Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Nov 2007
Randomized Controlled Trial[Transient neurological symptoms in puerperas after epidural analgesia during labor].
The investigation was undertaken to elucidate the impact of epidural analgesia (EA) during labor on the incidence of transient neurological symptoms (TNS). By the agreement of a local ethics committee, an informed consent was obtained from 90 healthy puerperas enrolled in the investigation. The patients were randomized into 3 groups, with 30 patients in each. ⋯ The duration of TNS was generally short; in all the patients, the symptoms were completely resolved after 24-72 hours. Labor EA is not a cause of TNS. The type of a local anesthetic (lidocaine, ropivacaine) does not affect the incidence of TNS in puerperas after labor EA.
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Anesteziol Reanimatol · Nov 2007
Clinical Trial[Hemodynamics in puerparas during subarachnoidal anesthesia with lidocaine].
Hemodynamic changes in response to subarachnoidal injection of 1.2-1.4 mg/kg of lidocaine at various concentrations were comparatively evaluated in 106 pregnant women aged 21 to 36 years (with 53 patients in each group). All the women underwent lumbar puncture at the level of L(II)-L(IV), 1.2-1.4 mg/kg of hyperbaric lidocaine solution being subarachnoidally administered. Groups 1 and 2 patients received 2 and 5% solution of the anesthetic, respectively. ⋯ No significant differences were established at the time of development of a complete sensomotor block with the use of 2% (Group 1) and 5% (Group 2) lidocaine solutions. At the same time there were 16.8 +/- 0.6 and 11.9 +/- 0.5 blocked segments in Groups 1 and 2, respectively. In Group 1, severe hemodynamic disorders to be corrected were recorded in 30.2% of the women and in Group 2, subarachnoidal administration of the same doses of lidocaine did not cause any disorders.
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Anesteziol Reanimatol · Nov 2007
Clinical Trial[Current approaches to the analgesia of spontaneous child birth].
The authors have compared various modes of spontaneous labor. Prolonged epidural infusion of naropine in combination with fentanyl has been found to cause a less motor block and therefore it may be used in the late first-to-second period of labor. Adequate analgesia ensures a smooth course of the second labor period and promotes the reduction in its duration and the correction of central hemodynamic and hormonal homeostastic disorders. The administration of moradol provides adequate analgesia of the first labor period, prevention, and elimination of abnormal labor activity, without exerting a depressive effect on maternal and neonatal respiration, which makes it possible to consider this procedure as an alternative mode of labor pain relief if there are contraindications to epidural analgesia.