International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 2011
ReviewTransthoracic echocardiography in obstetric anaesthesia and obstetric critical illness.
Transthoracic echocardiography (TTE) is a powerful non-invasive diagnostic, monitoring and measurement device in medicine. In addition to cardiologists, many other specialised groups, including emergency and critical care physicians and cardiac anaesthetists, have recognised its ability to provide high quality information and utilise TTE in the care of their patients. In obstetric anaesthesia and management of obstetric critical illness, the favourable characteristics of pregnant women facilitate TTE examination. ⋯ This article outlines the application of TTE in the specialty of obstetric anaesthesia and in the management of obstetric critical illness. It describes the importance of TTE education, quality assurance and outcome recording. It also discusses how barriers to the routine implementation of TTE in obstetric anaesthesia and management of obstetric critical illness can be overcome.
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Int J Obstet Anesth · Apr 2011
Randomized Controlled Trial Comparative StudyA randomised comparison of intravenous remifentanil patient-controlled analgesia with epidural ropivacaine/sufentanil during labour.
The μ-opioid agonist remifentanil has a rapid onset and offset and a short half-life making it an attractive option for intravenous patient-controlled labour analgesia. We aimed to compare the efficacy of intravenous remifentanil patient-controlled analgesia with epidural ropivacaine/sufentanil during labour. ⋯ In the 20 patients recruited to this study, pain relief in labour with epidural ropivacaine/sufentanil was more effective than with intravenous remifentanil patient-controlled analgesia.
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Int J Obstet Anesth · Apr 2011
Randomized Controlled TrialA randomised, double-blinded, placebo-controlled study of acupressure wristbands for the prevention of nausea and vomiting during labour and delivery.
Approximately 50% of women experience nausea or vomiting during labour. P6 acupoint stimulation reduces postoperative nausea and vomiting in early pregnancy and after chemotherapy. The aim of this randomised, double-blinded, placebo-controlled trial was to determine whether P6 acupressure prevented nausea and vomiting during labour and delivery. ⋯ In this study acupressure wristbands applied bilaterally did not reduce the incidence of nausea and vomiting during labour and delivery.
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Int J Obstet Anesth · Apr 2011
Case ReportsThe use of thromboelastography for the peripartum management of a patient with platelet storage pool disorder.
We describe the peripartum management of a 26-year-old primigravida with a platelet storage pool disorder who underwent spontaneous vaginal delivery of twins with epidural analgesia. Postpartum hemorrhage from uterine atony, and cervical and vaginal lacerations were treated successfully with 1-desamino-8D-arginine vasopressin and blood products. The use of thromboelastography in the assessment and management of bleeding risk in the setting of platelet storage pool disorder is described.
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Int J Obstet Anesth · Apr 2011
ReviewInterventions at caesarean section for reducing the risk of aspiration pneumonitis.
Various interventions are used as prophylaxis for aspiration pneumonitis in obstetric anaesthesia. This review, based on a Cochrane systematic review currently being updated, examines whether interventions given before caesarean section reduce the risk of aspiration pneumonitis. ⋯ The quality of evidence was weak and may not reflect a reduction in the risk of aspiration pneumonitis since none of the studies assessed substantive clinical outcomes or potential adverse effects. Further work is required to validate the suitability of surrogate markers of pH and gastric volume for clinical outcomes in the context of aspiration pneumonitis.