International journal of obstetric anesthesia
-
Int J Obstet Anesth · Jan 2009
A survey of anesthesiologists' and nurses' attitudes toward the implementation of an Anesthesia Information Management System on a labor and delivery floor.
An anesthesia information management system (AIMS) is most frequently used in the operating room, but not on labor and delivery (L&D). The purpose of this study is to describe the implementation of an AIMS on L&D and the attitudes of practitioners (anesthesiologists and nurses) toward the system. ⋯ Overall, the anesthesiologists and nurses are satisfied with the L&D AIMS and would not want to switch back to a handwritten record. We conclude that AIMS should not be limited to the operating room setting and can successfully be used in L&D.
-
Int J Obstet Anesth · Jan 2009
Case ReportsAnaesthesia for caesarean section in a patient with dopa-responsive dystonia or Segawa's syndrome.
Dopa-responsive dystonia, also known as hereditary progressive dystonia with diurnal fluctuation or Segawa's syndrome, is a rare hereditary progressive dystonia with two striking clinical features: a marked diurnal fluctuation of symptoms with symptoms worsening throughout the day and improving after sleep, and a dramatic response to levodopa therapy. Whilst rare, it is treatable, with function being normal or near normal after levodopa therapy. We present our experience of providing anaesthesia for caesarean section in a patient with dopa-responsive dystonia and discuss the safety of levodopa therapy during pregnancy and the anaesthetic management of these patients.
-
Int J Obstet Anesth · Jan 2009
Randomized Controlled TrialA double-blind randomized controlled trial of patient-controlled epidural analgesia with or without a background infusion following initial spinal analgesia for labor pain.
Patient-controlled epidural analgesia (PCEA) combined with spinal analgesia is an option for pain relief in labor. However, the effect of a CBI on the analgesic requirements of laboring women is still debated. This double-blind study investigated the effect of CBI with PCEA following spinal analgesia on the local anesthetic requirements of parturients during labor. ⋯ In laboring nulliparous patients provided initial labor analgesia with spinal anesthesia, the use of a continuous background infusion decreases PCEA demand dosing, but not the total hourly amount of ropivacaine and fentanyl used.