International journal of obstetric anesthesia
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Int J Obstet Anesth · Jul 2013
Randomized Controlled TrialEfficacy of ultrasound-guided transversus abdominis plane blocks for post-cesarean delivery analgesia: a double-blind, dose-comparison, placebo-controlled randomized trial.
TAP blocks may offer some small analgesic benefit after caesarean section at 6h and 12h, but not 24h, in patients also receiving intrathecal morphine.
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Int J Obstet Anesth · Jul 2013
Outcomes after institution of a new oxytocin infusion protocol during the third stage of labor and immediate postpartum period.
Due to safety concerns when oxytocin is administered in an uncontrolled fashion, and recent dose-response data that indicate oxytocin's effectiveness at doses lower than those traditionally used, we instituted a new protocol for the infusion of oxytocin during the third stage of labor and in the immediate postpartum period. We undertook this study to confirm that this change in practice did not have untoward effects on postpartum hemorrhage rates. ⋯ Adoption of a protocol to infuse oxytocin in a controlled manner at a lower dose than that historically used was not associated with an increased incidence of postpartum hemorrhage.
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Int J Obstet Anesth · Jul 2013
Randomized Controlled TrialHaemodynamic effects of glycopyrrolate pre-treatment before phenylephrine infusion during spinal anaesthesia for caesarean delivery.
Phenylephrine given during spinal anaesthesia for caesarean delivery often induces a decrease in heart rate which may decrease cardiac output. Anticholinergic drugs may be given to attenuate this effect but may also cause more labile blood pressure. This study evaluated the effects of glycopyrrolate pre-treatment on non-invasively measured cardiac output and accuracy of blood pressure control. ⋯ Glycopyrrolate 4μg/kg given at the start of a phenylephrine infusion increased heart rate and cardiac output but also decreased accuracy of blood pressure control, increased the incidence of hypertension and caused an increased incidence of dry mouth postoperatively compared with control.