Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2006
Case ReportsPrevention strategy for post dural puncture headache.
We report the anesthetic management of a parturient after an unintentional dural puncture while performing epidural anaesthesia for caesarean section and the strategy to prevent postdural puncture headache (PDPH). We injected the cerebrospinal fluid (CSF) back into the subarachnoid space and then administered intrathecal 1.5 mL 0.5% hyperbaric bupivacaine and fentanyl 20 microg to maintain CSF volume via epidural needle. ⋯ After adding 3 mL of 0.5% isobaric bupivacaine via epidural catheter, sensory block level reached at T4 bilaterally. No PDPH was observed.
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Between 0.1% and 0.2% of surgical patients given general anesthesia remember having been aware during the procedure. Not all, but some of these patients have experienced pain, anxiety or both while being aware. ⋯ The anxiety symptoms may be transient, but can persist in some patients. The majority of available studies on suffering due to awareness are retrospective, and potential selection bias in the studied cohorts should be considered when the likelihood for negative experiences of awareness are discussed.
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Acta Anaesthesiol Belg · Jan 2006
Randomized Controlled Trial Multicenter Study Comparative StudyRopivacaine versus bupivacaine 0.125% with fentanyl 1 microg/ml for epidural labour analgesia: is daily practice more important than pharmaceutical choice?
Ropivacaine might be superior to bupivcaine for epidural labour analgesia because it appears to induce less lower extremity motor blockade. The clinical relevance of this difference is not yet clear. ⋯ Institutional clinical practice can be significantly different. Pharmacological differences between bupivacaine and ropivacaine at 0.125% with 1 microg/ml fentanyl seem to be less important than differences between institutions in terms of clinical practice.