International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 1998
Incidence of epidural catheter replacement in parturients: a retrospective chart review.
We noted in our practice of obstetric anesthesia at a large teaching hospital that the epidural catheter failure rate was higher than previously reported. We undertook this study to determine the incidence of epidural catheter failure in parturients and to determine the primary causes of failure. After institutional approval, we evaluated the charts of parturients who received epidural analgesia for labor or anesthesia for cesarean section for 6 randomly selected months spanning one year. ⋯ The major causes of catheter failure were no analgesia and unilateral block. The experience of the anesthesiologist, the mode of delivery, patient age, patient weight, type of epidural catheter, occurrence of paresthesia and the use of CSE were all associated with significantly different epidural catheter replacement rates. Despite the initially high failure rate, the overall patient satisfaction rate was greater than 98%.
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Urticaria pigmentosa is a cutaneous variant of mastocytosis. This is a complex group of diseases distinguished by abnormal aggregation of mast cells within the skin and other organs. Mast cell degranulation and subsequent release of vasoactive amines may occur in response to a variety of non-immune triggers leading to, as its most severe manifestation, a clinical picture of anaphylactic shock. We present the anaesthetic management during labour of a patient with urticaria pigmentosa.