International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2017
Randomized Controlled TrialDoes the addition of active body warming to in-line intravenous fluid warming prevent maternal hypothermia during elective caesarean section? A randomised controlled trial.
Inadvertent perioperative hypothermia occurs frequently during elective caesarean section but perioperative active body warming is not widely used. There is a paucity of evidence of its use in the obstetric population, and no applicable guidelines. We set out to identify a superior active warming method for preventing inadvertent perioperative hypothermia. ⋯ In-line intravenous fluid warming is sufficient to prevent maternal hypothermia and maintain core temperature. The addition of active body warming conferred no added benefit.
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Int J Obstet Anesth · May 2017
Case ReportsParaplegia after accidental continuous subdural analgesia.
Almost all reported cases of unintentional subdural block have described a reversible disorder. We report a patient who developed an incomplete mixed sensory and motor neurological deficit after accidental continuous subdural infusion of 0.1% levobupivacaine given to provide postoperative analgesia after cesarean section. Our report shows that accidental continuous subdural injection can cause permanent neurological sequelae. In the event of suspected compressive neural damage, subdural fluid accumulation, although very rare, should be considered.
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Int J Obstet Anesth · May 2017
Anaesthesia for abnormally invasive placenta: a single-institution case series.
Abnormally invasive placenta describes a spectrum of disorders resulting in pathological placental implantation. It is associated with the potential for severe maternal haemorrhage and poor fetal outcome. Increasing numbers of women are at risk owing to the rising incidence of uterine surgery and increasing maternal age. We report data over a five-year period describing anaesthetic management of cases of abnormally invasive placenta in a UK tertiary-referral maternity unit and assess how management has developed. ⋯ Our data illustrate the burden on healthcare resources associated with management of abnormally invasive placenta, underlining the continued need for centralised services for treatment of these complex cases. An integrated multidisciplinary approach to case planning, case management and service provision is key to a successful outcome in these cases.
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Int J Obstet Anesth · May 2017
What's trending now? An analysis of trends in internet searches for labor epidurals.
The study aim was to investigate internet use for obtaining information about epidurals for labor and delivery. ⋯ The findings provide an insight into internet use by those seeking information about labor analgesic options. Identifying the most common and rapidly increasing online search queries may guide physician-parturient interactions and online content creation, to address labor analgesic topics that most interest users.