable than a standard continuous infusion of oxytocin in maintaining adequate uterine tone and preventing excessive intraoperative blood loss during cesarean section after delivery of the placenta. Patients receiving carbetocin required less intervention. Carbetocin was well tolerated.
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Review Case Reports
Recurrent seizures in a neonate after lidocaine administration.
We report recurrent seizures in a neonate after intravenous lidocaine administration at the recommended dose for intubation and supplementation of general anesthesia. ⋯ We caution that lidocaine administration to newborn infants at previously accepted doses may result in life-threatening side effects, including prolonged seizures.
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To describe the timing of initiation of administration of parenteral antibiotics to infants with suspected sepsis at birth, identify barriers to prompt administration, and assess the effectiveness of subsequent interventions designed to minimize these barriers. The goals were to administer antibiotics within 1 hour of the physician order and within 2 hours of birth with more than 80% compliance for both goals. ⋯ Administration of the first dose of parenteral antibiotics to newborns with suspected sepsis at birth frequently takes more than 1 hour after the order is written and more than 2 hours after birth. Efforts to identify and minimize common barriers significantly improved the timing of antibiotic administration. Additional improvement was attained by means of continued surveillance and individual feedback to caregivers of infants when timing objectives were not fulfilled.