International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2023
Persistent opioid use after cesarean delivery in the United States of America: a systematic review.
This systematic review assessed the incidence of persistent opioid use after cesarean delivery in opioid-naïve individuals in the United States of America (USA). ⋯ Findings emphasize the importance of developing a standardized definition of persistent opioid use to accurately assess the risk, rate, and trends for persistent opioid use among opioid-naïve individuals undergoing cesarean delivery.
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Int J Obstet Anesth · Feb 2023
Comment ReviewChallenges and pitfalls of extracorporeal membrane oxygenation in critically-ill pregnant and peripartum women with COVID-19: a retrospective case series.
Available data identify pregnancy as a strong determinant of a severe course of COVID-19 with increased mortality. Extracorporeal membrane oxygenation (ECMO) remains the last resort treatment in the critical course of COVID-19 yet may increase the risk of excessive bleeding, especially in the immediate post-cesarean section period. One in five patients receiving ECMO during the COVID-19 pandemic were women who were pregnant or postpartum. While the risk of critical respiratory failure in the peripartum period is high, in an early survey only 52% of pregnant patients intended to receive the COVID-19 vaccine. ⋯ ECMO is feasible in the third trimester but not devoid of complications. The severity of respiratory failure during COVID-19 and extracorporeal support may not adversely impact neonatal outcomes.
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Int J Obstet Anesth · Nov 2022
ReviewPeripartum anesthetic management in patients with left ventricular noncompaction: a case series and review of the literature.
This retrospective review focuses on peripartum anesthetic management and outcome of a series of five pregnant women with left ventricular noncompaction (LVNC). ⋯ This case series adds new evidence to that already available about pregnancies among women with LVNC. Favorable obstetrical outcomes were achievable when multidisciplinary teams were prepared to manage the maternal and fetal consequences of intrapartum cardiac arrhythmias and hemodynamic instability.
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Int J Obstet Anesth · Aug 2022
ReviewThe role of total intravenous anaesthesia for caesarean delivery.
Obstetric general anaesthesia technique usually involves intravenous induction and maintenance with volatile agents. Total intravenous anaesthesia has gained in popularity in non-obstetric practice because of environmental concerns associated with volatile inhalational anaesthetics and evidence of a superior recovery profile. ⋯ However, there are practical barriers to utilising total intravenous anaesthesia in obstetric anaesthesia. We discuss the evidence and potential role of total intravenous anaesthesia for caesarean delivery.