Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Jun 2011
ReviewOxytocin for labour and caesarean delivery: implications for the anaesthesiologist.
The implications of the obstetric use of oxytocin for obstetric anaesthesia practice are summarised. The review focuses on recent research on the uterotonic effects of oxytocin for prophylaxis and management of uterine atony during caesarean delivery. ⋯ Oxytocin remains the first-line uterotonic after vaginal and caesarean delivery. Recent research elucidates the therapeutic range of oxytocin during caesarean delivery, as well as receptor desensitization. Evidenced-based protocols for the prevention and treatment of uterine atony during caesarean delivery are recommended.
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To describe the recent advances in labor epidural analgesia, which may have an impact on maternal ambulation during labor. ⋯ Since the earliest 'walking epidural' was described in the early 1990s, there has been much research into finding the ideal regional technique for labor analgesia that provides excellent analgesia with high maternal satisfaction scores while having little adverse effect on obstetric outcome. This review attempts to map the journey of the 'walking epidural' from its earliest form to its more recognizable modern day appearance.
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Distress in children during hospitalization is increasingly seen as unacceptable and preventable. Surgery and anaesthesia are distressing events for children with maximum stress at induction of anaesthesia. This review aims to report the recent research relevant to reducing this distress in children with a focus on the preoperative period and the impact of this on behaviour at induction and long-term postoperatively. ⋯ New measures of anxiety will facilitate better evaluation of children clinically and better future research. The role of α2-adrenergic agonists in premedication remains unclear. There is still little research, which examines outcomes for techniques for minimizing distress, which are based on specific assessment of the child and family.