International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 2012
Randomized Controlled TrialContinuous wound infusion with ropivacaine fails to provide adequate analgesia after caesarean section.
Continuous wound infusion with local anaesthetic has been used in post-caesarean pain management with conflicting results. We carried out a study comparing three groups: continuous ropivacaine wound infusion, intrathecal morphine with saline wound infusion and saline wound infusion only. ⋯ Compared to saline control, continuous wound infusion with ropivacaine failed to reduce the use of intravenous oxycodone patient-controlled analgesia or pain scores. Intrathecal morphine decreased oxycodone consumption by 46% in the first 24 h after surgery when compared to continuous ropivacaine wound infusion.
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Int J Obstet Anesth · Apr 2012
Case ReportsTransversus abdominis plane catheters for post-cesarean delivery analgesia: a series of five cases.
We present five cases of women who received ultrasound-guided transversus abdominis plane catheters for post-cesarean delivery analgesia. Pain relief was maintained with repeated boluses of local anesthetic combined with oral acetaminophen and ibuprofen unless contraindicated. We conclude that repeated dosing through transversus abdominis plane catheters may be offered to women as an alternative or adjuvant to intrathecal morphine. Larger studies to evaluate the safety and further refinements of this novel procedure are warranted.
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Int J Obstet Anesth · Apr 2012
Pharmacokinetics of a loading dose of intravenous paracetamol post caesarean delivery.
The postpartum period affects drug disposition, but data of intravenous paracetamol loading dose pharmacokinetics immediately following caesarean delivery have not yet been reported. ⋯ Pharmacokinetics of intravenous paracetamol have been estimated following caesarean delivery. Although limited to a loading dose shortly after surgery, the results are clinically relevant since this is the first description in this patient population. These data provide evidence on which to base further integrated pharmacokinetic/pharmacodynamic studies in peripartum analgesia.