International journal of obstetric anesthesia
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Int J Obstet Anesth · Aug 2016
Comparative StudyEphedrine versus ondansetron in the prevention of hypotension during cesarean delivery: a randomized, double-blind, placebo-controlled trial.
Maternal hypotension is common after spinal anesthesia for cesarean delivery. We compared the effects of prophylactic ephedrine with ondansetron on post-spinal blood pressure. ⋯ There was no significant difference in maternal blood pressure in women administered prophylactic ephedrine or ondansetron after spinal anesthesia for cesarean delivery compared with placebo. Ephedrine reduced the proportion of patients requiring a rescue vasoconstrictor before delivery.
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Int J Obstet Anesth · Aug 2016
Prophylactic abdominal aorta balloon occlusion during caesarean section: a retrospective case series.
The management of patients with morbidly adherent placenta has been described using vascular balloon catheters placed in the iliac arteries, but rarely in the aorta. This case series presents our experience with prophylactic lower abdominal aorta balloon occlusion in 45 women. ⋯ Prophylactic lower abdominal aorta balloon occlusion has the potential to reduce intraoperative blood loss, transfusion and hysterectomy rate in patients with morbidly adherent placenta undergoing caesarean section. Careful patient selection is critical as the technique may be associated with potentially serious complications.
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Starting with the earliest biographies of James Young Simpson, the topic of religious opposition to obstetric anaesthesia in 1847 was gradually embellished in historical articles. Objective data are lacking and it has been suggested that this is a myth of recent medical history. ⋯ This revealed a marked increase (P<0.01) in the provision of anaesthesia for childbirth after the publication of Simpson's pamphlet in December 1847. This analysis supports the existence of opposition to obstetric anaesthesia and the success of Simpson's pamphlet in overcoming it, but the introduction of chloroform about six weeks earlier, may also have contributed.