International journal of obstetric anesthesia
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Int J Obstet Anesth · Aug 2014
Randomized Controlled TrialPrevention versus treatment of intrathecal morphine-induced pruritus with ondansetron.
Intrathecal morphine is used for post-cesarean analgesia, but pruritus is a common side effect. Ondansetron would be an attractive treatment because it prevents nausea, is non-sedative or has no anti-analgesic effect. We undertook a study to assess the efficacy of ondansetron for treatment or prophylaxis of intrathecal morphine-induced pruritus. ⋯ Prophylactic ondansetron did not reduce pruritus when compared with placebo. The use of ondansetron as a treatment did not decrease the severity of pruritus when compared with placebo.
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Int J Obstet Anesth · Aug 2014
Randomized Controlled Trial Comparative StudySpinal anaesthesia for caesarean section: an ultrasound comparison of two different landmark techniques.
Spinal anaesthesia performed at levels higher than the L3-4 intervertebral space may result in spinal cord injury. Our aim was to establish a protocol to reduce the chance of spinal anaesthesia performed at or above L2-3. ⋯ Our data suggest that when performing spinal anaesthesia in pregnant patients, if the intercristal line intersects an intervertebral space then the space below should be chosen and if the intercristal line intersects a spinous process then the interspace below should be chosen. This will reduce the incidence of spinal anaesthesia performed at or above L2-3.
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Int J Obstet Anesth · Aug 2014
Randomized Controlled TrialEvaluation of levobupivacaine passage to breast milk following epidural anesthesia for cesarean delivery.
Following maternal administration, local anesthetics pass into breast milk. In the present study, we aimed to compare the passage of levobupivacaine and bupivacaine into breast milk following epidural anesthesia for cesarean delivery. ⋯ Both levobupivacaine and bupivacaine pass into breast milk following epidural administration. The concentration of both drugs was approximately three times lower in breast milk than in maternal plasma.
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Int J Obstet Anesth · Aug 2014
Randomized Controlled Trial Comparative StudyUltrasound-guided spinal anaesthesia in obstetrics: is there an advantage over the landmark technique in patients with easily palpable spines?
Data are scarce on the advantage of ultrasound-guided spinal anaesthesia in patients with easily identifiable bony landmarks. In this study, we compared the use of ultrasound to the landmark method in patients with no anticipated technical difficulty, presenting for caesarean delivery under spinal anaesthesia. ⋯ The present results indicate that when performed by anaesthetists experienced in both ultrasound and landmark techniques, the use of ultrasound does not appear to increase the success rate of spinal anaesthesia, or reduce the procedure time or number of attempts in obstetric patients with easily palpable spines.