International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 1996
Transient radicular pain following spinal anesthesia: review of the literature and report of a case involving 2% lidocaine.
Recent reports of transient radicular irritation following intrathecal administration of 5% lidocaine in 7.5% dextrose, a common drug choice in many obstetric centers, have generated concern that its use for single injection spinal anesthesia can result in transient neurologic toxicity. Accordingly, many have advocated dilution of this anesthetic solution prior to subarachnoid administration. ⋯ The similarity of the present case to those previously reported implies a common etiology and suggests that risk is not restricted to the use of 5% lidocaine with 7.5% glucose. It underscores the need for carefully controlled prospective evaluation of the factors that affect transient neurologic dysfunction following spinal anesthesia.
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Int J Obstet Anesth · Jan 1996
Advance prediction of hypotension at cesarean delivery under spinal anesthesia.
Cardiovascular responses to supine inferior vena cava compression might predict hypotension risk during elective cesarean delivery using spinal anesthesia. In this pilot study we investigated 27 women before operation by taking blood pressure and heart rate measurements for 5 min in the left lateral position, 5 min supine, and then performed one further reading in the left lateral position and one sitting. Anesthesia with hyperbaric bupivacaine was rigorously standardised. ⋯ I. 48% to 98%). A positive test was associated with twice as much vasopressor use as a negative test (30.7 +/-/14.5 mg versus 13.5 +/-/ 9.9 mg; P = 0.0014). Unlike the SST, cardiovascular responses to the change from recumbent to sitting (tilt test) were not useful as a predictor of hypotension.