International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 2008
Randomized Controlled TrialRemifentanil for cesarean section under general anesthesia: effects on maternal stress hormone secretion and neonatal well-being: a randomized trial.
Remifentanil may attenuate maternal hemodynamic response during cesarean section under general anesthesia, but could cause transient but significant neonatal depression. We investigated the effect of low-dose remifentanil on maternal neuroendocrine response and fetal wellbeing. ⋯ Remifentanil administration before peritoneal incision partially reduced the hormonal stress response. Maternal benefits must be weighed against transitory but significant neonatal respiratory depression. Neonatal resuscitation facilities are mandatory when remifentanil is used.
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Int J Obstet Anesth · Apr 2008
Case ReportsAnaesthetic management of two different modes of delivery in patients with dystrophic epidermolysis bullosa.
Dystrophic epidermolysis bullosa is an inherited severe bullous condition characterised by extreme skin fragility and blistering in response to minor trauma. We present two obstetric cases with recessive dystrophic epidermolysis bullosa, one who underwent elective caesarean section, the other who delivered vaginally. The key points in the anaesthetic management of the obstetric patient with dystrophic epidermolysis bullosa include multidisciplinary preassessment, airway management strategies and the role of regional anaesthesia.
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Int J Obstet Anesth · Apr 2008
Case ReportsAnaesthetic management of a craniopagus conjoined twin delivery.
We report the successful caesarean delivery of craniopagus conjoined twins in a 21-year-old using a neuraxial technique. Early diagnosis at 19(+5) weeks of gestation enabled thorough multidisciplinary antepartum planning. The multidisciplinary approach aimed to reduce maternal and fetal morbidity. ⋯ At delivery there were 17 members of the multidisciplinary team present in the operating theatre. They were from five specialities from two separate hospitals. We discuss the anaesthetic considerations for the delivery of conjoined twins and the multidisciplinary approach used in this case.