International journal of obstetric anesthesia
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Int J Obstet Anesth · Feb 2021
Randomized Controlled TrialPre-operative carbohydrate loading prior to elective caesarean delivery: a randomised controlled trial.
Women undergoing elective caesarean deliveries are fasted for long periods prior to surgery and can become catabolic. The use of pre-operative carbohydrate drinks to optimise patients ahead of major surgery is now well established. However, evidence to support this in women undergoing elective caesarean delivery is limited. ⋯ The results of this study support the introduction of carbohydrate drinks ahead of caesarean delivery to offset the effects of pre-operative fasting. However, the results may not be generalisable to all maternity units due to differences in fasting protocols.
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Int J Obstet Anesth · Feb 2021
The incidence of dry chlorhexidine gluconate transfer from skin to surgical gloves: a simulation and in vitro study.
To prevent alcohol-based chlorhexidine from reaching the cerebrospinal fluid, it is recommended that the antiseptic solution be allowed to dry before skin palpation or puncture. However, no guidelines specify a drying time interval. Manufacturers recommend 3 min of air drying, based upon the isopropyl alcohol component. Therefore, to fill this knowledge gap, we designed a simulation study to investigate the incidence of primary chlorhexidine transfer from skin to gloves following three drying time intervals. We also investigated the incidence of secondary chlorhexidine transfer from gloves to another surface following one drying time interval. ⋯ Gloves are routinely contaminated with chlorhexidine during central neuraxial blockade. The high incidence of secondary transfer in our simulation suggests a pathway by which chlorhexidine may gain access to the neuraxial space.
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Int J Obstet Anesth · Feb 2021
Observational StudyA prospective observational study to investigate the relationship between local anesthetic infiltration pain before spinal anesthesia and acute and chronic postsurgical pain in women undergoing elective cesarean delivery.
Cesarean delivery is one of the most common procedures performed worldwide. We conducted this prospective cohort study to evaluate the association between local anesthetic infiltration (LAI) pain prior to spinal anesthesia and pain and morphine consumption within 24 h after cesarean delivery (primary outcomes). A secondary objective was to assess the association between LAI pain and pain at one month postoperatively. ⋯ Pain from LAI prior to spinal anesthesia is significantly associated with subsequent postoperative pain both acutely and at one month in women scheduled for elective cesarean delivery under spinal anesthesia.