International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 2010
Randomized Controlled Trial Multicenter Study Comparative StudySatisfaction, control and pain relief: short- and long-term assessments in a randomised controlled trial of low-dose and traditional epidurals and a non-epidural comparison group.
Childbirth is an important life event for which a positive experience is important to many women. ⋯ Whilst satisfaction with the experience of childbirth appears intimately related to the attainment of a spontaneous delivery, mobile epidurals enhance women's feeling of control in labour and are popular for future choice of regional analgesia.
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Int J Obstet Anesth · Jan 2010
Randomized Controlled Trial Comparative StudyReduction of severity of pruritus after elective caesarean section under spinal anaesthesia with subarachnoid morphine: a randomised comparison of prophylactic granisetron and ondansetron.
The incidence of pruritus after elective caesarean section under spinal anaesthesia with subarachnoid morphine may be 60-100%, and is a common cause of maternal dissatisfaction. Ondansetron has been shown to reduce pruritus but the effect is short-lived. The objective of this randomized double-blind trial was to evaluate the anti-pruritic efficacy of granisetron compared with ondansetron. ⋯ Administration of granisetron 3mg i.v. reduces the severity of pruritus and the use of rescue anti-pruritic medication, and improves satisfaction but does not reduce the overall incidence of pruritus in women who have received subarachnoid morphine 150 microg compared to ondansetron 8 mg i.v.
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Int J Obstet Anesth · Jan 2010
Randomized Controlled Trial Comparative StudyMaternal and neonatal effects of bolus administration of ephedrine and phenylephrine during spinal anaesthesia for caesarean delivery: a randomised study.
Maternal haemodynamic changes and neonatal well-being following bolus administration of ephedrine and phenylephrine were compared in 60 term parturients undergoing elective caesarean delivery under spinal anaesthesia. ⋯ Phenylephrine 100 mug and ephedrine 6 mg had similar efficacy in the treatment of maternal hypotension during spinal anaesthesia for elective caesarean delivery. Neonates in group P had significantly higher umbilical arterial pH and base excess values than those in group E, which is consistent with other studies.
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Int J Obstet Anesth · Jan 2010
Randomized Controlled Trial Comparative StudyA double blind comparison of the variability of block levels assessed using a hand help Neurotip or a Neuropen at elective caesarean section under spinal anaesthesia.
We previously noted that when two experienced anaesthetists assessed the level of spinal block to touch at caesarean section, one with a hand held device (Neurotip), and the other with a very similar spring loaded device (Neuropen), the median difference between the assessed levels of block was zero but there were some wide individual paired differences between the anaesthetists. We theorised that differences in the applied pressure of the stimulus may have contributed to this variation. We wished to investigate whether compared to the Neurotip, the Neuropen would reduce the variability of assessed block levels between anaesthetists of varying experience. ⋯ Compared to the Neurotip, the Neuropen did not result in a reduction of the variability in the differences in spinal block levels when assessed by 35 different pairs of anaesthetists.
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Int J Obstet Anesth · Jan 2010
Randomized Controlled Trial Comparative StudyA randomised comparison of regular oral oxycodone and intrathecal morphine for post-caesarean analgesia.
Primary post-caesarean analgesia based on oral opioid has not been adequately studied. This approach may show a good side-effect profile and high satisfaction and avoid neuraxial complications. ⋯ Oral oxycodone produced comparable postoperative pain relief to intrathecal morphine with a lower incidence of pruritus, but was associated with a lower satisfaction score.