International journal of obstetric anesthesia
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Int J Obstet Anesth · Nov 2017
Observational StudyIntravenous dexmedetomidine for cesarean delivery and its concentration in colostrum.
Dexmedetomidine is a sedative agent with high α2-adrenoreceptor selectivity. We investigated intravenous dexmedetomidine administration during scheduled cesarean delivery under neuraxial anesthesia; and its concentration in the colostrum. ⋯ The dexmedetomidine milk-to-plasma ratio did not exceed 1 in any participant, and the relative infant dose was very low. Maternal sedation using dexmedetomidine is unlikely to be harmful for the infant.
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Int J Obstet Anesth · Nov 2017
A prospective study of post-cesarean delivery hypoxia after spinal anesthesia with intrathecal morphine 150μg.
Delayed respiratory depression is a feared complication of intrathecal morphine in patients undergoing cesarean delivery. The incidence, timing and risk factors for hypoxia in this population are not known. ⋯ Mild hypoxemia occurred frequently in women receiving intrathecal morphine 150μg for post-cesarean analgesia. Desaturations were observed most frequently 4-8hours after administration of intrathecal morphine. Obesity and a positive Berlin Questionnaire were risk factors for hypoxemic events.
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Each calendar year the Society for Obstetric Anesthesia and Perinatology invites an individual to conduct a review of the medical literature, identifying clinically relevant publications of interest to the obstetric anesthesia provider. This report of that effort covers the publications from 2015 and includes the categories of anesthesia and analgesia, complications of neuraxial procedures, and the effects of anesthesia on the fetus. Neuraxial procedures represent the foundation of obstetric anesthesia; advances in anesthesia and analgesia include novel modes of administration, and refinements in care of the medically complex patient. ⋯ Finally, there are potential effects of anesthesia on the fetal/neonatal brain, much of which remains poorly defined. An analysis of recent papers suggests that epidural fever is not an independent cause of adverse neurologic fetal injury. On the other hand, evidence continues to grow to support the hypothesis that anesthetic drugs impact neonatal neurologic outcome.