International journal of obstetric anesthesia
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Int J Obstet Anesth · Jul 2010
Observational study of the effect of mu-opioid receptor genetic polymorphism on intrathecal opioid labor analgesia and post-cesarean delivery analgesia.
The purpose of this two-part prospective observational and blinded trial was to determine whether the single nucleotide polymorphism of the mu-opioid receptor gene (OPRM1:c.304A>G) modifies (1) the duration of intrathecal fentanyl labor analgesia and (2) supplemental analgesic requirements after intrathecal morphine analgesia following cesarean delivery. ⋯ Using the two outcome parameters duration of analgesia and treatment for breakthrough pain, we did not find a simple association between intrathecal opioid analgesia and OPRM1 304A/G polymorphism.
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Int J Obstet Anesth · Jul 2010
Randomized Controlled Trial Comparative StudyPerineal infiltration with lidocaine 1%, ropivacaine 0.75%, or placebo for episiotomy repair in parturients who received epidural labor analgesia: a double-blind randomized study.
Episiotomies are performed in approximately 20% of vaginal deliveries and may result in postpartum pain. Perineal infiltration with lidocaine during the episiotomy is widely used, despite an early study showing no difference when compared with saline. Ropivacaine has increasingly been used in the obstetric setting, although not for episiotomies. We sought to compare the analgesic efficacy of ropivacaine, lidocaine or saline for perineal infiltration before repair of a mediolateral episiotomy in patients who delivered with epidural labor analgesia. ⋯ For the first 24 h, perineal infiltration of ropivacaine, lidocaine, and saline were equivalent in producing post-episiotomy analgesia.
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Int J Obstet Anesth · Jul 2010
Randomized Controlled TrialSensory testing of spinal anaesthesia for caesarean section: differential block and variability.
The aim of this study was to determine if sensory block following spinal anaesthesia, measured with a range of devices, corresponded to the hierarchy of nerve fibre size in the area of differential block, and to compare the distribution and variability of recorded measurements. ⋯ Sensory fibre hierarchy could be identified. Tests for light touch showed the least variability. More expensive tests do not appear to have any advantage over the least expensive test, cotton wool.