International journal of obstetric anesthesia
-
Int J Obstet Anesth · Apr 1995
Levels of anaesthesia and intraoperative pain at caesarean section under regional block.
This prospective study recorded levels of analgesia (loss of sharp pin prick sensation) and anaesthesia (loss of touch sensation) in 220 women during caesarean section under regional anaesthesia (70 epidurals, 150 spinals). At delivery the difference between analgesia and anaesthesia varied from 0-7 segments for epidurals and 0-9 segments for spinals. ⋯ No patient with a level of anaesthesia which remained above T5 experienced pain. These results indicate that assessing the adequacy of block by sharp pin prick may be misleading and that in the absence of spinal or epidural narcotics a level of anaesthesia up to and including T5 is required to prevent pain during caesarean section.
-
Int J Obstet Anesth · Apr 1995
Epidural analgesia with 4 mg of morphine after caesarean section: modulating effect of epidural block compared to general anaesthesia.
Forty patients had epidural catheters placed for analgesia in active labour. For caesarean section patients in the epidural (EA) group (n = 20) had epidural anaesthesia with 0.5% bupivacaine supplemented if necessary with 2% lidocaine with adrenaline. Patients in the general anaesthesia (GA) group (n = 20) had standardized general anaesthesia for surgery. ⋯ Patients in the EA group consumed significantly less pain medication during the first 24 h after surgery (P = 0.0002). Itching was less frequent in the GA group (P = 0.011). It is concluded that epidural administration of 4 mg of morphine produces more effective postoperative pain relief when emergency caesarean section is conducted under epidural than when it is conducted under general anaesthesia.
-
Int J Obstet Anesth · Apr 1995
The elective use of oxytocin infusion during labour in nulliparous women using epidural analgesia: a randomised double-blind placebo-controlled trial.
The obstetric outcome following the elective use of oxytocin infusion was determined in a randomised, double-blind placebo-controlled trial. 93 nulliparous women in a London hospital, who had requested epidural analgesia in labour (
-
Int J Obstet Anesth · Apr 1995
Acute pulmonary edema in the post partum and cor triatriatum sinistrum.
A case is described of an apparently healthy young woman in her first pregnancy who presented with acute pulmonary edema in the early postpartum period in the context of mild pregnancy-induced hypertension. After quick improvement in her condition, a Doppler followed by a transesophageal study revealed a left atrial septation with a small atrial septal defect secundum type and moderate mitral regurgitation strongly suggestive of a cor triatriatum sinistrum.