International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 1996
Unexpected postpartum seizures associated with post-dural puncture headache treated with caffeine.
This report describes a case of isolated postpartum seizures, in an apparently healthy woman who had suffered an accidental dural puncture during epidural analgesia for labour, and was on caffeine for relief of post-dural puncture headache. Investigation failed to determine the aetiology of the seizures. The possible contribution of dural puncture and caffeine toxicity are discussed.
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Int J Obstet Anesth · Jan 1996
Anesthetic considerations for parturients with primary pulmonary hypertension: review of the literature and clinical presentation.
Primary pulmonary hypertension, though uncommon, is found relatively frequently in women of childbearing age and carries a high peripartum mortality. We present a patient with severe primary pulmonary hypertension who underwent two cesarean sections 3 and 6 years after the diagnosis of primary pulmonary hypertension was made. Epidural anesthesia was provided on both occasions and resulted in a good maternal and fetal outcome. We have reviewed the literature as it relates to the choice of anesthetic technique and maternal outcome in patients with primary pulmonary hypertension.
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Int J Obstet Anesth · Jan 1996
Anaesthetic characteristics and long-term backache after obstetric epidural anaesthesia.
Anaesthetic casenotes of 4700 women who had epidural anaesthesia for deliveries between 1978-1985 were examined to look for associations between various epidural characteristics and subsequently reported long-term backache. The data on long-term backache came from a postal questionnaire sent to the women. ⋯ There were no relationships between long-term backache and the duration of the epidural or various indicators of the extent of motor or sensory block. Within the range of local anaesthetic concentration levels used in this series, the extent of block did not seem to affect backache, but the effect of minimal motor block with corresponding increased mobility, such as is available with low concentration anaesthetics mixed with opiates, merits further study.