International journal of obstetric anesthesia
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Int J Obstet Anesth · Jul 2005
Randomized Controlled Trial Clinical TrialA randomized comparison of a five-minute versus fifteen-minute lockout interval for PCEA during labor.
The best combination of bolus size and lockout interval for patient-controlled epidural analgesia (PCEA) is not known. This study compared a 5-min with a 15-min lockout interval. ⋯ The 5-min lockout interval appears the more efficient and has been used safely in our practice for 15,000 parturients, although a larger study is required to confirm the relative efficacy, efficiency and safety of this regimen.
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Int J Obstet Anesth · Apr 2005
Randomized Controlled Trial Comparative Study Clinical TrialComparison of continuous background infusion plus demand dose and demand-only parturient-controlled epidural analgesia (PCEA) using ropivacaine combined with sufentanil for labor and delivery.
Using ropivacaine combined with sufentanil, we determined the analgesic efficacy of parturient-controlled epidural analgesia (PCEA) with or without (demand-only PCEA) continuous background infusion in reducing labor pain in 66 parturients. ⋯ Under the conditions of the study, PCEA plus continuous background infusion was more effective than demand-only PCEA in treating labor pain without increasing consumption of anesthetic solution.
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Int J Obstet Anesth · Apr 2005
Randomized Controlled Trial Clinical TrialIntrathecal epinephrine in combined spinal-epidural analgesia for labor: dose-response relationship for epinephrine added to a local anesthetic-opioid combination.
The purpose was to investigate the dose-response relationship for intrathecally administered epinephrine added to a local anesthetic-opioid combination in combined spinal-epidural analgesia for labor, in order to evaluate analgesia and side-effects. ⋯ The results suggest that adding epinephrine to a combination of standard intrathecal doses of bupivacaine and fentanyl in combined spinal-epidural analgesia for labor significantly prolongs spinal analgesia. Of the four epinephrine doses tested, the lowest one (12.5 microg) was optimal for this clinical setting.
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Int J Obstet Anesth · Jan 2005
Randomized Controlled Trial Clinical TrialEffects of epidural naloxone on pruritus induced by epidural morphine: a randomized controlled trial.
Epidural morphine produces prolonged analgesia but has many side effects including pruritus. Naloxone is an antagonist that can reverse the side effects of morphine. ⋯ Continuous epidural infusion of naloxone combined with morphine is effective in reducing the incidence and severity of pruritus induced by epidural morphine.
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Int J Obstet Anesth · Jan 2005
Randomized Controlled Trial Clinical TrialHemodynamic effects of spinal anesthesia and simultaneous intravenous bolus of combined phenylephrine and ephedrine versus ephedrine for cesarean delivery.
Hypotension following spinal anesthesia for cesarean delivery can produce adverse maternal symptoms and neonatal acid-base effects. Single-agent prophylaxis, most notably with ephedrine, does not reliably prevent spinal anesthesia-induced hypotension; recently, however, the prophylactic use of phenylephrine with ephedrine as an infusion was observed to be effective. We postulated that this combination, when given as an intravenous bolus for prophylaxis and rescue treatment, could be similarly effective. ⋯ The combination of ephedrine and phenylephrine given as an intravenous bolus at the doses selected is not superior to ephedrine alone in preventing or treating hypotension in healthy parturients undergoing cesarean delivery.