International journal of obstetric anesthesia
-
Int J Obstet Anesth · Apr 1997
Randomized Controlled Trial Clinical TrialPatient-controlled analgesia following caesarean section: a comparison of morphine and meptazinol.
Forty-eight women were investigated in a prospective double-blind study and randomised to receive intravenous patient-controlled analgesia (PCA) with meptazinol or morphine following elective caesarean section. Women received PCA boluses of 1 mg morphine or 10 mg meptazinol with no background infusion. ⋯ There was no statistically significant difference in pain scores (P = 0.47) or the incidence of side-effects (nausea/vomiting P = 0.076, sedation P = 0.63) between the two drugs. Meptazinol is more expensive and offers no clinical advantages in this group of patients.
-
Int J Obstet Anesth · Apr 1997
Cardiac arrest complicating spinal anaesthesia for caesarean section.
We present a 36-year-old multiparous woman who developed intractable hypotension and cardiac arrest during spinal anaesthesia for elective caesarean section. Cardiopulmonary resuscitation was successful and both mother and baby made a good recovery. Postoperative investigation revealed a dilated cardiomyopathy related to pregnancy. This case highlights the importance of expediting delivery of the neonate during maternal cardiopulmonary resuscitation, the prompt use of adrenaline as inotropic support, and preoperative assessment in apparently healthy parturients.
-
Int J Obstet Anesth · Apr 1997
Transient radicular irritation after hyperbaric lidocaine spinal anesthesia in parturients.
Two cases of transient radicular irritation in pregnant patients are presented. Both cases involve the combination of spinal anesthesia employing hyperbaric 5% lidocaine and a small gauge pencilpoint needle as well as the surgery being performed in the lithotomy position. We recommend that until the potential for lidocaine-induced neuroradicular irritation under these circumstances is evaluated prospectively, hyperbaric lidocaine should not be used for cases in which a small gauge spinal needle is employed and the patient is placed in the lithotomy position.
-
Int J Obstet Anesth · Apr 1997
Prostaglandin-induced ventricular fibrillation during cesarean section.
A case report is presented of ventricular fibrillation after intramyometrial injection of 1 mg dinoprostone (PGE(2)) during cesarean section performed under general anesthesia. Anesthesiologists should be aware of the potential cardiovascular side-effects of prostaglandins used by the obstetrician.
-
Int J Obstet Anesth · Apr 1997
Anaesthesia and the antiphospholipid syndrome: a review of 20 obstetric patients.
The case notes of 20 obstetric patients with antiphospholipid syndrome delivering over a 4-year period were reviewed retrospectively. There were complete details for 22 singleton pregnancies. Obstetric complications in the pregnancies under review were frequent. ⋯ The estimated blood loss at these deliveries did not exceed 600 ml. Eleven women (55%) had a previous history of thrombosis. Two women had thrombotic episodes during their pregnancies and three had them post partum despite antithrombotic measures.