International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 2007
Review Case ReportsAnaesthesia for caesarean section in a woman with lung cancer: case report and review.
A 33-year-old woman pregnant with twins was diagnosed with metastatic lung cancer during pregnancy. Her multidisciplinary care raised many medical and ethical issues. To help decide on the best anaesthetic technique for caesarean section, a literature search of published case reports of pregnancy associated with lung cancer was performed. ⋯ Anaesthetic technique was reported in only five of the 20 patients who underwent caesarean section: one spinal, three epidurals and one general anaesthetic. Of the 11 patients who delivered vaginally, only one was reported to have received epidural analgesia. As published data regarding anaesthesia and analgesia are limited for women with lung cancer in pregnancy, we describe our perioperative approach and review the potential challenging aspects of management in a pregnant patient with metastatic lung cancer.
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Int J Obstet Anesth · Jan 2007
Review Case ReportsUse of recombinant activated factor VII in massive obstetric haemorrhage.
Massive obstetric haemorrhage is a life-threatening emergency that remains a major cause of maternal mortality. Conventional management is aimed at optimising uterine tone, replacing circulating volume and blood products, and surgery to achieve haemostasis. ⋯ We report our experience of using it in the treatment of major post-partum haemorrhage in four previously healthy parturients. The published reports of recombinant activated factor VII use in post-partum haemorrhage (unrelated to pre-existing coagulopathies) are compared.
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Int J Obstet Anesth · Jul 2006
ReviewA survey of labor patient-controlled epidural anesthesia practice in California hospitals.
Patient-controlled epidural analgesia (PCEA) offers many advantages over continuous epidural infusions for labor analgesia including fewer physician interventions, improved analgesia and satisfaction, and reduced local anesthetic doses. However, anesthesiologists have been slow to adopt this technique, first described in 1988. No previous studies have evaluated specific labor patient-controlled epidural analgesia practices in the United States. The aim of this study was to determine labor epidural and patient-controlled epidural analgesia practices among California hospitals. ⋯ Despite the potential advantages of patient-controlled epidural analgesia over continuous epidural infusions for labor analgesia, patient-controlled epidural analgesia has not been widely adopted in California hospitals. Education regarding this technique is needed to encourage its increased use.
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Int J Obstet Anesth · Apr 2006
Review Case ReportsAnesthetic management for cesarean section in moyamoya disease: a report of five consecutive cases and a mini-review.
We report five consecutive cases of neuraxial anesthesia for cesarean section in women with moyamoya disease. Either epidural or combined spinal-epidural anesthesia was provided, with adequate sedation using intravenous diazepam and/or opioid(s). ⋯ The neonates were all in good health. The literature is reviewed on the anesthetic management for cesarean section in patients with moyamoya disease.
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Int J Obstet Anesth · Apr 2006
ReviewPractical management of the parturient with congenital heart disease.
Cardiac disease is becoming more common in women presenting for maternity care and is a major cause of maternal mortality in the UK. We present a review of the management of parturients with congenital heart disease, focusing on practical aspects and the problems that may be expected.