International journal of obstetric anesthesia
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Int J Obstet Anesth · Nov 2015
Randomized Controlled TrialDifferences in maternal temperature during labour with remifentanil patient-controlled analgesia or epidural analgesia: a randomised controlled trial.
Epidural analgesia and remifentanil patient-controlled analgesia are two popular techniques for the treatment of labour pain, each with its own efficacy and toxicity. ⋯ During treatment of labour pain, epidural analgesia is associated with a higher incidence of maternal fever, while remifentanil analgesia results in more frequent and deeper hypoxaemic events.
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Int J Obstet Anesth · Nov 2015
Randomized Controlled TrialA randomised controlled trial of the effect of an head-elevation pillow on intrathecal local anaesthetic spread in caesarean section.
A head-elevation pillow places a patient in a ramped posture, which maximises the view of the larynx during laryngoscopy, particularly in obese parturients. In our institution an elevation pillow is used pre-emptively for neuraxial anaesthesia. We hypothesised that head-elevation may impair cephalad spread of local anaesthetic before caesarean section resulting in a lower block or longer time to achieve a T6 level. We aimed to investigate the effect of head-elevation on spread of intrathecal local anaesthetics during anaesthesia for caesarean section. ⋯ Use of a ramped position with an head-elevation pillow following injection of the intrathecal component of a combined spinal-epidural anaesthetic for scheduled caesarean section was associated with a significantly lower block height at 10min.
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Int J Obstet Anesth · Nov 2015
Randomized Controlled TrialPostural change from lateral to supine is an important mechanism enhancing cephalic spread after injection of intrathecal 0.5% plain bupivacaine for cesarean section.
Spinal anesthesia is widely used for cesarean section, but the factors that affect the spread of the block in pregnant patients are still not fully explained. This study was designed to investigate the effect of postural changes on sensory block level. ⋯ In our population, using 0.5% plain bupivacaine 7.5mg, postural change from the lateral position to the supine position is an important mechanism enhancing cephalic spread of spinal anesthesia during late pregnancy.
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Int J Obstet Anesth · Nov 2015
Randomized Controlled TrialThe use of phenylephrine to obtund oxytocin-induced hypotension and tachycardia during caesarean section.
Oxytocin causes clinically significant hypotension and tachycardia. This study examined whether prior administration of phenylephrine obtunds these unwanted haemodynamic effects. ⋯ Intravenous phenylephrine 50 μg immediately before 3U oxytocin during elective caesarean section does not prevent maternal hypotension and tachycardia.