International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 2010
Clinical TrialFactors influencing cesarean delivery operative times: a prospective observational cohort study.
This study aimed to determine the distribution of operative delivery times for uncomplicated parturients undergoing elective cesarean delivery with neuraxial anesthesia. A secondary aim was to explore patient and surgical factors associated with longer cesarean delivery times. ⋯ These findings identify previous cesarean deliveries, increased scar intensity, tubal ligation and surgical experience as factors that increase operative times for cesarean delivery. The data also suggest that neuraxial anesthesia lasting 90 min should provide adequate analgesia for most uncomplicated parturients undergoing elective cesarean delivery.
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Int J Obstet Anesth · Oct 2010
Comment Letter Case ReportsSpinal anaesthesia for caesarean section for a woman with von Hippel Lindau disease.
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Int J Obstet Anesth · Oct 2010
Randomized Controlled TrialThe effect of adding magnesium sulphate to epidural bupivacaine and fentanyl in elective caesarean section using combined spinal-epidural anaesthesia: a prospective double blind randomised study.
Combined spinal-epidural anaesthesia is commonly used for elective caesarean section. Intrathecal injection produces rapid onset with minimal doses of local anaesthetic and epidural administration can be used to prolong the block. Our study examined the effects of adding magnesium sulphate to epidural bupivacaine and fentanyl in patients undergoing elective caesarean section using combined spinal-epidural anaesthesia. ⋯ The addition of magnesium to epidural bupivacaine and fentanyl in women undergoing elective caesarean section with combined spinal-epidural anaesthesia improved intraoperative conditions and the quality of postoperative analgesia.
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Int J Obstet Anesth · Oct 2010
Case ReportsThe successful use of extra-corporeal membrane oxygenation in the management of a pregnant woman with severe H1N1 2009 influenza complicated by pneumonitis and adult respiratory distress syndrome.
We report a case of H1N1 2009 influenza A, in a previously fit woman at 24 weeks of gestation, who presented atypically with abdominal pain. The infection was complicated by severe respiratory failure and acute respiratory distress syndrome, requiring ventilatory support, including extra-corporeal membrane oxygenation (ECMO). This was one of the first cases of severe H1N1 disease presenting in the UK. Use of extra-corporeal membrane oxygenation for the complications of H1N1 resulted in full maternal recovery and subsequent delivery of a healthy infant.
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Int J Obstet Anesth · Oct 2010
Clinical TrialSelf-reported post-discharge symptoms following obstetric neuraxial blockade.
Economic pressures are leading to earlier hospital discharge following delivery, before complications of obstetric neuraxial block may become apparent. Our aim was to estimate the incidence of symptoms presenting post-discharge at a single tertiary obstetric centre. ⋯ New post-discharge symptoms were self-reported by 1.4% of patients following neuraxial blockade. These were not detected during hospital stay despite routine directed post-block review. Only 4% of these symptoms could be directly attributable to neuraxial block.