International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 2008
Randomized Controlled TrialLow-dose ropivacaine-sufentanil spinal anaesthesia for caesarean delivery: a randomised trial.
It is well known that intrathecal opioids have a synergic effect with spinal local anaesthetics. The aim of this study was to evaluate whether low-dose ropivacaine in combination with sufentanil could produce effective spinal anaesthesia with less maternal hypotension and vomiting than ropivacaine alone. ⋯ The combination of hyperbaric ropivacaine 10 mg with sufentanil 5 lg produced effective spinal anaesthesia for caesarean delivery with significantly less hypotension, vomiting and shivering, shorter duration of motor blockade and longer lasting analgesia than hyperbaric ropivacaine 15 mg.
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Int J Obstet Anesth · Oct 2008
Case ReportsAnaesthesia for caesarean section in a patient with Ehlers-Danlos syndrome associated with postural orthostatic tachycardia syndrome.
We report the use of regional anaesthesia for elective caesarean section in a primigravida with hypermobility type Ehlers-Danlos syndrome (type III) associated with postural orthostatic tachycardia syndrome. Single-shot spinal anaesthesia was performed after failed epidural anaesthesia. This genotype, although generally associated with fewer antenatal and peripartum complications, is more likely than other types to display dysautonomia and orthostatic intolerance. This requires careful management for delivery.
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Int J Obstet Anesth · Oct 2008
Ten years of experience with accidental dural puncture and post-dural puncture headache in a tertiary obstetric anaesthesia department.
Accidental dural puncture (ADP) and post-dural puncture headache (PDPH) are important complications of obstetric regional anaesthesia. ⋯ The incidence of ADP, PDPH, blood patching and repeat blood patching is similar to previous studies. Many ADPs are unrecognised during epidural insertion. CSE does not appear to increase the risk of ADP or PDPH; 29-gauge rather than 27-gauge pencil-point spinal needles conferred no benefit. Inserting the epidural catheter intrathecally did not significantly reduce the incidence of PDPH and blood patching in our series.