International journal of obstetric anesthesia
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Int J Obstet Anesth · Aug 2018
Randomized Controlled TrialThe effect of a single intraoperative dose of intravenous dexamethasone 8 mg on post-cesarean delivery analgesia: a randomized controlled trial.
A single perioperative dose of dexamethasone has been shown to improve postoperative analgesia and reduce opioid consumption. However, this analgesic and opioid sparing effect has not been well assessed as part of a multimodal analgesic regimen in women post-cesarean delivery. ⋯ The addition of intravenous dexamethasone 8 mg to a multimodal postoperative analgesic regimen that included intrathecal morphine, in women who had a cesarean delivery under spinal anesthesia, did not reduce 24 hour postoperative opioid consumption.
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Int J Obstet Anesth · Aug 2018
Randomized Controlled TrialPruritus after intrathecal morphine for cesarean delivery: incidence, severity and its relation to serum serotonin level.
Pruritus is the most common side effect of intrathecal morphine, especially in parturients. The exact mechanism is not clear and many possible mechanisms have been suggested. Among these is the activation of the 5-hydroxytryptamine sub-type-3 receptors by intrathecal morphine. ⋯ The serum serotonin level increased significantly in the postoperative period in both groups, suggesting a role of serotonin in the genesis of intrathecal morphine-induced pruritus.
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Int J Obstet Anesth · Aug 2018
Randomized Controlled TrialThe optimal concentration of bupivacaine and levobupivacaine for labor pain management using patient-controlled epidural analgesia: a double-blind, randomized controlled trial.
The study aim was to evaluate the efficacy and safety of different low concentrations of two local anesthetics for labor analgesia using patient-controlled epidural analgesia. ⋯ Higher local anesthetic concentration resulted in higher total doses infused and greater motor block. Labor analgesia was less effective when the lowest concentrations were used, but patient satisfaction was unaffected.
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Int J Obstet Anesth · Aug 2018
ReviewA review of blood pressure measurement in obese pregnant women.
Blood pressure monitoring is a critical component of antenatal, peripartum and postnatal care. The accurate detection and treatment of abnormal blood pressure during pregnancy is essential for the optimisation of maternal and neonatal outcomes. Increasing maternal obesity in western populations is well documented. ⋯ The limitations of the current validation protocols in pregnancy will be highlighted. It is concluded that a pregnancy-specific validation protocol is required: this would facilitate the introduction of new technology for use in high-risk pregnant women. More accurate blood pressure measurement has the potential to improve the diagnosis and management of abnormal blood pressure in pregnancy and influence maternal and neonatal outcomes.
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Int J Obstet Anesth · Aug 2018
Neuraxial block for delivery among women with low platelet counts: a retrospective analysis.
Laboring women with low platelet counts may be denied neuraxial block due to concerns about causing a spinal-epidural hematoma. ⋯ This study contributes a substantial series of neuraxial blocks among women with low platelet counts. The findings support that the risk of hematoma is low if the platelet count is <100 000/μL, specifically between 70 and 99 000/μL. Risk assessment in the lower count ranges requires a much larger sample.