International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 2011
Randomized Controlled TrialHemodynamic effects of a right lumbar-pelvic wedge during spinal anesthesia for cesarean section.
Aortocaval compression is a major cause of maternal hypotension. A randomized controlled trial was designed to determine the effectiveness of a mechanical intervention using a right lumbar-pelvic wedge in preventing hypotension after spinal anesthesia for cesarean delivery. ⋯ In our study population the use of right lumbar-pelvic wedge was not effective in reducing the incidence of hypotension during spinal anesthesia for cesarean section. Patients in whom the wedge was used had higher systolic blood pressure values during the first 5 min of anesthesia and fewer episodes of nausea. The risk of hypotension remains substantial.
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Int J Obstet Anesth · Oct 2011
Randomized Controlled TrialThe effect on maternal temperature of delaying initiation of the epidural component of combined spinal-epidural analgesia for labor: a pilot study.
Labor epidural analgesia is associated with maternal hyperthermia. This pilot study compared the effects on maternal temperature during labor of different timing of initiation of the epidural component of combined spinal-epidural analgesia. ⋯ Delaying the epidural component of combined spinal-epidural analgesia did not significantly affect maternal temperature in the study population of whom 83.3% had a labor of <5 h. However, this study was underpowered to detect a difference in the incidence of fever and a larger prospective study is required.
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Int J Obstet Anesth · Oct 2011
Letter Randomized Controlled TrialEpidural catheter migration during labor: a comparison between standard and Epi-Guard fixation.
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Int J Obstet Anesth · Jul 2011
Randomized Controlled Trial Comparative StudySerum oxytocin concentrations in elective caesarean delivery: a randomized comparison of three infusion regimens.
The aim of this study was to determine serum oxytocin concentrations following different regimens of prophylactic oxytocin administration in women undergoing elective caesarean delivery. ⋯ Serum oxytocin measurements made using enzyme immunoassay in healthy pregnant women undergoing elective caesarean delivery showed that administration of 80 IU oxytocin over 30 min resulted in higher serum oxytocin levels after 5 and 30 min than the two other regimens. The concentrations did not differ between groups at 60 min.
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Int J Obstet Anesth · Jul 2011
Randomized Controlled Trial Comparative StudyComparison of relative potency of intrathecal bupivacaine for motor block in pregnant versus non-pregnant women.
Pregnancy is associated with facilitated spread of spinal and epidural anesthesia. There are limited data available for relative potency of motor block of neuraxial local anesthetics in non-pregnant versus pregnant women. The purpose of this study was to investigate the median effective dose (ED(50)) of intrathecal isobaric bupivacaine for motor block in non-pregnant and pregnant women and to estimate the respective potency ratio. ⋯ Intrathecal bupivacaine was 1.14 times more potent for motor block in pregnant versus non-pregnant women. Our current data confirm the difference in local anesthetic requirement between non-pregnant and pregnant patients.