International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 1996
Randomized Controlled Trial Clinical TrialA comparison between epidural anaesthesia using alkalinized solution and spinal (combined spinal/epidural) anaesthesia for elective caesarean section.
In a double-blind investigation, 40 women undergoing elective lower segment caesarean section were randomly divided into two groups. Group I (n = 20) received spinal anaesthesia with 2.0 ml hyperbaric 0.5% bupivacaine using a single space combined spinal epidural technique. Group II (n = 20) received epidural anaesthesia with a local anaesthetic mixture consisting of 0.5% bupivacaine plain 10 ml and 2% lignocaine plain 10 ml to which was added 0.1 ml of adrenaline 1 in 1000 and 2 ml of 8.4% sodium bicarbonate. ⋯ There was no difference between the two groups in the quality of analgesia or the incidence of hypotension and nausea. The relatively rapid onset of the pH adjusted epidural solution may provide an attractive alternative to spinal anaesthesia. Moreover, this study underlines the important role of pH adjusted epidural solutions in parturients progressing to emergency caesarean section with epidural catheters previously inserted for labour analgesia.
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Int J Obstet Anesth · Oct 1996
A case of postoperative anxiety due to low dose droperidol used with patient-controlled analgesia.
A multiparous woman in good psychological health underwent urgent caesarean section in labour. Postoperatively, she was given a patient-controlled analgesia device delivering boluses of diamorphine 0.5 mg and droperidol 0.025 mg. ⋯ After she had received a total of only 0.9 mg droperidol, a syringe containing diamorphine only was substituted and her unease resolved completely. We feel that, although the dramatic extrapyramidal side effects of dopaminergic antiemetics are well known, more subtle manifestations may easily be overlooked.