International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 2008
Randomized Controlled TrialA double-blind randomised controlled trial of paracetamol, diclofenac or the combination for pain relief after caesarean section.
Few studies have investigated efficacy and side effects of the combination of diclofenac and paracetamol used for pain relief after major surgery. ⋯ Patients given a combination of diclofenac and paracetamol used 38% less morphine compared to patients given paracetamol.
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The safety of cell salvage in obstetrics has been questioned because of the presumed risk of precipitating amniotic fluid embolism and, to a lesser extent, maternal alloimmunisation. For these reasons, experience in this field is limited and has lagged far behind that in other surgical specialties. There has, however, been renewed interest in its use over recent years, mainly as a result of problems associated with allogeneic blood transfusion. ⋯ Although large prospective trials of cell salvage with autotransfusion in obstetrics are lacking, to date, no single serious complication leading to poor maternal outcome has been directly attributed to its use. Cell salvage in obstetrics has been endorsed by several bodies based on current evidence. Current evidence supports the use of cell salvage in obstetrics, which is likely to become increasingly commonplace, but more data are required concerning its clinical use.
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Int J Obstet Anesth · Jan 2008
Randomized Controlled Trial Comparative StudyThe effect of anesthetic method for prophylactic cervical cerclage on plasma oxytocin: a randomized trial.
This study compared the changes in plasma oxytocin, intraoperative hemodynamics and postoperative uterine activity in patients who underwent elective Shirodkar cerclage for cervical incompetence with general or spinal anesthesia. ⋯ Anesthetic method used for elective Shirodkar procedure did not affect the perioperative changes in plasma oxytocin nor postoperative uterine activity.
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Int J Obstet Anesth · Jan 2008
Multicenter StudyPrescribing intramuscular opioids for labour analgesia in consultant-led maternity units: a survey of UK practice.
Intramuscular opioids are widely used for analgesia in labour. We conducted a postal survey to establish current prescribing and monitoring guidelines for intramuscular opioids in consultant-led obstetric units in the UK. ⋯ When compared with previous studies the use of intramuscular diamorphine is increasing in UK consultant-led obstetric units, although pethidine remains the widely used opioid. At present this change cannot be justified by a suitably powered, randomised study comparing intramuscular pethidine with diamorphine.