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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Postpartum haemorrhage is an important cause of maternal morbidity and mortality. It is associated with haemostatic impairment which may exacerbate bleeding. ⋯ Fibrinogen level was the parameter that best correlated with increasing volume of haemorrhage and was the most useful marker of developing haemostatic impairment. Guidelines for fresh frozen plasma use in major postpartum haemorrhage were rarely followed and should be reviewed.
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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 · Apr 2011
Case ReportsCaesarean section for twin pregnancy in a parturient with Brugada syndrome.
Brugada syndrome is a common cause of sudden cardiac death. We report the anaesthetic management of a woman with Brugada syndrome for elective caesarean section of twins. ⋯ The characteristic electrocardiographic changes of the syndrome are linked to sodium channel blockers including local anaesthetics such as bupivacaine. The use of bupivacaine for intrathecal central neuraxial blockade as well as other drugs commonly used in obstetric anaesthesia is discussed.