International journal of obstetric anesthesia
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The 1998 guidelines for obstetric anaesthesia services state: "postoperative care of the obstetric patient should be in accordance with that of any postoperative patient". We sought to discover whether this standard of care was provided. ⋯ The survey demonstrates that current obstetric recovery room practice does not always adhere to the recommended Association of Anaesthetists of Great Britain and Ireland guidelines. The provision of dedicated recovery staff or a cohort of specifically trained midwives may help to improve existing standards.
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Int J Obstet Anesth · Jul 2005
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of epidural ropivacaine 0.75% and bupivacaine 0.5% with fentanyl for elective caesarean section.
Early studies suggested that ropivacaine had clinical advantages over bupivacaine with respect to cardiotoxicity and motor block, and that it was suitable for epidural caesarean section. This study was set up to compare epidural 0.75% ropivacaine with a popular bupivacaine/fentanyl mixture for elective caesarean section. ⋯ This study suggests that epidural 0.75% ropivacaine without opioid may be used as an alternative to bupivacaine 0.5% with fentanyl for elective caesarean section, but it does not induce anaesthesia any faster and may result in a denser, more prolonged, motor block.
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Int J Obstet Anesth · Jul 2005
Randomized Controlled Trial Clinical TrialA randomized comparison of a five-minute versus fifteen-minute lockout interval for PCEA during labor.
The best combination of bolus size and lockout interval for patient-controlled epidural analgesia (PCEA) is not known. This study compared a 5-min with a 15-min lockout interval. ⋯ The 5-min lockout interval appears the more efficient and has been used safely in our practice for 15,000 parturients, although a larger study is required to confirm the relative efficacy, efficiency and safety of this regimen.
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Int J Obstet Anesth · Jul 2005
Case ReportsEpidural blood patch with allogeneic blood for post-dural puncture headache.
A parturient suffered post dural puncture headache following accidental dural puncture during attempted epidural anesthesia for cesarean section. Post partum fever was regarded as a contraindication to autologous epidural blood patch; compatible and infection-free allogeneic blood was therefore used with good effect and without apparent complications.
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Int J Obstet Anesth · Jul 2005
Case ReportsA subdural abscess and infected blood patch complicating regional analgesia for labour.
We report two very unusual cases of infection complicating labour analgesia. The first case was a sub-dural abscess presenting with deep-seated backache seven days after combined spinal-epidural analgesia for labour. The second was a painful lumbar swelling and septicaemia that presented three days after a blood patch for a post dural puncture headache. Because of their complicated and unusual presentation, the diagnosis and management of both were initially delayed.