International journal of obstetric anesthesia
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Int J Obstet Anesth · Feb 2014
Randomized Controlled Trial Comparative StudyRemifentanil versus placebo for analgesia during external cephalic version: a randomised clinical trial.
Breech presentation occurs in up to 3% of pregnancies at term and may be an indication for caesarean delivery. External cephalic version can be effective in repositioning the fetus in a cephalic presentation, but may be painful for the mother. Our aim was to assess the efficacy of remifentanil versus placebo for pain relief during external cephalic version. ⋯ Intravenous remifentanil with bolus doses on demand during external cephalic version achieved a reduction in pain and increased maternal satisfaction. There were no additional adverse effects, and no difference in the success rate of external cephalic version or the incidence of fetal bradycardia.
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Int J Obstet Anesth · Feb 2014
Randomized Controlled Trial Comparative StudyA randomized comparison of onset of anesthesia between spinal bupivacaine 5mg with immediate epidural 2% lidocaine 5mL and bupivacaine 10mg for cesarean delivery.
Previous studies using low-dose spinal anesthesia for cesarean delivery have focused on hypotension and efficacy. This study evaluated whether, using a combined spinal-epidural technique, there was a difference in onset of anesthesia for cesarean delivery between low-dose spinal with an immediate epidural local anesthetic bolus, and conventional-dose spinal anesthesia. ⋯ Intrathecal bupivacaine 5 mg with immediate 2% epidural lidocaine 5 mL provided comparable onset and efficacy of anesthesia as bupivacaine 10 mg with immediate epidural normal saline 5 mL for cesarean delivery.