International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 2011
Randomized Controlled Trial Comparative StudyA randomised comparison of intravenous remifentanil patient-controlled analgesia with epidural ropivacaine/sufentanil during labour.
The μ-opioid agonist remifentanil has a rapid onset and offset and a short half-life making it an attractive option for intravenous patient-controlled labour analgesia. We aimed to compare the efficacy of intravenous remifentanil patient-controlled analgesia with epidural ropivacaine/sufentanil during labour. ⋯ In the 20 patients recruited to this study, pain relief in labour with epidural ropivacaine/sufentanil was more effective than with intravenous remifentanil patient-controlled analgesia.
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The current article covers some of the major themes that emerged in 2009 in the fields of obstetric anesthesiology, obstetrics, and perinatology, with a special emphasis on the implications for the obstetric anesthesiologist.
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Int J Obstet Anesth · Apr 2011
ReviewTransthoracic echocardiography in obstetric anaesthesia and obstetric critical illness.
Transthoracic echocardiography (TTE) is a powerful non-invasive diagnostic, monitoring and measurement device in medicine. In addition to cardiologists, many other specialised groups, including emergency and critical care physicians and cardiac anaesthetists, have recognised its ability to provide high quality information and utilise TTE in the care of their patients. In obstetric anaesthesia and management of obstetric critical illness, the favourable characteristics of pregnant women facilitate TTE examination. ⋯ This article outlines the application of TTE in the specialty of obstetric anaesthesia and in the management of obstetric critical illness. It describes the importance of TTE education, quality assurance and outcome recording. It also discusses how barriers to the routine implementation of TTE in obstetric anaesthesia and management of obstetric critical illness can be overcome.
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Int J Obstet Anesth · Apr 2011
Case ReportsCaesarean section for twin pregnancy in a parturient with Brugada syndrome.
Brugada syndrome is a common cause of sudden cardiac death. We report the anaesthetic management of a woman with Brugada syndrome for elective caesarean section of twins. ⋯ The characteristic electrocardiographic changes of the syndrome are linked to sodium channel blockers including local anaesthetics such as bupivacaine. The use of bupivacaine for intrathecal central neuraxial blockade as well as other drugs commonly used in obstetric anaesthesia is discussed.
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Int J Obstet Anesth · Apr 2011
ReviewInterventions at caesarean section for reducing the risk of aspiration pneumonitis.
Various interventions are used as prophylaxis for aspiration pneumonitis in obstetric anaesthesia. This review, based on a Cochrane systematic review currently being updated, examines whether interventions given before caesarean section reduce the risk of aspiration pneumonitis. ⋯ The quality of evidence was weak and may not reflect a reduction in the risk of aspiration pneumonitis since none of the studies assessed substantive clinical outcomes or potential adverse effects. Further work is required to validate the suitability of surrogate markers of pH and gastric volume for clinical outcomes in the context of aspiration pneumonitis.