International journal of obstetric anesthesia
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Int J Obstet Anesth · Jul 2010
Randomized Controlled Trial Comparative StudyPerineal infiltration with lidocaine 1%, ropivacaine 0.75%, or placebo for episiotomy repair in parturients who received epidural labor analgesia: a double-blind randomized study.
Episiotomies are performed in approximately 20% of vaginal deliveries and may result in postpartum pain. Perineal infiltration with lidocaine during the episiotomy is widely used, despite an early study showing no difference when compared with saline. Ropivacaine has increasingly been used in the obstetric setting, although not for episiotomies. We sought to compare the analgesic efficacy of ropivacaine, lidocaine or saline for perineal infiltration before repair of a mediolateral episiotomy in patients who delivered with epidural labor analgesia. ⋯ For the first 24 h, perineal infiltration of ropivacaine, lidocaine, and saline were equivalent in producing post-episiotomy analgesia.
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Int J Obstet Anesth · Jul 2010
Randomized Controlled Trial Comparative StudyPulmonary effects of bupivacaine, ropivacaine, and levobupivacaine in parturients undergoing spinal anaesthesia for elective caesarean delivery: a randomised controlled study.
Spinal anaesthesia is the method of choice for elective caesarean delivery, but has been reported to worsen dynamic pulmonary function when using bupivacaine. Similar investigations are lacking for ropivacaine and levobupivacaine. We have therefore compared the pulmonary effects of intrathecal bupivacaine, ropivacaine and levobupivacaine used for caesarean delivery. ⋯ Decreases in maternal pulmonary function tests were similar following spinal anaesthesia with bupivacaine, ropivacaine, or levobupivacaine for caesarean delivery. The clinical maternal and neonatal effects of these alterations appeared negligible.
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Int J Obstet Anesth · Jul 2010
ReviewUltrasound in obstetric anaesthesia: a review of current applications.
Ultrasound equipment is increasingly used by non-radiologists to perform interventional techniques and for diagnostic evaluation. Equipment is becoming more portable and durable, with easier user-interface and software enhancement to improve image quality. ⋯ Within the broader specialty of anaesthesia; vascular access, cardiac imaging and regional anaesthesia are the areas in which ultrasound is becoming increasingly established. In addition to ultrasound for neuraxial blocks, these other clinical applications may be of value in obstetric anaesthesia practice.
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Int J Obstet Anesth · Jul 2010
Randomized Controlled TrialSensory testing of spinal anaesthesia for caesarean section: differential block and variability.
The aim of this study was to determine if sensory block following spinal anaesthesia, measured with a range of devices, corresponded to the hierarchy of nerve fibre size in the area of differential block, and to compare the distribution and variability of recorded measurements. ⋯ Sensory fibre hierarchy could be identified. Tests for light touch showed the least variability. More expensive tests do not appear to have any advantage over the least expensive test, cotton wool.