International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 2010
Case ReportsParadoxical amniotic fluid embolism presenting before caesarean section in a woman with an atrial septal defect.
We present a case of presumed amniotic fluid embolism in a 33-year-old parturient at 30 weeks of gestation, which occurred just before she was due to receive spinal anaesthesia for urgent caesarean section. While sitting, the woman suddenly lost consciousness, started having convulsions and finally suffered cardiorespiratory collapse. She was resuscitated and a live baby was delivered by emergency caesarean section. ⋯ After extubation she was aphasic and had a right hemiparesis. She made a good recovery and was discharged from hospital 24 days later, at which time she had a slight weakness on her right side. Three months later she had a normal gait with no obvious neurological deficit.
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Int J Obstet Anesth · Jan 2010
Persistent pain after caesarean section and vaginal birth: a cohort study.
Although persistent pain has been described to occur after various types of surgery, little is known about this entity following caesarean section or vaginal birth. We sought to examine the association between mode of delivery and development of persistent pain, as well as the nature and intensity of the pain. ⋯ Persistent pain is more common one year after a caesarean section than after vaginal birth. A history of previous pain and pain on the day after delivery correlated with persistent pain.
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Int J Obstet Anesth · Jan 2010
Randomized Controlled Trial Comparative StudyA double blind comparison of the variability of block levels assessed using a hand help Neurotip or a Neuropen at elective caesarean section under spinal anaesthesia.
We previously noted that when two experienced anaesthetists assessed the level of spinal block to touch at caesarean section, one with a hand held device (Neurotip), and the other with a very similar spring loaded device (Neuropen), the median difference between the assessed levels of block was zero but there were some wide individual paired differences between the anaesthetists. We theorised that differences in the applied pressure of the stimulus may have contributed to this variation. We wished to investigate whether compared to the Neurotip, the Neuropen would reduce the variability of assessed block levels between anaesthetists of varying experience. ⋯ Compared to the Neurotip, the Neuropen did not result in a reduction of the variability in the differences in spinal block levels when assessed by 35 different pairs of anaesthetists.