International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 2010
Randomized Controlled TrialUltrasound decreases the failed labor epidural rate in resident trainees.
Epidural analgesia is widely used for pain relief during labor. The purpose of this study was to determine if ultrasound measurement of the depth from skin to epidural space before the epidural technique decreases the failure rate of labor analgesia. A secondary objective was to correlate ultrasound depth to the epidural space with actual depth of the needle at placement. ⋯ Ultrasound measurement of the epidural space depth before epidural technique placement decreases the rate of epidural catheter replacements for failed labor analgesia, and reduces the number of epidural attempts when performed by first year residents and compared to attempts without ultrasound guidance.
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Int J Obstet Anesth · Oct 2010
Case ReportsNon-invasive mechanical ventilation with spinal anesthesia for cesarean delivery.
We present the successful use of perioperative non-invasive mechanical ventilation in a morbidly obese pregnant woman with bronchial asthma, severe preeclampsia and pulmonary edema undergoing an emergency cesarean delivery with spinal anesthesia. The combination of non-invasive mechanical ventilation with neuraxial anesthesia may be of value in selected parturients with acute or chronic respiratory insufficiency requiring surgery.
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Int J Obstet Anesth · Oct 2010
Randomized Controlled Trial Comparative StudyAddition of low-dose morphine to intrathecal bupivacaine/sufentanil labour analgesia: A randomised controlled study.
Single-shot spinal analgesia with bupivacaine and a short-acting opioid for labour pain is popular due to its simplicity, rapid onset, and profound analgesia without significant motor block. Its limitation is the short duration of action. Supplementation with intrathecal morphine has been shown to prolong analgesia. We compared the addition of placebo or morphine 50 or 100 μg to intrathecal bupivacaine and sufentanil to evaluate the impact on duration of labour analgesia. ⋯ The addition of 50 or 100 μg morphine to 1.25mg bupivacaine and 5 μg sufentanil during established labour did not significantly increase the duration of analgesia.
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Int J Obstet Anesth · Oct 2010
Obstetric anesthesia units in Israel: a national questionnaire-based survey.
This survey was performed to assess the organization and practice of obstetric anesthesia units in Israel. ⋯ In this national appraisal of Israeli obstetric anesthesia services, a notable lack of written protocols, wide variations in staffing, and few specifically trained obstetric anesthesia personnel were observed.
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Int J Obstet Anesth · Oct 2010
Anesthesiologists' practices for late termination of pregnancy: a French national survey.
Approximately 6600 cases of medical termination of pregnancy are performed in France annually, of which 78% are performed during the second or third trimester of pregnancy. There are few data and no recommendations regarding anesthesia and analgesia for these late terminations. The aims of this study were to determine the role of anesthesiologists and analgesia and anesthesia practices used for late terminations in France. ⋯ French anesthesiologists do not participate routinely in the decision and planning of all late terminations. Overall, very similar analgesic and anesthetic practices are observed in high- and low- volume centers, with epidural techniques being the most common.