International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 1995
Comparison of fentanyl with clonidine as adjuvants for epidural analgesia with 0.125% bupivacaine in the first stage of labor: a preliminary report.
48 primiparae received epidural analgesia in labor with 10 ml of 0.125% bupivacaine with epinephrine 1:800 000, and then were divided in 4 equal groups (n = 12) to receive one of the following: 5 ml saline (B); 100 mug of fentanyl (BF); 150 microg of clonidine (BC); 75 microg of clonidine and 50 microg of fentanyl (BCF). All the patients had satisfactory analgesia. Onset was similar in the 4 groups but the duration of analgesia was significantly prolonged by the addition of either 100 microg of fentanyl or 150 microg of clonidine (respectively 89.8 min and 92.5 min vs 62.5 min) (P < 0.0001). ⋯ Only patients receiving fentanyl had pruritus. Both fentanyl and clonidine produced sedation, but both incidence and severity were greater with the mixture. No differences in neonatal outcome assessed by Apgar scores and NACS, were observed.
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Int J Obstet Anesth · Jan 1995
Risk information supplied by obstetric anaesthetists in Britain and Ireland to mothers awaiting elective caesarean section.
Mothers presenting for elective caesarean section may be offered the choice of regional or general anaesthesia. Their decision requires sensible information on the risks and benefits of each technique. In order to determine the level of consensus that exists among doctors in Britain and Ireland concerning the options offered and risk information provided for such patients, a questionnaire comprising a fictitious case history and a list of sample statements was mailed to 613 members of the Obstetric Anaesthetists' Association. 523 (85.3%) replied of whom 63% would advise surgery under regional anaesthesia, 32% after full discussion would allow the mother a choice of techniques, while only 5% would advise general anaesthesia. There was broad agreement on what information should be provided, with a consensus value of 0.60 or more in 15 of 20 statements.
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A case of anaphylaxis to a latex urethral catheter in a 33-year-old at full term pregnancy is presented. The diagnosis is based on clinical findings and supported by subsequent immunological tests. ⋯ Despite the good maternal outcome the child showed early signs of severe perinatal asphyxia, the long-term sequelae of which remain to be seen. This report discusses this unusual cause of anaphylaxis and highlights the problems of resuscitation in the pregnant patient.
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Int J Obstet Anesth · Jan 1995
Backache and epidural analgesia: a retrospective survey of mothers 1 year after childbirth.
A questionnaire was sent to 2065 mothers 1 year after delivery as part of a larger study into patient satisfaction with all aspects of their obstetric care. The response rate adjusted for non-delivered mail was 67.1%. There was a high incidence of new long-term backache in mothers who had received epidural analgesia (26.2% at one year) compared to the mothers who had not (1.7%). Further analysis of the data revealed no other significant associated factor.