International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 2012
Case ReportsAnesthetic management of a spontaneous spinal-epidural hematoma during pregnancy.
Spontaneous spinal-epidural hematoma is uncommon and rare during pregnancy. We were presented with a 31-year-old patient who developed back pain with lower extremity paralysis at 36 weeks of gestation. ⋯ Postoperatively, dopamine was infused to maintain the blood pressure within the high-normal range to optimize spinal cord perfusion. Successful anesthetic and postoperative management is described together with a review of the literature.
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Int J Obstet Anesth · Apr 2012
Case ReportsAcute intrathecal haematoma following neuraxial anaesthesia: diagnostic delay after apparently normal radiological imaging.
We describe a case of intrathecal haematoma following combined spinal-epidural anaesthesia for caesarean section. The parturient was previously well with no risk factors for haematoma development. ⋯ Incorrect interpretation of clinical findings and magnetic resonance imaging contributed to the delay in definitive treatment. We discuss the difficulties in diagnosis, image interpretation and the need for a specialist opinion when abnormal neurological symptoms persist despite apparently normal imaging.
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Int J Obstet Anesth · Apr 2012
Case ReportsA combined spinal-epidural technique for labor analgesia and symptomatic relief in two parturients with idiopathic intracranial hypertension.
Idiopathic intracranial hypertension is a condition consisting of increased intracranial pressure of unknown etiology, predominantly affecting obese women of childbearing age. Symptomatic relief can be provided by lumbar puncture and withdrawal of cerebrospinal fluid, and the technique has been described in laboring women using an intrathecal catheter. We present two patients who achieved both labor analgesia and symptomatic relief via a combined spinal-epidural technique with small volume cerebrospinal fluid withdrawal. ⋯ One patient proceeded to cesarean delivery for fetal indications under epidural anesthesia. Both women described significant improvement in headache symptoms that persisted until discharge from hospital, and neither developed new neurologic symptoms. A combined spinal-epidural technique with a small volume of cerebrospinal fluid withdrawal may provide labor analgesia and symptomatic relief in the parturient with idiopathic intracranial hypertension.
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Int J Obstet Anesth · Apr 2012
Letter Randomized Controlled TrialTwo doses of spinal bupivacaine for caesarean delivery in severe preeclampsia: a pilot study.