International journal of obstetric anesthesia
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A 32-year-old patient developed pseudo-obstruction of the large bowel following elective caesarean section. The association of this rare postoperative complication with anaesthesia is discussed. ⋯ The reported mortality varies from 14-30% rising to 40-50% if there is caecal perforation. The underlying mechanism is thought to be an imbalance of the autonomic nervous system.
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Int J Obstet Anesth · Oct 1994
Epidural lidocaine versus 2-chloroprocaine for fetal distress requiring urgent cesarean section.
Chloroprocaine is a local anesthetic widely used for the urgent cesarean delivery of a distressed fetus in an mother with a epidural catheter because of its quick onset and short half-life. However, chloroprocaine has disadvantages that include decreased effectiveness of subsequently administered epidural amides and narcotics. ⋯ A retrospective review revealed that though the drug administration to incision time was significantly faster (P < 0.005) for 3% chloroprocaine, both 3% chloroprocaine and 1.5% lidocaine were clinically effective. There were no differences in neonatal Apgar scores or neonatal umbilical cord pH values between the two treatment populations, offering lidocaine as an attractive alternative to chloroprocaine.
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Int J Obstet Anesth · Oct 1994
Parturients' assessment of water blocks, pethidine, nitrous oxide, paracervical and epidural blocks in labour.
This prospective study evaluated the extent to which the analgesic procedures available resulted in efficient pain relief in 833 Finnish parturients. Their pain ratings were recorded according to their own assessment of pain intensity during labour before and after pain management and according to their total pain experience recalled on the third day after delivery. Only regional blocks significantly diminished pain scores during labour and a striking decrease in pain level (P < 0.0001) was maintained until the second stage by epidural analgesia (EDA) alone. ⋯ After delivery 60% of parturients in this group recalled labour pain as being very severe or intolerable. This was partly due to delays in receiving epidural blockade and partly due to the parturient's reticence in requesting analgesia. Pain relief was rated as excellent or good by 94% of the EDA group but by only 50% of the remaining patients.