International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 2011
Randomized Controlled Trial Comparative StudyA randomised comparison of intravenous remifentanil patient-controlled analgesia with epidural ropivacaine/sufentanil during labour.
The μ-opioid agonist remifentanil has a rapid onset and offset and a short half-life making it an attractive option for intravenous patient-controlled labour analgesia. We aimed to compare the efficacy of intravenous remifentanil patient-controlled analgesia with epidural ropivacaine/sufentanil during labour. ⋯ In the 20 patients recruited to this study, pain relief in labour with epidural ropivacaine/sufentanil was more effective than with intravenous remifentanil patient-controlled analgesia.
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Int J Obstet Anesth · Apr 2011
Randomized Controlled TrialA randomised, double-blinded, placebo-controlled study of acupressure wristbands for the prevention of nausea and vomiting during labour and delivery.
Approximately 50% of women experience nausea or vomiting during labour. P6 acupoint stimulation reduces postoperative nausea and vomiting in early pregnancy and after chemotherapy. The aim of this randomised, double-blinded, placebo-controlled trial was to determine whether P6 acupressure prevented nausea and vomiting during labour and delivery. ⋯ In this study acupressure wristbands applied bilaterally did not reduce the incidence of nausea and vomiting during labour and delivery.
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Int J Obstet Anesth · Jan 2011
Randomized Controlled Trial Comparative StudyLow-dose ketamine with multimodal postcesarean delivery analgesia: a randomized controlled trial.
Ketamine at subanesthetic doses has analgesic properties that have been shown to reduce postoperative pain and morphine consumption. We hypothesized that intravenous ketamine 10mg administered during spinal anesthesia for cesarean delivery, in addition to intrathecal morphine and intravenous ketorolac, would decrease the incidence of breakthrough pain and need for supplemental postoperative analgesia. ⋯ We found no additional postoperative analgesic benefit of low-dose ketamine during cesarean delivery in patients who received intrathecal morphine and intravenous ketorolac. Subjects who received ketamine reported lower pain scores 2weeks postpartum.
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Int J Obstet Anesth · Oct 2010
Randomized Controlled Trial Comparative StudyA randomized comparison of automated intermittent mandatory boluses with a basal infusion in combination with patient-controlled epidural analgesia for labor and delivery.
Automated mandatory boluses (AMB), when used in place of a continuous basal infusion, have been shown to reduce overall local anesthetic consumption without compromising analgesic efficacy in patient-controlled epidural analgesia (PCEA). We hypothesized that our PCEA+AMB regimen could result in a reduction of breakthrough pain requiring epidural supplementation in comparison with PCEA with a basal infusion (PCEA+BI). ⋯ PCEA+AMB, when compared to PCEA+BI, confers greater patient satisfaction and a longer duration of effective analgesia after CSE despite reduced analgesic consumption.