International journal of obstetric anesthesia
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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
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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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.
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The experiences of 890 parturients were studied across Finland during one week to determine how they experienced labour pain and how effective they regarded the means to alleviate it. The majority of women (72%) had been afraid of labour and 88% had intended to request some pharmacological pain relief. 84% of primiparous and 72% of multiparous rated their pain severe or unbearable. Epidural analgesia was found to be the most effective method in the first stage of labour, but in the second this superiority was no longer apparent. Unfortunately, it seems to be readily available only during office hours in spite of the fact that the majority of deliveries happen outside of that time.