International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 2006
Randomized Controlled TrialA randomised trial comparing 5 mL/kg and 10 mL/kg of pentastarch as a volume preload before spinal anaesthesia for elective caesarean section.
Colloid solutions are more effective at preventing hypotension than crystalloids when used as a volume preload before caesarean delivery under spinal anaesthesia. The ideal volume to infuse has not been established. ⋯ Pentastarch, 10 mL/kg is more effective than 5 mL/kg at preventing hypotension following spinal anaesthesia for caesarean delivery.
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Int J Obstet Anesth · Oct 2006
Randomized Controlled TrialUltra-low dose combined spinal-epidural anesthesia with intrathecal bupivacaine 3.75 mg for cesarean delivery: a randomized controlled trial.
We wished to investigate the feasibility of an ultra low-dose combined spinal-epidural technique in providing surgical anesthesia for uncomplicated cesarean deliveries in a randomized, double-blind controlled trial. ⋯ We conclude that this technique results in a significantly lower incidence of maternal hypotension and has a role in high-risk parturients in whom maintenance of stable hemodynamics is imperative.
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Int J Obstet Anesth · Oct 2006
Case ReportsAnaesthetic management of labour and caesarean delivery of a patient with hyperkalaemic periodic paralysis.
We describe a parturient with hyperkalaemic periodic paralysis who presented for induction of labour and subsequently, caesarean section. Epidural analgesia and anaesthesia were used successfully in a multidisciplinary plan aimed at avoiding a peripartum attack and providing safe delivery. Management of this rare condition is discussed along with a review of the available literature.
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Limited information exists on obstetric anesthesia experience and training within residency training programs in the United States. ⋯ The average number of obstetric deliveries per year for institutions with a resident training program was 3498+/-2383. Dedicated obstetric anesthesia staffing was more common when >3700 deliveries/year were performed; the presence of this staffing corresponded with a reduction in the use of general anesthesia for cesarean deliveries. Few differences in the resident lecture didactic exposure were observed in terms of numbers of lectures and months on the obstetric anesthesia service, although a significantly greater number of clinical cases was available to each resident in those institutions with greater overall numbers of obstetric cases.
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Int J Obstet Anesth · Oct 2006
Case ReportsStatus epilepticus after electroconvulsive therapy in a pregnant patient.
Status epilepticus after electroconvulsive therapy is a rare complication, and its occurrence during pregnancy has not been reported previously. We discuss the case of a 31-year-old primigravida at 22 weeks of gestation, with a history of bipolar disorder, who underwent electroconvulsive therapy under general anesthesia. ⋯ As a consequence, the fetus died. We discuss the possible causes and the management of status epilepticus after electroconvulsive therapy during pregnancy and its implications for maternal and fetal outcome.