International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2020
Fentanyl concentration in maternal and umbilical cord plasma following intranasal or subcutaneous administration in labour.
The effect that the route of maternal fentanyl administration has on placental transfer of drug to the neonate is not well studied. Plasma concentration ratios are an indicator of fetal exposure, relative to the mother. ⋯ This study is the first to examine fetal and maternal fentanyl concentrations after subcutaneous administration. This research supports the safe use of fentanyl for labour analgesia for women.
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Int J Obstet Anesth · May 2020
Letter Case ReportsIsolated chronic tinnitus after neuraxial labor analgesia.
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Int J Obstet Anesth · May 2020
Case ReportsA case of local anesthetic toxicity that wasn't: lipid rescue from self-administered benzodiazepine overdose in labor.
A 32-year-old G2P1 woman presented for induction of labor at term. Her past medical history included polysubstance use disorder and methadone maintenance, scant prenatal care, morbid obesity, and intimate partner violence. Her induction was progressing smoothly until the acute onset of altered mental status near to the time of delivery, several minutes after a clinician-administered epidural local anesthetic bolus for significant pain. ⋯ Shortly after this event, it was discovered that the patient had been self-administering benzodiazepines throughout the course of her labor, in addition to her hospital staff-administered medications. Presumably, her intrapartum altered mental status was a result of self-administered benzodiazepine that was then "rescued" with lipid emulsion. This case illustrates the potential for lipid emulsion as a reversal agent for medications other than local anesthetics.