International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2020
Inadvertent neuraxial block placement at or above the L1-L2 interspace in the super-obese parturient: a retrospective study.
Increasing body mass index (BMI) increases the difficulty of neuraxial procedures. We hypothesized that it may put patients at risk for inappropriately high dural puncture. The accuracy of anesthesiologists' estimates of the interspinous level in super-obese parturients has not been studied. We evaluated the frequency of inadvertently high epidural and/or intrathecal catheter placement (at or above the L1/L2 interspace) in parturients of BMI ≥50 kg/m2. ⋯ A high rate of inadvertently high epidural or intrathecal catheter placement occurs in super-obese parturients. Ultrasound did not prevent this.
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Int J Obstet Anesth · May 2020
Observational StudyThe association between the introduction of quantitative assessment of postpartum blood loss and institutional changes in clinical practice: an observational study.
Imprecise visual estimates of blood loss contribute to morbidity from postpartum hemorrhage. We examined the impact of quantitative assessment of postpartum blood loss on clinical practice and outcomes. ⋯ Quantifying blood loss may result in increased vigilance for vaginal and cesarean delivery. We identified an association between quantifying blood loss and improved identification of postpartum hemorrhage, patient management steps and cost savings.
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Int J Obstet Anesth · May 2020
Fentanyl concentration in maternal and umbilical cord plasma following intranasal or subcutaneous administration in labour.
The effect that the route of maternal fentanyl administration has on placental transfer of drug to the neonate is not well studied. Plasma concentration ratios are an indicator of fetal exposure, relative to the mother. ⋯ This study is the first to examine fetal and maternal fentanyl concentrations after subcutaneous administration. This research supports the safe use of fentanyl for labour analgesia for women.
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Int J Obstet Anesth · May 2020
Letter Case ReportsIsolated chronic tinnitus after neuraxial labor analgesia.