International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 2010
Randomized Controlled Trial Comparative StudyMaternal and neonatal effects of bolus administration of ephedrine and phenylephrine during spinal anaesthesia for caesarean delivery: a randomised study.
Maternal haemodynamic changes and neonatal well-being following bolus administration of ephedrine and phenylephrine were compared in 60 term parturients undergoing elective caesarean delivery under spinal anaesthesia. ⋯ Phenylephrine 100 mug and ephedrine 6 mg had similar efficacy in the treatment of maternal hypotension during spinal anaesthesia for elective caesarean delivery. Neonates in group P had significantly higher umbilical arterial pH and base excess values than those in group E, which is consistent with other studies.
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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.
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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
Comparative StudyRetrospective study of association between choice of vasopressor given during spinal anaesthesia for high-risk caesarean delivery and fetal pH.
Phenylephrine given during spinal anaesthesia for low-risk caesarean section is associated with higher fetal pH than ephedrine. However, there is little evidence on the effects of ephedrine and phenylephrine in complicated pregnancies. The aim of this study was to compare umbilical artery pH with phenylephrine and ephedrine given during spinal anaesthesia where caesarean section was performed because of an increased risk of fetal compromise. ⋯ Umbilical artery pH was similar whether ephedrine or phenylephrine was used to maintain maternal arterial pressure, which contrasts with studies of low-risk caesarean section.
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Int J Obstet Anesth · Jan 2010
Prospective case control comparison of fetal intrapartum oxygen saturations during epidural analgesia.
The purpose of this study was to compare fetal oxygen saturation by fetal pulse oximetry in parturients with and without epidural labor analgesia in a prospective case control study. ⋯ Fetal oxygen saturation values are similar in the first and second stage of labor in the presence or absence of epidural labor analgesia.