International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 2010
Randomized Controlled TrialA randomised study of magnesium sulphate as an adjuvant to intrathecal bupivacaine in patients with mild preeclampsia undergoing caesarean section.
Adequate analgesia following caesarean section decreases morbidity, hastens ambulation, improves patient outcome and facilitates care of the newborn. Intrathecal magnesium, an NMDA antagonist, has been shown to prolong analgesia without significant side effects in healthy parturients. We therefore studied the effect of adding intrathecal magnesium sulphate to bupivacaine-fentanyl spinal anaesthesia in patients with mild preeclampsia undergoing caesarean section. ⋯ In parturients with mild preeclampsia undergoing caesarean delivery, the addition of magnesium sulphate 50 mg to the intrathecal combination of bupivacaine and fentanyl prolongs the duration of analgesia and reduces postoperative analgesic requirements without additional side effects.
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Int J Obstet Anesth · Apr 2010
Randomized Controlled Trial Comparative StudyMaternal haemodynamics at elective caesarean section: a randomised comparison of oxytocin 5-unit bolus and placebo infusion with oxytocin 5-unit bolus and 30-unit infusion.
Rapid intravenous injection of oxytocin is associated with marked hypotension secondary to decreased venous return. Reductions in dose and rate of bolus administration have reduced the incidence of cardiovascular side effects, but no study has yet investigated cardiovascular stability when oxytocin is infused for several hours after delivery. This study compared maternal haemodynamics during a 4-h 30-unit oxytocin infusion and during a placebo infusion following caesarean section. ⋯ An additional oxytocin infusion at elective caesarean section did not adversely affect maternal haemodynamics either during or after surgery.
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Int J Obstet Anesth · Apr 2010
Case ReportsCardiac arrest due to uterine inversion during caesarean section.
We describe the case of a 20-year-old G3P0 woman who was delivered by caesarean section under general anaesthesia, complicated by uterine inversion secondary to undiagnosed placenta accreta and cardiac arrest requiring cardiopulmonary resuscitation. Uterine inversion is a known complication of placenta accreta and is a rare occurrence at caesarean section. Similar cases have been reported, though cardiac arrest is an uncommon feature. The possible causes and management are discussed.