International journal of obstetric anesthesia
-
Int J Obstet Anesth · Aug 2016
Meta Analysis Comparative StudyDuration of motor block with intrathecal ropivacaine versus bupivacaine for caesarean section: a meta-analysis.
When used for Caesarean section, intrathecal ropivacaine results in faster recovery of motor block but no difference in onset, sensory duration or GA conversion when compared to bupivacaine.
pearl -
Int J Obstet Anesth · Aug 2016
ReviewThe value of decision tree analysis in planning anaesthetic care in obstetrics.
The use of decision tree analysis is discussed in the context of the anaesthetic and obstetric management of a young pregnant woman with joint hypermobility syndrome with a history of insensitivity to local anaesthesia and a previous difficult intubation due to a tongue tumour. The multidisciplinary clinical decision process resulted in the woman being delivered without complication by elective caesarean section under general anaesthesia after an awake fibreoptic intubation. The decision process used is reviewed and compared retrospectively to a decision tree analytical approach. The benefits and limitations of using decision tree analysis are reviewed and its application in obstetric anaesthesia is discussed.
-
Int J Obstet Anesth · Aug 2016
Case ReportsAnesthetic management of a parturient with Stiff person syndrome for urgent cesarean delivery.
Stiff person syndrome is a rare neurologic disorder with an estimated incidence of 1:1000000. The underlying pathophysiology is truncal and proximal limb muscle stiffness resulting from continuous co-contracture of agonist and antagonist muscle groups concomitant with superimposed episodic muscle spasms. ⋯ To date, only three case reports referred indirectly to the anesthetic management of parturients with Stiff person syndrome. The authors describe their management of a parturient with Stiff person syndrome who underwent urgent cesarean delivery under epidural anesthesia.