International journal of obstetric anesthesia
-
Int J Obstet Anesth · Feb 2018
Randomized Controlled TrialPreoperative anterior thigh temperature does not correlate with perioperative temporal hypothermia during cesarean delivery with spinal anesthesia: Secondary analysis of a randomized control trial.
Core-to-peripheral redistribution of heat, secondary to sympathetic-mediated vasodilation, is the major mechanism leading to early perioperative hypothermia after neuraxial anesthesia. The study aim was to determine if preoperative anterior thigh (peripheral lower extremity) temperature predicted perioperative temporal (core) temperature decrease during cesarean delivery with spinal anesthesia. ⋯ Preoperative anterior thigh temperature does not correlate with the degree of perioperative temporal temperature decrease, likelihood of developing hypothermia, shivering, or thermal comfort during cesarean delivery with spinal anesthesia. Although core-to-peripheral redistribution of heat after neuraxial anesthesia is a major mechanism of perioperative heat loss, a lower extremity temperature prediction hypothesis was not confirmed in this population.
-
Int J Obstet Anesth · Feb 2018
Review Case ReportsThe need for an epidural "window of opportunity" in pregnant women with a lumbar tattoo.
Pregnant women with lower back tattoos who wish to have an epidural placed during labour pose a dilemma to anesthesiologists. Clear guidelines have not been established. We reviewed the epidural risks in pregnant women with low back tattoos and have suggested precautionary measures to minimise them. Given the limited information available, and in the absence of a clear evidence-based medical contraindication, an epidural technique should not be excluded in those women with a lower back tattoo.
-
Int J Obstet Anesth · Feb 2018
Case ReportsAnesthetic considerations in a parturient with renal tubular acidosis and hypothyroidism undergoing cesarean delivery.
Renal tubular acidosis, associated with hypothyroidism, is rare. We present the case of a woman with known renal tubular acidosis and treated hypothyroidism who underwent emergency cesarean delivery under uneventful combined spinal-epidural anesthesia. The rationale for choosing the anesthetic technique and the potential risks associated with anesthesia and renal tubular acidosis are discussed.
-
Int J Obstet Anesth · Feb 2018
Case ReportsAplastic anemia in two consecutive pregnancies: obstetric and anesthetic management.
Aplastic anemia is a serious condition occasionally coexisting with pregnancy. This pathological process is associated with significant maternal and neonatal morbidity and mortality. Obstetric and anesthetic management are particularly challenging, and treatment requires knowledge of pathophysiologic mechanisms in order to provide safe care to this group of patients. We describe the successful obstetric management and labor analgesia of a patient with a diagnosis of aplastic anemia in two consecutive pregnancies.