International journal of obstetric anesthesia
-
Int J Obstet Anesth · Feb 2017
Randomized Controlled Trial Comparative StudyAn open-label randomized controlled clinical trial for comparison of continuous phenylephrine versus norepinephrine infusion in prevention of spinal hypotension during cesarean delivery.
During spinal anesthesia for cesarean delivery phenylephrine is the vasopressor of choice but can cause bradycardia. Norepinephrine has both β- and α-adrenergic activity suitable for maintaining blood pressure with less bradycardia. We hypothesized that norepinephrine would be superior to phenylephrine, requiring fewer rescue bolus interventions to maintain blood pressure. ⋯ Norepinephrine fixed-rate infusion has efficacy for preventing hypotension and can be considered as an alternative to phenylephrine.
-
Int J Obstet Anesth · Feb 2017
Observational StudyPersistent pain after caesarean section and its association with maternal anxiety and socioeconomic background.
Pain, both from the surgical site, and from other sources such as musculoskeletal backache, can persist after caesarean section. In this study of a predominantly socially deprived population we have sought to prospectively examine the association between antenatal maternal anxiety and socioeconomic background and the development of persistent pain of all sources after caesarean section. ⋯ Persistent pain from a variety of sources after caesarean section is common. Our findings do not support the use of antenatal anxiety scoring to predict persistent pain in this setting, but suggest that persistent pain is influenced by acute pain, postnatal depression and socioeconomic deprivation.
-
Int J Obstet Anesth · Feb 2017
Case ReportsOut-of-hospital cardiac arrest in pregnancy with good neurological outcome for mother and infant.
Cardiac arrest in pregnancy is rare (about 1:30000 pregnancies) and out-of-hospital cardiac arrests are even less frequent. Resuscitation of the pregnant mother is challenging and requires attention to the altered physiology, specific pathologies and the presence and well-being of the fetus. ⋯ We present a case of out-of-hospital maternal cardiac arrest with successful resuscitation and good neurological outcome for mother and infant. The principal emphases are on decision making, resuscitation and education.