International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 2008
Randomized Controlled Trial Comparative StudyA randomized comparison of levobupivacaine, bupivacaine and ropivacaine with fentanyl, for labor analgesia.
To compare the analgesic efficacy of epidural infusions of levobupivacaine, bupivacaine and ropivacaine in labor. ⋯ All three regimens were effective during first stage of labor although pain scores were higher in those receiving levobupivacaine. Motor block was greater with bupivacaine than with levobupivacaine.
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Int J Obstet Anesth · Apr 2008
Randomized Controlled Trial Comparative StudyThe incidence of maternal fever during labor is less with intermittent than with continuous epidural analgesia: a randomized controlled trial.
This prospective, randomized study was performed to see if intermittent labor epidural analgesia was protective against maternal intrapartum fever, compared to continuous epidural infusion. ⋯ Intermittent epidural injections appear to protect against intrapartum fever in the first 4 hours of labor analgesia, compared to continuous infusion. This may be due to intermittent partial recovery of heat loss mechanisms between injections. Neonatal sepsis evaluation rates were similar in the two groups.
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Int J Obstet Anesth · Apr 2008
Case ReportsAnaesthetic management of two different modes of delivery in patients with dystrophic epidermolysis bullosa.
Dystrophic epidermolysis bullosa is an inherited severe bullous condition characterised by extreme skin fragility and blistering in response to minor trauma. We present two obstetric cases with recessive dystrophic epidermolysis bullosa, one who underwent elective caesarean section, the other who delivered vaginally. The key points in the anaesthetic management of the obstetric patient with dystrophic epidermolysis bullosa include multidisciplinary preassessment, airway management strategies and the role of regional anaesthesia.
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Int J Obstet Anesth · Apr 2008
Case ReportsCare of a parturient with preeclampsia, morbid obesity, and Crouzon's syndrome.
We present the case of a 31-year-old woman with severe preeclampsia, morbid obesity, and a craniofacial syndrome who developed respiratory failure necessitating intubation and delivery by cesarean section. Her airway management was complicated by supraglottic edema and macroglossia. ⋯ After delivery of the infant, tracheostomy was performed to provide a secure airway until the supraglottic edema resolved over the subsequent two weeks. The airway implications of preeclampsia and Crouzon's syndrome are reviewed.
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Int J Obstet Anesth · Apr 2008
Case ReportsAnaesthetic management of a craniopagus conjoined twin delivery.
We report the successful caesarean delivery of craniopagus conjoined twins in a 21-year-old using a neuraxial technique. Early diagnosis at 19(+5) weeks of gestation enabled thorough multidisciplinary antepartum planning. The multidisciplinary approach aimed to reduce maternal and fetal morbidity. ⋯ At delivery there were 17 members of the multidisciplinary team present in the operating theatre. They were from five specialities from two separate hospitals. We discuss the anaesthetic considerations for the delivery of conjoined twins and the multidisciplinary approach used in this case.