International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 2010
Randomized Controlled Trial Comparative StudyAddition of low-dose morphine to intrathecal bupivacaine/sufentanil labour analgesia: A randomised controlled study.
Single-shot spinal analgesia with bupivacaine and a short-acting opioid for labour pain is popular due to its simplicity, rapid onset, and profound analgesia without significant motor block. Its limitation is the short duration of action. Supplementation with intrathecal morphine has been shown to prolong analgesia. We compared the addition of placebo or morphine 50 or 100 μg to intrathecal bupivacaine and sufentanil to evaluate the impact on duration of labour analgesia. ⋯ The addition of 50 or 100 μg morphine to 1.25mg bupivacaine and 5 μg sufentanil during established labour did not significantly increase the duration of analgesia.
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Int J Obstet Anesth · Oct 2010
Case ReportsThe successful use of extra-corporeal membrane oxygenation in the management of a pregnant woman with severe H1N1 2009 influenza complicated by pneumonitis and adult respiratory distress syndrome.
We report a case of H1N1 2009 influenza A, in a previously fit woman at 24 weeks of gestation, who presented atypically with abdominal pain. The infection was complicated by severe respiratory failure and acute respiratory distress syndrome, requiring ventilatory support, including extra-corporeal membrane oxygenation (ECMO). This was one of the first cases of severe H1N1 disease presenting in the UK. Use of extra-corporeal membrane oxygenation for the complications of H1N1 resulted in full maternal recovery and subsequent delivery of a healthy infant.
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Int J Obstet Anesth · Oct 2010
Comparative StudyA comparison of a Neuropen monofilament and ethyl chloride for assessing loss of touch sensation during combined spinal-epidural anaesthesia for caesarean section.
Before caesarean section is performed under regional anaesthesia the block should be assessed, preferably using a touch stimulus. What constitutes a touch stimulus remains unclear. The aim of this study was to compare a Neuropen monofilament with ethyl chloride in the assessment of touch. ⋯ Data from this study suggest that a Neuropen monofilament and ethyl chloride are equivalent when used to assess a block to touch. However, subtle differences in the level of block to touch indicate that sensory level assessments should state the stimulus used. As the block to touch was below T5 at all time points, when opioids are added to local anaesthetics, T5 might no longer represent a necessary goal to ensure the absence of pain during caesarean section.
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Int J Obstet Anesth · Oct 2010
Obstetric anesthesia units in Israel: a national questionnaire-based survey.
This survey was performed to assess the organization and practice of obstetric anesthesia units in Israel. ⋯ In this national appraisal of Israeli obstetric anesthesia services, a notable lack of written protocols, wide variations in staffing, and few specifically trained obstetric anesthesia personnel were observed.