International journal of obstetric anesthesia
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Int J Obstet Anesth · Nov 2019
Review Meta AnalysisInduction opioids for caesarean section under general anaesthesia: a systematic review and meta-analysis of randomised controlled trials.
Remifentanil and alfentanil effectively reduce the pressor response to intubation for general anaesthesia cesarean section, without depressing neonatal Apgar scores.
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Int J Obstet Anesth · Nov 2019
Case ReportsSuccessful treatment of a recurrent post-dural puncture headache with an epidural blood patch 18 months after the initial dural puncture.
Inadvertent dural puncture is a recognised complication of epidural insertion. Parturients are at increased risk of developing a post-dural puncture headache, which can be debilitating for a mother caring for a newborn infant. ⋯ We present the case of a woman with a recurrent post-dural puncture headache who was successfully treated with an epidural blood patch 18 months after the initial dural puncture. Patients who develop post-dural puncture headaches may remain symptomatic for some time and an epidural blood patch may be beneficial, following appropriate investigation.
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Int J Obstet Anesth · Nov 2019
Meta AnalysisCarbetocin reduces the need for additional uterotonics in elective caesarean delivery: a systematic review, meta-analysis and trial sequential analysis of randomised controlled trials.
Carbetocin has been found to be superior to oxytocin in terms of need for additional uterotonics and prevention of postpartum haemorrhage at caesarean delivery. However, this is based on combined data from labouring and non-labouring parturients and it remains unclear how effective carbetocin is in the purely elective setting. The aim of this review was to compare carbetocin to oxytocin in elective caesarean delivery. ⋯ Carbetocin is associated with a reduced need for additional uterotonics when compared with oxytocin at elective caesarean delivery. Standardisation of bleeding-related outcomes in studies is necessary to facilitate synthesis of data in future analyses.
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Int J Obstet Anesth · Nov 2019
Need for additional anesthesia after single injection spinal analgesia for labor: a retrospective cohort study.
There is little information about the use and efficacy of single injection spinal blocks for labor analgesia; specifically, how frequently subsequent analgesia or anesthesia is needed. This study determined how frequently an additional anesthetic intervention was needed in women who received single injection spinal analgesia. ⋯ This retrospective review provides evidence that single injection spinal anesthesia may be used for multiparous women with spontaneous labor and more advanced cervical dilation.