The Australian & New Zealand journal of obstetrics & gynaecology
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Aust N Z J Obstet Gynaecol · Nov 1999
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA randomized clinical trial comparing oral misoprostol with synthetic oxytocin or syntometrine in the third stage of labour.
This is a multicentre, blocked, randomized trial to compare the efficacy of oral misoprostol 400 microg with current injectable uterotonic agents (oxytocin/ Syntometrine) used prophylactically in the third stage of labour. Main outcome measures were blood loss, use of a second uterotonic agent and difference in haemoglobin level from antepartum to postpartum. ⋯ The use of a second uterotonic agent was higher in the misoprostol group (RR 2.89: 95% Cl 2.00-4.18) as well as a greater decrease in postpartum haemoglobin (p = 0.015). Oral misoprostol 400 microg is significantly less effective than the traditional intramuscular uterotonic agents currently used and therefore cannot be considered as a viable option to these agents in the management of the third stage of labour.
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Aust N Z J Obstet Gynaecol · Aug 1997
Randomized Controlled Trial Clinical TrialPatient-controlled epidural analgesia after caesarean section using a disposable device.
We have evaluated the use of a disposable device, the Patient Controlled Epidural Infusor, for patient-controlled epidural analgesia (PCEA) using pethidine, for pain relief in the first 24 hours after elective Caesarean section. Patients using the Patient Controlled Epidural Infusor (n = 20) were compared with a control group (n = 20) who received PCEA using a standard electronic device. Efficacy, as assessed by visual analogue scores, was comparable to that achieved in the control group. ⋯ There was a low incidence of side-effects with both devices. Patients using the disposable device used less pethidine than patients using the electronic device (median (interquartile range) 181 (100-275) mg versus 238 (213-375) mg; p = 0.035). Use of this disposable device is an acceptable alternative to more expensive and bulkier electronic devices for PCEA after Caesarean section.
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Aust N Z J Obstet Gynaecol · Feb 1996
Randomized Controlled Trial Clinical TrialThe effect of intraumbilical oxytocin on the third stage of labour.
The umbilical vein administration of oxytocin in saline was compared with umbilical vein saline alone and the traditional management of the third stage of labour. Seventy-two women were randomized to 3 groups. ⋯ No significant differences were found in terms of the length of the third stage, the blood loss in the third stage and postpartum haematocrit differences among the 3 groups. The administration of diluted oxytocin or saline do not seem to have any superiority to the traditional management of the third stage of labour.
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Aust N Z J Obstet Gynaecol · Feb 1996
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialGoserelin depot versus danazol in the treatment of endometriosis the Australian/New Zealand experience.
A multicentre, open, randomized comparison of depot goserelin versus danazol to treat endometriosis was undertaken in 9 Australian/New Zealand centres. The study compared the effects of the 2 drugs on subjective and objective parameters in women with symptomatic and/or infertility associated endometriosis. ⋯ Patients in our study showed considerably more intolerance of study drugs, particularly danazol, than women in American and European reports: 19 of 36 women randomized to danazol in our study failed to complete 6 months therapy, because of adverse events (9/36) or because of unwillingness to continue with therapy (8/36). Consumer satisfaction with medical treatment for endometriosis was an important issue in this study.
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Aust N Z J Obstet Gynaecol · Nov 1995
Randomized Controlled Trial Clinical TrialEfficacy of bupivacaine delivered by wound catheter for post-Caesarean section analgesia.
A prospective, randomized, double-blind trial was conducted to assess contribution to postoperative analgesia of intermittent instillation of 0.25% bupivacaine beneath the rectus sheath in 70 women delivered by lower uterine segment Caesarean section. The operations were performed via a Pfannenstiel incision under spinal anaesthesia. Background intravenous narcotic analgesia was provided with a patient controlled analgesia system (PCAS) using a standard morphine regimen. ⋯ The overall incidence of nausea was lower in the treatment group compared to the control group (Chi squared with Yates' correction p = 0.046) and a lower degree of sedation was seen in those receiving bupivacaine between 4 and 8 hours after commencing PCAS (Mann-Whitney U = 427, p = 0.028). No differences in other narcotic related side-effects (vomiting and pruritus) were shown between groups. Regular instillation of 0.25% bupivacaine beneath the rectus sheath of women delivered by Caesarean section reduces their morphine requirements by 25% in the 44 hours after operation, with an associated reduction in both nausea and early sedation.