International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2019
Randomized Controlled TrialEffect of companion presence on maternal satisfaction during neuraxial catheter placement for labor analgesia: a randomized clinical trial.
Companion presence during labour epidural placement reduces maternal anxiety and improves maternal satisfaction.
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Int J Obstet Anesth · May 2019
Case ReportsRotational thromboelastometry (ROTEM®)-guided diagnosis and management of amniotic fluid embolism.
Point-of-care haemostasis testing may be helpful in rapidly diagnosing amniotic fluid embolism.
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Int J Obstet Anesth · May 2019
Case ReportsMultimodal general anesthesia approach for Ex Utero Intrapartum Therapy (EXIT) procedures: two case reports.
High-dose volatile anesthesia is the most common method of achieving uterine relaxation for Ex Utero Intrapartum Therapy (EXIT) procedures. Other methods employ nitroglycerin for additional uterine relaxation with or without remifentanil for additional fetal analgesia. We report a combination approach including one minimum alveolar concentration of volatile anesthetic plus nitroglycerin and remifentanil infusions, to provide timely uterine relaxation under general anesthesia for both mother and fetus, during two EXIT procedures.
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Int J Obstet Anesth · May 2019
Randomized Controlled Trial Comparative StudyComparison of the potency of phenylephrine and norepinephrine bolus doses used to treat post-spinal hypotension during elective caesarean section.
Phenylephrine, although considered the vasopressor of choice, can cause reflex bradycardia and a fall in cardiac output. Norepinephrine, due to its direct positive chronotropic and reflex negative chronotropic actions, is expected to overcome this problem. However, limited information about its effective dose for management of post-spinal hypotension, and its potency compared to phenylephrine, is available. ⋯ Based on the results of this study, norepinephrine is about 11 times more potent than phenylephrine. When used as bolus doses for treatment of hypotension, 100 μg phenylephrine should be approximately equivalent to 9 μg norepinephrine.
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Int J Obstet Anesth · May 2019
Increasing body mass index and abdominal subcutaneous fat thickness are associated with increased skin-to-epidural space distance in pregnant women.
Body mass index does not indicate the distribution of adipose tissue. Central adiposity may be measured using ultrasound measurement of subcutaneous fat thickness. This study determined if the abdominal subcutaneous fat thickness measured correlated with skin-to-epidural space distance at delivery, and compared this with the booking body mass index. ⋯ Booking body mass index had a stronger relationship with skin-to- epidural space distance at delivery than subcutaneous fat thickness, explaining 47% of the variation in the skin-to-epidural distance.