International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 1994
Combined spinal epidural (CSE) analgesia: technique, management, and outcome of 300 mothers.
Epidural analgesia in labour is commonly associated with some degree of lower limb weakness often severe enough to be described as paralysis by the mother. We aimed to produce rapid reliable analgesia with no motor block throughout labour. We report a pilot survey of 300 consecutive women requesting regional analgesia in labour who received a combined spinal epidural blockade (CSE). ⋯ Transient hypotension occurred in 24 women (8%) and was treated with 6 mg intravenous boluses of ephedrine. Complete satisfaction with analgesia and mobility was reported 12-24 h post partum by 95% of mothers. The use of this analgesic technique caused no alteration in obstetric management or post partum care of the women.
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Int J Obstet Anesth · Apr 1994
Continuous arteriovenous hemofiltration in the treatment of amniotic fluid embolism.
Continuous arteriovenous hemofiltration (CAVH) was successfully used in a 35-year-old woman, who had developed amniotic fluid embolism in the course of a premature labor and cesarean delivery. With CAVH, the pulmonary artery pressure decreased, the cardiac index rose, and the arterial oxygenation improved dramatically. This technique seems to be an important contribution to the management of amniotic fluid embolism.
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Continuous electrocardiographic monitoring was performed in 20 term parturients during labor, vaginal delivery, and recovery. Mean duration of monitoring was 13.37 h. ⋯ Eight patients exhibited premature ventricular contractions or supraventricular tachycardia. ST-segment depression was noted in 3 patients (15%); in all 3, this was concurrent with maximum heart rate, was not associated with any symptoms, and occurred in the post-partum period.
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Int J Obstet Anesth · Apr 1994
Awake fibre optic intubation in a 38-week pregnant patient with submandibular abscess.
A 38-week pregnant patient with trismus required surgery for drainage of a submandibular abscess. Her anaesthetic management involved an awake fibre optic intubation. We describe below the details of this and discuss the options for management of similar patients.
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Int J Obstet Anesth · Apr 1994
The morphine sparing effect of diclofenac sodium following caesarean section under spinal anaesthesia.
We have studied the morphine sparing effect of a single 100 mg diclofenac sodium suppository following elective caesarean section performed under spinal anaesthesia. Fifty patients randomly allocated into a placebo or an active group were compared. There was a statistically significant (P < 0.05) reduction in total morphine consumption and in consumption calculated as mg kg h(-1) in the diclofenac group, although pain scores were comparable in the two groups.