International journal of obstetric anesthesia
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Int J Obstet Anesth · Jul 1994
The incidence of herpes simplex virus labialis after cesarean delivery.
Epidural and subarachnoid opioids have been associated with the development of oral herpes simplex lesions. Because of this risk, some anesthesiologists avoid neuraxial morphine in parturients with a history of herpes simplex virus labialis. When we began using neuraxial opioids for analgesia after cesarean delivery, we did not see any increased incidence of facial lesions. ⋯ Neuraxial morphine did not increase the risk of labial lesions significantly (3.5% vs. 2.6%). Despite published data to the contrary, we found no correlation between neuraxial morphine and the risk of facial herpes virus lesions in women after cesarean delivery. We offer patients the option of neuraxial morphine for analgesia after cesarean delivery despite any history of oral herpes lesions.
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Int J Obstet Anesth · Jul 1994
Anesthetic management of a parturient with mixed mitral valve disease and uncontrolled atrial fibrillation.
This case report describes the anesthetic management of a 32-year-old parturient with combined severe mitral regurgitation and moderate mitral stenosis, complicated by fast atrial fibrillation. The advantageous effects of epidural analgesia during labor and vaginal delivery and the importance of invasive monitoring are discussed. We also report the rare complication of right bundle branch block related to the use of a pulmonary artery catheter.
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Int J Obstet Anesth · Jul 1994
The association between foot temperature and asymmetrical epidural blockade.
This study was designed to explore the correlation between sensory block asymmetry and a disparity in foot temperature following epidural bupivacaine administration in labour. Sixty parturients requesting epidural analgesia had epidural catheters sited at L 3/4 while in the lateral position. A test dose was followed 5 min later by a main dose of 25-30 mg of plain bupivacaine. ⋯ Most staff were able to detect a foot temperature difference > 1 degrees C. Our findings indicate a clear association between sensory block asymmetry and the difference between the temperature of the feet. This difference can be detected simply by feeling the feet.