International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 2007
Case ReportsUncorrected total anomalous pulmonary venous drainage in pregnancy.
Total anomalous pulmonary venous drainage is a rare form of congenital heart disease. It usually presents in the neonatal period, although later presentation, including in adulthood, is known to occur. We could not find any accounts of adult survivors with the undiagnosed disease becoming pregnant. ⋯ She underwent corrective cardiac surgery 14 months after delivery. To our knowledge, this is the first report of caesarean section in a patient with uncorrected total anomalous pulmonary venous drainage. In this case, regional anaesthesia was successfully used.
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Int J Obstet Anesth · Apr 2007
Randomized Controlled Trial Comparative StudyPrevention of postoperative nausea and vomiting after intrathecal morphine for Cesarean section: a randomized comparison of dexamethasone, droperidol, and a combination.
Intrathecal morphine provides good analgesia after cesarean delivery but the side effects include nausea and vomiting. Low-dose droperidol (0.625 mg) combined with dexamethasone 4 mg is postulated to have an additive antiemetic effect with less side effects. We therefore compared single doses of dexamethasone and droperidol alone with a low-dose combination of the two, to prevent spinal morphine-induced nausea and vomiting after cesarean section. ⋯ An additive antiemetic effect and no significant side effects were shown for the combination of dexamethasone 4 mg and droperidol 0.625 mg. This combination was more effective than either dexamethasone 8 mg or droperidol 1.25 mg alone in preventing nausea and vomiting after spinal anesthesia using 0.5% bupivacaine and morphine 0.2 mg.
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Int J Obstet Anesth · Apr 2007
Randomized Controlled TrialLocal infiltration of epinephrine-containing lidocaine with bicarbonate reduces superficial bleeding and pain during labor epidural catheter insertion: a randomized trial.
Superficial bleeding after labor epidural catheter placement is a common phenomenon. In addition to delaying securing the epidural catheter, it may loosen the adhesive catheter dressing. The primary aim of this study was to determine whether skin infiltration with epinephrine-containing rather than plain lidocaine reduces superficial bleeding after catheter placement. Secondary objectives were to determine whether adding epinephrine and/or sodium bicarbonate affected infiltration pain. ⋯ Local infiltration of epinephrine-containing lidocaine before epidural catheter insertion reduces superficial bleeding and the addition of bicarbonate decreases pain during skin infiltration.
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Int J Obstet Anesth · Apr 2007
Randomized Controlled Trial Comparative StudyInfluence of uterine exteriorization versus in situ repair on post-Cesarean maternal pain: a randomized trial.
This study was done to compare post-cesarean delivery pain associated with routine exteriorization of the uterus versus in situ uterine repair in the puerperium. ⋯ Exteriorization of the uterus for repair of the uterine incision increases the first- and second-night postoperative pain significantly in women undergoing cesarean section.
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Int J Obstet Anesth · Apr 2007
Randomized Controlled TrialPrediction of hypotension during spinal anesthesia for Cesarean section and its relation to the effect of crystalloid or colloid preload.
If parturients prone to develop caval compression in the supine position were identified before delivery, this might be a method of predicting hypotension during caesarean section under spinal anesthesia. Colloid preloading is superior to crystalloid in reducing the risk for spinal anesthetic-induced hypotension. It is postulated that parturients preoperatively susceptible to the supine position would benefit the most from colloid preloading. ⋯ Pregnant women with a positive preoperative supine stress test constitute a subset at increased risk for clinically significant hypotension during cesarean delivery under spinal anesthesia. These women seem more likely to benefit from prophylactic colloid solution than women with a negative stress test.