International journal of obstetric anesthesia
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Int J Obstet Anesth · Jul 2007
Case ReportsIntracranial arachnoid cyst: anaesthetic management in pregnancy.
Arachnoid cysts may be intracranial or extracranial in the neuraxis and may present with headache and neurological signs or acutely with rupture and its complications. We report a case of spinal anaesthesia for elective caesarean section in a woman with an intracranial arachnoid cyst of the posterior fossa. We are unaware of any other such case reports published in the English language.
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Int J Obstet Anesth · Jul 2007
Case ReportsVentricular bigeminy during phenylephrine infusion used to maintain normotension during caesarean section under spinal anaesthesia.
A 31-year-old primiparous, healthy woman presented for emergency caesarean section. Following the siting of a spinal anaesthetic, seconds after starting a phenylephrine infusion, she developed ventricular bigeminy. ⋯ The possible proarrhythmic and antiarrhythmic effects of phenylephrine are discussed. We suggest that this was most probably a stretch-induced ventricular arrhythmia due to increased ventricular afterload.
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Int J Obstet Anesth · Jul 2007
Case ReportsRapid reversal of critical haemodynamic compromise with nitric oxide in a parturient with amniotic fluid embolism.
We describe a case of amniotic fluid embolism presenting as cardiovascular collapse during labour. After initial resuscitation and emergency caesarean section, the patient was transferred to the intensive care unit with profound hypoxaemia, a high inotropic drug requirement and severe coagulopathy. ⋯ The introduction of nitric oxide at 40 ppm produced a dramatic improvement in her cardiorespiratory status. Mother and baby both survived with no apparent long term sequelae.
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Int J Obstet Anesth · Jul 2007
Intravenous patient-controlled analgesia for labour: a survey of UK practice.
Although regional techniques offer superior analgesia during labour, many women receive other methods of pain relief. Furthermore, there is a specific need for analgesia in a small population of labouring women for whom regional techniques are contraindicated, unavailable or impossible to perform. We surveyed current UK practice of labour analgesia for such patients, with particular reference to the use of intravenous patient-controlled analgesia. ⋯ The survey demonstrated that, when regional techniques were contraindicated, patient-controlled intravenous opioid analgesia was employed in almost half of the units responding to the questionnaire.