International journal of obstetric anesthesia
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Int J Obstet Anesth · Jul 2007
Randomized Controlled Trial Retracted PublicationA randomized study of the effects of preoperative ketorolac on general anaesthesia for caesarean section.
Ketorolac may attenuate the maternal stress response to tracheal intubation, while avoiding opioid-induced neonatal depression. We aimed to evaluate the haemodynamic and hormonal effects of prophylactic ketorolac on surgical stress and analgesia after caesarean delivery. ⋯ Prophylactic ketorolac is safe and effective in attenuating the maternal stress response to intubation and improves the quality of analgesia after caesarean delivery.
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Int J Obstet Anesth · Apr 2007
Randomized Controlled Trial Comparative StudyPrevention of postoperative nausea and vomiting after intrathecal morphine for Cesarean section: a randomized comparison of dexamethasone, droperidol, and a combination.
Intrathecal morphine provides good analgesia after cesarean delivery but the side effects include nausea and vomiting. Low-dose droperidol (0.625 mg) combined with dexamethasone 4 mg is postulated to have an additive antiemetic effect with less side effects. We therefore compared single doses of dexamethasone and droperidol alone with a low-dose combination of the two, to prevent spinal morphine-induced nausea and vomiting after cesarean section. ⋯ An additive antiemetic effect and no significant side effects were shown for the combination of dexamethasone 4 mg and droperidol 0.625 mg. This combination was more effective than either dexamethasone 8 mg or droperidol 1.25 mg alone in preventing nausea and vomiting after spinal anesthesia using 0.5% bupivacaine and morphine 0.2 mg.
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Int J Obstet Anesth · Apr 2007
Randomized Controlled TrialLocal infiltration of epinephrine-containing lidocaine with bicarbonate reduces superficial bleeding and pain during labor epidural catheter insertion: a randomized trial.
Superficial bleeding after labor epidural catheter placement is a common phenomenon. In addition to delaying securing the epidural catheter, it may loosen the adhesive catheter dressing. The primary aim of this study was to determine whether skin infiltration with epinephrine-containing rather than plain lidocaine reduces superficial bleeding after catheter placement. Secondary objectives were to determine whether adding epinephrine and/or sodium bicarbonate affected infiltration pain. ⋯ Local infiltration of epinephrine-containing lidocaine before epidural catheter insertion reduces superficial bleeding and the addition of bicarbonate decreases pain during skin infiltration.
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Int J Obstet Anesth · Apr 2007
Randomized Controlled Trial Comparative StudyInfluence of uterine exteriorization versus in situ repair on post-Cesarean maternal pain: a randomized trial.
This study was done to compare post-cesarean delivery pain associated with routine exteriorization of the uterus versus in situ uterine repair in the puerperium. ⋯ Exteriorization of the uterus for repair of the uterine incision increases the first- and second-night postoperative pain significantly in women undergoing cesarean section.
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Int J Obstet Anesth · Apr 2007
Randomized Controlled TrialPrediction of hypotension during spinal anesthesia for Cesarean section and its relation to the effect of crystalloid or colloid preload.
If parturients prone to develop caval compression in the supine position were identified before delivery, this might be a method of predicting hypotension during caesarean section under spinal anesthesia. Colloid preloading is superior to crystalloid in reducing the risk for spinal anesthetic-induced hypotension. It is postulated that parturients preoperatively susceptible to the supine position would benefit the most from colloid preloading. ⋯ Pregnant women with a positive preoperative supine stress test constitute a subset at increased risk for clinically significant hypotension during cesarean delivery under spinal anesthesia. These women seem more likely to benefit from prophylactic colloid solution than women with a negative stress test.