International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 2007
Case ReportsAnaesthetic management of a woman with autosomal recessive limb-girdle muscular dystrophy for emergency caesarean section.
We report the successful management of a 28-year-old parturient with an autosomal recessive limb-girdle muscular dystrophy with severe restrictive lung disease, who required non-invasive positive pressure ventilation in the third trimester of her pregnancy. At 37 weeks' gestation she had combined spinal-epidural anaesthesia for emergency caesarean section and had an uncomplicated intra- and postoperative course. The anaesthetic management is discussed and the literature briefly reviewed.
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Int J Obstet Anesth · Oct 2007
An observational study of the relationship between lumbar epidural space depth and body mass index in Michigan parturients.
Studies of urban parturient populations demonstrate increasing prevalence of obesity, which contributes to difficult epidural catheter placement. The aim of this study was to characterize the relationship between lumbar epidural space depth and body mass index in United States parturients from Michigan. ⋯ When maternal age, gestational age and vertebral interspace are controlled for, increasing body mass index is associated with increasing depth, while increasing maternal age is associated with decreasing depth.
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Int J Obstet Anesth · Oct 2007
Clinical TrialDetermination of the ED95 for intrathecal plain bupivacaine combined with fentanyl in active labor.
Combined spinal-epidural (CSE) analgesia is an effective technique for pain control in labor and is particularly useful in the active phase. Excessive doses of intrathecal bupivacaine may be associated with adverse effects. This study is designed to estimate the ED95 for intrathecal plain bupivacaine with fentanyl 15 microg in labor. ⋯ This is the first dose-finding study specifically designed to estimate the ED95 of intrathecal bupivacaine combined with a fixed amount of fentanyl for analgesia in active labor. The combination of bupivacaine 1.75 mg with fentanyl 15 microg rapidly and reliably alleviated pain in the active phase of labor.