International journal of obstetric anesthesia
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Int J Obstet Anesth · Aug 2015
Blood pressure assessment and first-line pharmacological agents in women with eclampsia.
Eclampsia is a life-threatening complication of pregnancy. Timely blood pressure assessment and administration of magnesium sulphate are essential management. In this retrospective single-centre study we examined the timing and magnitude of maternal blood pressure before eclampsia, and whether magnesium sulphate was administered as the first agent for treatment. ⋯ Our study highlights the need for vigilance when managing pregnant women with hypertension, especially in the third trimester as eclampsia is most likely preceded by raised blood pressure. It also highlights the need for timely commencement of magnesium sulphate in the community and during transfer to hospital for the treatment of eclampsia, and for prevention of eclampsia in hospital when thresholds for severe preeclampsia are met.
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Int J Obstet Anesth · Aug 2015
Letter Case ReportsSpinal subdural haematoma after an epidural blood patch.
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Int J Obstet Anesth · Aug 2015
Review Meta AnalysisA systematic review of the effects of adding neostigmine to local anesthetics for neuraxial administration in obstetric anesthesia and analgesia.
Drugs used in obstetric patients must accomplish two goals: efficacy and safety for both mother and fetus. Neostigmine has been co-administered epidurally and intrathecally with local anesthetics and other adjuncts in the obstetric setting. The aim of this meta-analysis was to assess the efficacy and incidence of adverse events related to the use of neostigmine in obstetric anesthesia. ⋯ Neuraxial administration of neostigmine significantly reduces local anesthetic consumption without serious adverse side effects to the mother or fetus. However, neostigmine is only recommended for epidural administration as intrathecal use significantly increases the incidence of maternal nausea and vomiting.