International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 2006
Review Case ReportsDoes postdural puncture headache left untreated lead to subdural hematoma? Case report and review of the literature.
The patient was a 39-year-old pregnant woman who was scheduled for cesarean section. Spinal anesthesia was induced using a 26-gauge needle with an atraumatic bevel. Postoperatively, the patient developed cranial subdural hematoma manifesting as severe non-postural headache, associated with right eye tearing, fifth cranial nerve palsy and left hemiparesis. ⋯ Our report reviews the literature on 46 patients who developed a postdural puncture headache complicated by subdural hematoma following spinal or epidural anesthesia. It is possible that postdural puncture headache left untreated may be complicated by the development of subdural hematoma. Patients developing a postdural puncture headache unrelieved by conservative measures, as well as the change from postural to non-postural, require careful follow-up for early diagnosis and management of possible subdural hematoma.
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Int J Obstet Anesth · Jan 2006
Preoperative anxiety and postoperative satisfaction in women undergoing elective caesarean section.
The primary aim was to investigate whether preoperative anxiety in women undergoing elective caesarean section predicts postoperative maternal satisfaction with the process, perceptions of recovery, analgesic use or length of hospital stay. Other factors that might influence postoperative satisfaction were also explored. ⋯ Lower preoperative anxiety is associated with greater maternal satisfaction with elective caesarean section and better recovery. Information provided by anaesthetists and perceived emotional support are also of importance. It may be possible to identify women with high anxiety and facilitate satisfaction and recovery through providing additional supportive input.
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Int J Obstet Anesth · Jan 2006
Case ReportsA case of unilateral Horner's syndrome after combined spinal epidural anesthesia with ropivacaine 10mg/mL for cesarean section.
We report a case of transient unilateral Horner's syndrome during the setting of combined spinal epidural anesthesia for elective cesarean section using ropivacaine 10mg/mL. The pathophysiology of Horner's syndrome and the possible mechanisms in relation to combined spinal epidural anesthesia are also presented.