International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2014
Preferred spoken language mediates differences in neuraxial labor analgesia utilization among racial and ethnic groups.
The aims of this study were to assess racial/ethnic disparities for neuraxial labor analgesia utilization and to determine if preferred spoken language mediates the association between race/ethnicity and neuraxial labor analgesia utilization. ⋯ This study provides evidence that preferred spoken language mediates the relationship between Hispanic ethnicity and neuraxial labor analgesia utilization.
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We report a novel circumstance of brachial plexus anesthesia in a parturient. A 25-year-old woman at 34 weeks of gestation presented with a pathologic proximal right humerus fracture from an intramedullary mass. She was scheduled for tumor biopsy which was performed using a two-site ultrasound-guided brachial plexus block to maximize odds of complete anesthesia while minimizing the risk of phrenic nerve paresis. ⋯ In the post-anesthesia care unit, she had normal respirations and oxygen saturations breathing room air, denied any shortness of breath or difficulty breathing, and was discharged shortly after her arrival. While we did not pursue radiologic examination to rule out hemidiaphragm paralysis, we assumed, as evidenced in a previous case report, that unlike most healthy patients, a parturient would demonstrate some clinical signs and/or symptoms of hemidiaphragm paralysis, given that the diaphragm is almost totally responsible for inspiration in the term parturient. This represents only the second brachial plexus block in a parturient reported in the literature; the first using ultrasound guidance and without respiratory embarrassment.
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Int J Obstet Anesth · May 2014
Relaxant effects of metoclopramide and magnesium sulfate on isolated pregnant myometrium: an in vitro study.
Metoclopramide and magnesium sulfate are extensively used agents in obstetrics. In this study, the relaxant properties of metoclopramide and magnesium sulfate on pregnant myometrium, together with the possible reversing influences of oxytocin and cabergoline (a dopamine D2 receptor agonist), were investigated. ⋯ Both magnesium sulfate and metoclopramide relaxed myometrial contractions, and exhibited different responses to subsequent oxytocin treatment. The relaxant mechanism of metoclopramide may be via blockade of dopamine D2 receptor, which requires further investigation.