International journal of obstetric anesthesia
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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.
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Int J Obstet Anesth · Apr 1997
Anesthesia for combined cesarean section and extra-adrenal pheochromocytoma resection: a case report and literature review.
Pheochromocytoma during pregnancy is unusual, with approximately 250 cases now reported in the literature. The current case describes the anesthetic management of a patient with a large extra-adrenal pheochromocytoma who underwent a combined cesarean section and tumor removal in which perioperative hemodynamic control was difficult despite high-dose a-adrenergic blockade. ⋯ Established criteria exist for the adequacy of alpha- and beta-adrebergic blockade for the management of pheochromocytoma in the non-pregnant patient. We discuss how these criteria apply to pregnant patients with pheochromocytoma, and suggest possible modifications to the criteria.
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Int J Obstet Anesth · Apr 1997
Use of sublingual glyceryl trinitrate as a supplement to volatile inhalational anaesthesia in a case of uterine inversion.
We present a case of uterine inversion in which glyceryl trinitrate was used via the sublingual route, as opposed to the intravenous route, in association with volatile inhalational anaesthesia in order to achieve relaxation of the uterus. A transient, but significant, hypotensive response occurred, which was easily corrected with a colloid infusion and vasopressors. Sublingual glyceryl trinitrate is easily administered, has a fast onset of action and may have a role in situations where rapid relaxation of the uterus is required.