International journal of obstetric anesthesia
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Int J Obstet Anesth · Apr 2011
Randomized Controlled Trial Comparative StudyA randomised comparison of intravenous remifentanil patient-controlled analgesia with epidural ropivacaine/sufentanil during labour.
The μ-opioid agonist remifentanil has a rapid onset and offset and a short half-life making it an attractive option for intravenous patient-controlled labour analgesia. We aimed to compare the efficacy of intravenous remifentanil patient-controlled analgesia with epidural ropivacaine/sufentanil during labour. ⋯ In the 20 patients recruited to this study, pain relief in labour with epidural ropivacaine/sufentanil was more effective than with intravenous remifentanil patient-controlled analgesia.
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Int J Obstet Anesth · Apr 2011
Case ReportsThe use of thromboelastography for the peripartum management of a patient with platelet storage pool disorder.
We describe the peripartum management of a 26-year-old primigravida with a platelet storage pool disorder who underwent spontaneous vaginal delivery of twins with epidural analgesia. Postpartum hemorrhage from uterine atony, and cervical and vaginal lacerations were treated successfully with 1-desamino-8D-arginine vasopressin and blood products. The use of thromboelastography in the assessment and management of bleeding risk in the setting of platelet storage pool disorder is described.
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Int J Obstet Anesth · Apr 2011
Case ReportsAnaesthetic management of a patient with Liddle's syndrome for emergency caesarean hysterectomy.
We describe the anaesthetic management of a patient with Liddle's syndrome during caesarean section and emergency hysterectomy for placenta accreta associated with significant intrapartum haemorrhage. Liddle's syndrome is a rare autosomal dominant disorder characterised by early onset arterial hypertension and hypokalaemic metabolic alkalosis. ⋯ Initial management with a low-dose combined spinal-epidural technique was subsequently converted to general anaesthesia due to patient discomfort. The management of Liddle's syndrome in the setting of neuraxial and general anaesthesia in a patient undergoing caesarean section is discussed.