Articles: analgesia.
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Case Reports
Unilateral trigeminal and facial nerve palsies associated with epidural analgesia in labour.
To report a rare complication related to epidural analgesia for obstetrics: the association of unilateral trigeminal and facial nerve palsies in a patient with the clinical syndrome of intracranial hypotension. ⋯ Post delivery trigeminal and facial nerve palsy in a 38 yr old woman recovered spontaneously with conservative therapy.
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Patient-controlled sedation (PCS) using propofol under spinal anesthesia in transurethral lithotripsy was carried out in a 44 year old patient with von Gierke disease accompanied with liver dysfunction, chronic renal failure, hypoglycemia and metabolic acidosis. After administering spinal anesthesia PCS was started (0.2 mg.kg-1 intravenous bolus dose of propofol; infusion at 2 mg.kg-1.h-1; a three-minute lockout time interval following an initial doses of 0.4 mg.kg-1). ⋯ This patient was much satisfied with this sedation in an interview during the postoperative period. PCS using propofol is a useful method without respiratory depression for a patient with von Gierke disease.
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Biography Historical Article
A reappraisal of Simpson's introduction of chloroform.
To examine the introduction of the use of chloroform in childbirth, assessing the role of Sir James Young Simpson, the various motives for the innovation, and the health and sociological consequences for those involved in childbirth. ⋯ The implications of the introduction of chloroform in childbirth were short, medium and long term. The changes associated with the acceptance of this drug may bear comparison with those relating to certain, current, pain-control methods.
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Obviously there is a world-wide trend towards regional analgesia for pain relief during delivery. Data on the current practice in Germany are lacking. ⋯ In 1977, 14 of 18 university departments of anaesthesiology offered epidural analgesia for parturients. This option was available in all university departments in 1996. A mean rate of 10-20% epidurals for vaginal delivery is well within the limits reported from other countries, whereas the rate of regional anaesthesia for scheduled caesarean section (40%) still is rather low in Germany, as reported in part 1 of this survey (Anaesthesist 1998;47:59-63).