International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 2010
Randomized Controlled Trial Comparative StudyA randomised comparison of regular oral oxycodone and intrathecal morphine for post-caesarean analgesia.
Primary post-caesarean analgesia based on oral opioid has not been adequately studied. This approach may show a good side-effect profile and high satisfaction and avoid neuraxial complications. ⋯ Oral oxycodone produced comparable postoperative pain relief to intrathecal morphine with a lower incidence of pruritus, but was associated with a lower satisfaction score.
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Int J Obstet Anesth · Jan 2010
Randomized Controlled Trial Comparative StudyMaternal and neonatal effects of bolus administration of ephedrine and phenylephrine during spinal anaesthesia for caesarean delivery: a randomised study.
Maternal haemodynamic changes and neonatal well-being following bolus administration of ephedrine and phenylephrine were compared in 60 term parturients undergoing elective caesarean delivery under spinal anaesthesia. ⋯ Phenylephrine 100 mug and ephedrine 6 mg had similar efficacy in the treatment of maternal hypotension during spinal anaesthesia for elective caesarean delivery. Neonates in group P had significantly higher umbilical arterial pH and base excess values than those in group E, which is consistent with other studies.
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Int J Obstet Anesth · Jan 2010
Case ReportsAnesthetic management for resection of cor triatriatum during the second trimester of pregnancy.
Hemodynamic changes during pregnancy can result in cardiovascular decompensation in women with pre-existing cardiac diseases. Despite optimized medical treatment, some patients with severe structural cardiac abnormalities may need surgical intervention during pregnancy. We describe a woman who presented at 20 weeks of gestation with acute heart failure due to cor triatriatum, a rare form of congenital heart disease. ⋯ She underwent urgent corrective open heart surgery with cardiopulmonary bypass. Perioperative anesthetic management included prevention of tachycardia, atrial dysrhythmias and pulmonary hypertension, close monitoring for and prompt treatment of maternal hypotension, maintaining euvolemia and good cardiac contractility and avoiding hemodilution and hypothermia. These approaches, together with minimizing bypass time, resulted in successful maternal and fetal outcome.
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Int J Obstet Anesth · Jan 2010
Prospective case control comparison of fetal intrapartum oxygen saturations during epidural analgesia.
The purpose of this study was to compare fetal oxygen saturation by fetal pulse oximetry in parturients with and without epidural labor analgesia in a prospective case control study. ⋯ Fetal oxygen saturation values are similar in the first and second stage of labor in the presence or absence of epidural labor analgesia.
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Int J Obstet Anesth · Jan 2010
Case ReportsCaesarean section in a parturient with a spinal cord stimulator.
A 35-year-old G2P1 parturient at 32 weeks of gestation with an implanted spinal cord stimulator was admitted for urgent caesarean section. Spinal anaesthesia was performed below the spinal cord stimulator leads at the L4-5 level, and a healthy female infant was delivered. A basic description of the technology and resulting implications for the parturient are discussed.