International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 2008
Case Reports Multicenter StudyA prospective study of awareness and recall associated with general anaesthesia for caesarean section.
The obstetric population is considered at high risk of awareness and recall when undergoing general anaesthesia for caesarean section. In recent years the incidence may have been altered by developments in obstetric anaesthesia. ⋯ Awareness with recall of intraoperative events remains a significant complication of obstetric general anaesthesia but was potentially avoidable in all cases detected in this study.
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Int J Obstet Anesth · Oct 2008
Randomized Controlled Trial Comparative StudyImpact of the addition of sufentanil 5 microg or clonidine 75 microg on the minimum local analgesic concentration of ropivacaine for epidural analgesia in labour: a randomized comparison.
Addition of lipophilic opioids or alpha2-agonists to local anaesthetic solutions reduces local anaesthetic requirements and side effects. While the efficacy and side effects of these adjuvants are dose-related, information about their relative analgesic potencies is lacking, making it difficult to draw meaningful clinical conclusions. The aim of the present study was to assess the relative sparing of ropivacaine by clinically relevant doses of sufentanil and clonidine using the minimum local analgesic concentration (MLAC) model. ⋯ Sufentanil 5 microg and clonidine 75 microg produce similar reductions in the MLAC of ropivacaine. This finding will make feasible the assessment of the side effects of these adjuvants administered at equipotent doses in further studies.
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Int J Obstet Anesth · Oct 2008
Randomized Controlled TrialLow-dose ropivacaine-sufentanil spinal anaesthesia for caesarean delivery: a randomised trial.
It is well known that intrathecal opioids have a synergic effect with spinal local anaesthetics. The aim of this study was to evaluate whether low-dose ropivacaine in combination with sufentanil could produce effective spinal anaesthesia with less maternal hypotension and vomiting than ropivacaine alone. ⋯ The combination of hyperbaric ropivacaine 10 mg with sufentanil 5 lg produced effective spinal anaesthesia for caesarean delivery with significantly less hypotension, vomiting and shivering, shorter duration of motor blockade and longer lasting analgesia than hyperbaric ropivacaine 15 mg.
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Int J Obstet Anesth · Oct 2008
Case ReportsAnaesthesia for caesarean section in a patient with Ehlers-Danlos syndrome associated with postural orthostatic tachycardia syndrome.
We report the use of regional anaesthesia for elective caesarean section in a primigravida with hypermobility type Ehlers-Danlos syndrome (type III) associated with postural orthostatic tachycardia syndrome. Single-shot spinal anaesthesia was performed after failed epidural anaesthesia. This genotype, although generally associated with fewer antenatal and peripartum complications, is more likely than other types to display dysautonomia and orthostatic intolerance. This requires careful management for delivery.