International journal of obstetric anesthesia
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Int J Obstet Anesth · Aug 2018
ReviewHorner's syndrome following obstetric neuraxial blockade - a systematic review of the literature.
Horner's syndrome is a rarely reported complication of neuraxial blockade. In obstetric practice, the neurological signs of Horner's syndrome may cause anxiety amongst patients and healthcare staff, but more importantly may herald the onset of maternal hypotension. Medline, CINAHL, and EMBASE databases were searched to identify cases of Horner's syndrome following obstetric neuraxial blockade. ⋯ Patients with a persistent Horner's syndrome, or one associated with atypical features such as neck pain, should undergo a diagnostic workup including magnetic resonance angiography of the neck. The dermatomal level of neuraxial blockade, maternal and fetal well-being should be taken into account when making decisions regarding neuraxial blockade. The presence of Horner's syndrome alone should not lead to discontinuation of neuraxial blockade.
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Int J Obstet Anesth · Aug 2018
Randomized Controlled TrialThe effect of a single intraoperative dose of intravenous dexamethasone 8 mg on post-cesarean delivery analgesia: a randomized controlled trial.
A single perioperative dose of dexamethasone has been shown to improve postoperative analgesia and reduce opioid consumption. However, this analgesic and opioid sparing effect has not been well assessed as part of a multimodal analgesic regimen in women post-cesarean delivery. ⋯ The addition of intravenous dexamethasone 8 mg to a multimodal postoperative analgesic regimen that included intrathecal morphine, in women who had a cesarean delivery under spinal anesthesia, did not reduce 24 hour postoperative opioid consumption.
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Int J Obstet Anesth · Aug 2018
Randomized Controlled TrialPruritus after intrathecal morphine for cesarean delivery: incidence, severity and its relation to serum serotonin level.
Pruritus is the most common side effect of intrathecal morphine, especially in parturients. The exact mechanism is not clear and many possible mechanisms have been suggested. Among these is the activation of the 5-hydroxytryptamine sub-type-3 receptors by intrathecal morphine. ⋯ The serum serotonin level increased significantly in the postoperative period in both groups, suggesting a role of serotonin in the genesis of intrathecal morphine-induced pruritus.