International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 1997
Transient radicular irritation after hyperbaric lidocaine spinal anesthesia in parturients.
Two cases of transient radicular irritation in pregnant patients are presented. Both cases involve the combination of spinal anesthesia employing hyperbaric 5% lidocaine and a small gauge pencilpoint needle as well as the surgery being performed in the lithotomy position. We recommend that until the potential for lidocaine-induced neuroradicular irritation under these circumstances is evaluated prospectively, hyperbaric lidocaine should not be used for cases in which a small gauge spinal needle is employed and the patient is placed in the lithotomy position.
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Int J Obstet Anesth · Apr 1997
Prostaglandin-induced ventricular fibrillation during cesarean section.
A case report is presented of ventricular fibrillation after intramyometrial injection of 1 mg dinoprostone (PGE(2)) during cesarean section performed under general anesthesia. Anesthesiologists should be aware of the potential cardiovascular side-effects of prostaglandins used by the obstetrician.
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A 31-year-old woman gravida 4 para 2 who had received epidural analgesia during labour (duration of catheterization 6.5 h) was readmitted 8 days later with a complaint of flu-like symptoms, severe backache and numbness of her thighs. She had a sensory deficit from T4 to L1 and was unable to stand without support. The severe backache prevented adequate assessment of motor function. ⋯ Culture of the drained pus grew Streptococcus pneumoniae. She made a complete recovery and was discharged home on the tenth day. This case illustrates the problem of diagnosing serious postnatal problems that arise following the now fashionable early discharge from hospital.
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Int J Obstet Anesth · Apr 1997
Transient seizure: a subtle clue to diagnosis of subarachnoid haemorrhage.
A case is described of a 25-year-old primigravida who sustained a transient seizure following the administration of an epidural bolus of local anaesthetic. She had previously complained of a headache, and 3 days after caesarean section, died from subarachnoid haemorrhage. This case report highlights the difficulty in diagnosing subarachnoid haemorrhage in pregnancy and discusses the anaesthetic complications that may arise in the presence of an undiagnosed aneurysmal rupture. In this case the diagnosis was delayed due to absence of neurological signs, but the transient seizure may have been a clue to an earlier diagnosis.
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Int J Obstet Anesth · Apr 1997
Anaesthesia and the antiphospholipid syndrome: a review of 20 obstetric patients.
The case notes of 20 obstetric patients with antiphospholipid syndrome delivering over a 4-year period were reviewed retrospectively. There were complete details for 22 singleton pregnancies. Obstetric complications in the pregnancies under review were frequent. ⋯ The estimated blood loss at these deliveries did not exceed 600 ml. Eleven women (55%) had a previous history of thrombosis. Two women had thrombotic episodes during their pregnancies and three had them post partum despite antithrombotic measures.