International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 1998
Randomized Controlled Trial Clinical TrialVolume preload: lack of effect in the prevention of spinal-induced hypotension at caesarean section.
A randomized double-blind study of 40 women was performed to compare blood pressure changes between two groups of women following induction of spinal anaesthesia for elective caesarean section. One group received a 1 L Ringer's solution preload, administered over 10 min, before spinal anaesthesia while the other group received no preload. ⋯ There were no differences between the groups in terms of neonatal outcome as assessed by Apgar score, umbilical arterial and venous blood pH, and Neonatal Adaptive Capacity Scores. When ephedrine is infused prophylactically immediately following spinal anaesthesia for elective caesarean section, a 1000 ml crystalloid preload confers no advantages in terms of maternal blood pressure control or neonatal outcome.
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This is a retrospective record of the analgesic management during labour of 16 patients with spina bifida seen at Leicester Royal Infirmary Maternity Hospital between March 1994 and February 1996. The information highlights the potential difficulties in providing epidural analgesia for this patient group, and demonstrates how an antenatal pre-anaesthetic clinic can help to optimize pain management by providing the opportunity to formulate a realistic analgesic plan, which can be documented in the notes.
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Int J Obstet Anesth · Apr 1998
Continuous caudal analgesia in labour for a patient with Harrington rods.
We report the case of a 29-year-old patient who had Harrington rods inserted from T8 to L4 at the age of 14. She had been discouraged from having epidural anaesthesia in the antenatal clinic but, whilst in labour, requested analgesia in addition to Entonox and pethidine. Continuous caudal analgesia was commenced and provided good pain relief for labour and delivery.