International journal of obstetric anesthesia
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Int J Obstet Anesth · Aug 2016
Comparative StudyEphedrine versus ondansetron in the prevention of hypotension during cesarean delivery: a randomized, double-blind, placebo-controlled trial.
Maternal hypotension is common after spinal anesthesia for cesarean delivery. We compared the effects of prophylactic ephedrine with ondansetron on post-spinal blood pressure. ⋯ There was no significant difference in maternal blood pressure in women administered prophylactic ephedrine or ondansetron after spinal anesthesia for cesarean delivery compared with placebo. Ephedrine reduced the proportion of patients requiring a rescue vasoconstrictor before delivery.
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Int J Obstet Anesth · Aug 2016
Meta Analysis Comparative StudyDuration of motor block with intrathecal ropivacaine versus bupivacaine for caesarean section: a meta-analysis.
When used for Caesarean section, intrathecal ropivacaine results in faster recovery of motor block but no difference in onset, sensory duration or GA conversion when compared to bupivacaine.
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Int J Obstet Anesth · Aug 2016
Randomized Controlled Trial Comparative StudyA randomized controlled trial comparing Ametop™ with placebo for reducing pain associated with local anesthetic skin infiltration before neuraxial anesthesia in parturients.
Between 10-22% of the general population experience needle phobia. Needle phobic parturients are at increased risk of adverse outcomes. We assessed the efficacy of topical Ametop™ (tetracaine 4%) gel in reducing the pain associated with local anesthetic skin infiltration before neuraxial block in non-laboring women. ⋯ The mean numeric pain score in the Ametop™ group was 33% lower compared to the placebo group. Topical Ametop™ gel applied at least 20min before local anesthetic infiltration of the skin prior to neuraxial block in elective cesarean delivery may be a useful adjunct in needle phobic women.
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Although cardiac arrest in pregnancy is rare, it is important that all individuals involved in the acute care of pregnant women are suitably trained, because the outcome for both mother and fetus can be affected by the management of the arrest. Perimortem caesarean delivery was first described in 715 BC. Initially the procedure was performed principally for religious or political reasons. ⋯ While evidence is limited, it is probable that both maternal and fetal survival are improved with early delivery by perimortem caesarean delivery. More importantly, no evidence was found from case report reviews that either maternal or fetal survival was worsened. Perimortem caesarean delivery therefore remains a key consideration in the management of maternal arrest from the mid second trimester.