International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 2007
An observational study of the relationship between lumbar epidural space depth and body mass index in Michigan parturients.
Studies of urban parturient populations demonstrate increasing prevalence of obesity, which contributes to difficult epidural catheter placement. The aim of this study was to characterize the relationship between lumbar epidural space depth and body mass index in United States parturients from Michigan. ⋯ When maternal age, gestational age and vertebral interspace are controlled for, increasing body mass index is associated with increasing depth, while increasing maternal age is associated with decreasing depth.
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Int J Obstet Anesth · Oct 2007
Clinical TrialDetermination of the ED95 for intrathecal plain bupivacaine combined with fentanyl in active labor.
Combined spinal-epidural (CSE) analgesia is an effective technique for pain control in labor and is particularly useful in the active phase. Excessive doses of intrathecal bupivacaine may be associated with adverse effects. This study is designed to estimate the ED95 for intrathecal plain bupivacaine with fentanyl 15 microg in labor. ⋯ This is the first dose-finding study specifically designed to estimate the ED95 of intrathecal bupivacaine combined with a fixed amount of fentanyl for analgesia in active labor. The combination of bupivacaine 1.75 mg with fentanyl 15 microg rapidly and reliably alleviated pain in the active phase of labor.
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Int J Obstet Anesth · Oct 2007
Survey of obstetric providers' views on the anesthetic risks of maternal obesity.
Maternal obesity is increasing in prevalence and associated with numerous complications. Surveys document that obstetricians recognize the obstetric and perinatal health risks of maternal obesity. To determine if they recognize the anesthetic risks and discuss them antenatally with obese patients, we surveyed all obstetric providers at a university-affiliated obstetric unit. ⋯ This preliminary study suggests that antenatal education about the anesthetic implications of obesity may not be part of routine prenatal care for obese pregnant women.
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Int J Obstet Anesth · Oct 2007
Case ReportsAnaesthesia for caesarean section in a patient with acute generalised pustular psoriasis.
We describe a 30-year-old parturient with acute generalised pustular psoriasis who presented for urgent caesarean section. A multidisciplinary team was involved and general anaesthesia was used successfully. ⋯ While generalised pustular psoriasis or impetigo herpetiformis is well recognised in pregnancy, it has not hitherto been reported in obstetric anaesthesia literature. The purpose of this article is to delineate the clinical picture of this disease, its treatment, and the effect on the mother and the fetus.