International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 1996
Randomized Controlled Trial Clinical TrialKetorolac and spinal morphine for postcesarean analgesia.
This study was designed to compare spinal morphine (SM), ketorolac (K), and a combination of the two drugs with respect to analgesic efficacy and side effects in postcesarean patients. Forty-eight parturients having bupivacaine spinal anesthesia for cesarean delivery randomly received in a double-blind manner either: SM: 0.1 mg or SM: 0.2 mg (but no K); SM: 0.1 mg plus K 60 mg intravenously (i.v.) one hour after spinal injection, and 30 mg i.v. every 6 h for three doses or i.v. K dosed as previously described (but no SM). ⋯ Pruritus was common in all patients receiving SM whereas patients who received K had the lowest overall scores for severity of side effects. No serious complications occurred and all groups expressed similarly high satisfaction at the 24 h visit. We conclude that there is no advantage to combining SM and K, and that K provides satisfactory postcesarean analgesia with few side effects.
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Int J Obstet Anesth · Jan 1996
Unexpected postpartum seizures associated with post-dural puncture headache treated with caffeine.
This report describes a case of isolated postpartum seizures, in an apparently healthy woman who had suffered an accidental dural puncture during epidural analgesia for labour, and was on caffeine for relief of post-dural puncture headache. Investigation failed to determine the aetiology of the seizures. The possible contribution of dural puncture and caffeine toxicity are discussed.
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Int J Obstet Anesth · Jan 1996
Anaesthetic characteristics and long-term backache after obstetric epidural anaesthesia.
Anaesthetic casenotes of 4700 women who had epidural anaesthesia for deliveries between 1978-1985 were examined to look for associations between various epidural characteristics and subsequently reported long-term backache. The data on long-term backache came from a postal questionnaire sent to the women. ⋯ There were no relationships between long-term backache and the duration of the epidural or various indicators of the extent of motor or sensory block. Within the range of local anaesthetic concentration levels used in this series, the extent of block did not seem to affect backache, but the effect of minimal motor block with corresponding increased mobility, such as is available with low concentration anaesthetics mixed with opiates, merits further study.