International journal of obstetric anesthesia
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Int J Obstet Anesth · Nov 2019
Need for additional anesthesia after single injection spinal analgesia for labor: a retrospective cohort study.
There is little information about the use and efficacy of single injection spinal blocks for labor analgesia; specifically, how frequently subsequent analgesia or anesthesia is needed. This study determined how frequently an additional anesthetic intervention was needed in women who received single injection spinal analgesia. ⋯ This retrospective review provides evidence that single injection spinal anesthesia may be used for multiparous women with spontaneous labor and more advanced cervical dilation.
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Int J Obstet Anesth · Nov 2019
Review Meta AnalysisInduction opioids for caesarean section under general anaesthesia: a systematic review and meta-analysis of randomised controlled trials.
Remifentanil and alfentanil effectively reduce the pressor response to intubation for general anaesthesia cesarean section, without depressing neonatal Apgar scores.
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Int J Obstet Anesth · Nov 2019
Review Meta AnalysisDifficult epidural placement in obese and non-obese pregnant women - A systematic review and meta-analysis.
Maternal obesity increases the risk of epidural failure (OR 1.8) and difficult insertion requiring multiple attempts (OR 2.2).
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Obstetric intensive care unit (ICU) admissions comprise only a small part of severe maternal morbidity. The incidence rate of both remains relatively unclear due to inconsistent definitions across publications, although this has begun to be addressed. There is a relative paucity of information regarding disease-specific survival following obstetric ICU admission, but outcomes are clearly related to the cause of admission and the quality of care. ⋯ Anesthesia complications remain a predominant cause of maternal death and likely intensive care admission. Data are lacking regarding the relative proportion of cases per disease that remain treated outside the ICU; and the outcomes of various management strategies. The only study of the health status of survivors of obstetric ICU admission revealed that six months after hospital discharge, one in five women still had a poorer health-related quality of life than those of a reference age- and sex-matched cohort.