International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 1995
A comparison of informed consent for obstetric anaesthesia in the USA and the UK.
The practice of 75 UK and 75 US obstetric anaesthetists in obtaining informed consent for obstetric anaesthesia (for caesarean section) and obstetric analgesia (for labour) was compared using a postal questionnaire. The response rate was approximately 60% for each group. Of the US anaesthetists 47% obtained separate written consent for obstetric anaesthesia compared to 22% of the UK group (P=0.012). ⋯ Significantly more of the listed risks and benefits relating to general anaesthesia were discussed by the US anaesthetists compared to the UK group, median (interquartile range), 6 (4-7) and 3 (1-4), P < 0.001. There was no significant difference in discussion before regional anaesthesia but the US group discussed more information before epidural analgesia for labouring mothers obtunded by pain or drugs. These results suggest that discussion and documentation of informed consent for obstetric anaesthesia and analgesia could be improved in both countries, especially the UK.
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Int J Obstet Anesth · Jan 1995
Risk information supplied by obstetric anaesthetists in Britain and Ireland to mothers awaiting elective caesarean section.
Mothers presenting for elective caesarean section may be offered the choice of regional or general anaesthesia. Their decision requires sensible information on the risks and benefits of each technique. In order to determine the level of consensus that exists among doctors in Britain and Ireland concerning the options offered and risk information provided for such patients, a questionnaire comprising a fictitious case history and a list of sample statements was mailed to 613 members of the Obstetric Anaesthetists' Association. 523 (85.3%) replied of whom 63% would advise surgery under regional anaesthesia, 32% after full discussion would allow the mother a choice of techniques, while only 5% would advise general anaesthesia. There was broad agreement on what information should be provided, with a consensus value of 0.60 or more in 15 of 20 statements.
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Int J Obstet Anesth · Jan 1995
Backache and epidural analgesia: a retrospective survey of mothers 1 year after childbirth.
A questionnaire was sent to 2065 mothers 1 year after delivery as part of a larger study into patient satisfaction with all aspects of their obstetric care. The response rate adjusted for non-delivered mail was 67.1%. There was a high incidence of new long-term backache in mothers who had received epidural analgesia (26.2% at one year) compared to the mothers who had not (1.7%). Further analysis of the data revealed no other significant associated factor.
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Int J Obstet Anesth · Jan 1995
Bradycardia and asystole following atropine-neostigmine administration after caesarean section in a parturient receiving methyldopa for pregnancy-induced hypertension.
We report one case of bradycardia and asystole immediately after the administration of 1 mg atropine and 2 mg neostigmine after the completion of an urgent caesarean section. We attribute this adverse reaction to the treatment of pregnancy-induced hypertension with methyldopa, perhaps facilitated by other drugs employed. Similar reactions have been reported relating to beta-receptor antagonists and tricyclic antidepressants, but not to methyldopa.