International journal of obstetric anesthesia
-
Int J Obstet Anesth · Oct 1997
Factors involved in the incidence of post-dural puncture headache with the 25 gauge Whitacre needle for obstetric anesthesia.
Parturients have the greatest risk of postdural puncture headache. use of a pencil-point needle, such as the 25 gauge Whitacre, has been associated with a lower incidence of PDPH. This observational study of 1009 obstetrical patients assessed possible factors related to the incidence of PDPH and other complications associated with spinal anesthesia using the 25 gauge Whitacre needle. The independent variables included procedure, maternal position at insertion, ease of insertion, intraoperative i.v. analgesia supplementation, use of intrathecal narcotics, parity and type of local anesthetic. ⋯ Six patients (0.59%) required epidural blood patch. There were eight (0.8%) failed finals which were converted to general anesthesia. None of the factors evaluated were significant in predicting the occurrence of PDPH.
-
Int J Obstet Anesth · Oct 1997
Randomized Controlled Trial Clinical TrialNalmefene or naloxone for preventing intrathecal opioid mediated side effects in cesarean delivery patients.
This study was designed to evaluate the efficacy of nalmefene vs. naloxone in preventing side effects resulting from intrathecal opioids, in patients undergoing cesarean delivery. Eighty patients who were scheduled for elective cesarean delivery under spinal anesthesia were included in a double-blind, placebo-controlled study. ⋯ There was a significant difference among the groups with respect to the occurrence of vomiting (P < 0.03): both nalmefene groups had a higher rate of vomiting than did the control group; the 0.25 microg.kg(-1) nalmefene group had a higher rate than did the naloxone group. The use of narcotic antagonists does not result in improved comfort in obstetrical patients receiving intrathecal morphine and fentanyl.
-
Int J Obstet Anesth · Oct 1997
Anaesthetic management of caesarean section in a parturient with acute myelodysplastic syndrome.
A 34-year-old pregnant woman developed a myelodysplastic syndrome during pregnancy which resulted in a refractory anaemia and an extreme thrombocytopenia. The report describes the anaesthetic management of elective caesarean section and successful childbirth in this patient. Following replacement therapy with packed red cells and platelets, general anaesthesia was used for the procedure.
-
Truncus arteriosus Type IV is a rare congenital cardiac malformation characterized by agenesis of the pulmonary arteries. Pulmonary perfusion is ensured by bronchial arteries. ⋯ Survival is rare without surgical correction. We report a case of uncorrected truncus arteriosus Type IV in a 28-year-old primigravid woman who underwent caesarean section.