International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 2010
Comparative StudyA comparison of a Neuropen monofilament and ethyl chloride for assessing loss of touch sensation during combined spinal-epidural anaesthesia for caesarean section.
Before caesarean section is performed under regional anaesthesia the block should be assessed, preferably using a touch stimulus. What constitutes a touch stimulus remains unclear. The aim of this study was to compare a Neuropen monofilament with ethyl chloride in the assessment of touch. ⋯ Data from this study suggest that a Neuropen monofilament and ethyl chloride are equivalent when used to assess a block to touch. However, subtle differences in the level of block to touch indicate that sensory level assessments should state the stimulus used. As the block to touch was below T5 at all time points, when opioids are added to local anaesthetics, T5 might no longer represent a necessary goal to ensure the absence of pain during caesarean section.
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Int J Obstet Anesth · Oct 2010
Randomized Controlled TrialThe effect of adding magnesium sulphate to epidural bupivacaine and fentanyl in elective caesarean section using combined spinal-epidural anaesthesia: a prospective double blind randomised study.
Combined spinal-epidural anaesthesia is commonly used for elective caesarean section. Intrathecal injection produces rapid onset with minimal doses of local anaesthetic and epidural administration can be used to prolong the block. Our study examined the effects of adding magnesium sulphate to epidural bupivacaine and fentanyl in patients undergoing elective caesarean section using combined spinal-epidural anaesthesia. ⋯ The addition of magnesium to epidural bupivacaine and fentanyl in women undergoing elective caesarean section with combined spinal-epidural anaesthesia improved intraoperative conditions and the quality of postoperative analgesia.
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Int J Obstet Anesth · Oct 2010
Case ReportsThe successful use of extra-corporeal membrane oxygenation in the management of a pregnant woman with severe H1N1 2009 influenza complicated by pneumonitis and adult respiratory distress syndrome.
We report a case of H1N1 2009 influenza A, in a previously fit woman at 24 weeks of gestation, who presented atypically with abdominal pain. The infection was complicated by severe respiratory failure and acute respiratory distress syndrome, requiring ventilatory support, including extra-corporeal membrane oxygenation (ECMO). This was one of the first cases of severe H1N1 disease presenting in the UK. Use of extra-corporeal membrane oxygenation for the complications of H1N1 resulted in full maternal recovery and subsequent delivery of a healthy infant.