International journal of obstetric anesthesia
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Int J Obstet Anesth · Oct 1996
Maternal expectations and experiences of labour pain and analgesia: a multicentre study of nulliparous women.
Six hospitals with large maternity units in five different European countries were involved in this multicentre study. At least 100 primiparae for each country were examined. All mothers received two standardized interviews, one during the last month of pregnancy, and one 24 h after delivery. ⋯ Maternal expectations of labor pain and the answers to the pre-delivery interview varied significantly between the centers, as did maternal knowledge, expectation and ultimate choice of analgesic technique. Generally speaking the level of maternal satisfaction with analgesia and childbirth experience was high; however, epidural analgesia was more effective than other methods of pain relief (P<0.0001). The most satisfied mothers were those who expected more pain, were satisfied with the analgesia received and had good pain relief after analgesia (P<0.001).
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Int J Obstet Anesth · Oct 1996
Comparison of 15 mg and 25 mg of bupivacaine both with 50 microg fentanyl as initial dose for epidural analgesia.
Bupivacaine 15 mg is commonly used as a test dose prior to the initial dose for epidural analgesia in labour. When 15 mg or 25 mg of bupivacaine (15 ml of 0.1% or 0.167%) with 50 microg fentanyl was administered blindly to two groups of labouring women, as an initial dose, 83% and 90% of women respectively, achieved analgesia within 20 min. All the remaining women achieved analgesia with a further dose of 10 mg bupivacaine (10 m10.1%) with fentanyl 2 microg per ml given at 20 min.
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Int J Obstet Anesth · Oct 1996
Dystrophia myotonica: combined spinal-epidural anaesthesia for caesarean section.
Patients with dystrophia myotonica requiring caesarean section pose significant problems for the anaesthetist. This report describes the successful use of a combined spinal-epidural technique for anaesthesia and postoperative analgesia in such a patient.
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Int J Obstet Anesth · Oct 1996
A case of postoperative anxiety due to low dose droperidol used with patient-controlled analgesia.
A multiparous woman in good psychological health underwent urgent caesarean section in labour. Postoperatively, she was given a patient-controlled analgesia device delivering boluses of diamorphine 0.5 mg and droperidol 0.025 mg. ⋯ After she had received a total of only 0.9 mg droperidol, a syringe containing diamorphine only was substituted and her unease resolved completely. We feel that, although the dramatic extrapyramidal side effects of dopaminergic antiemetics are well known, more subtle manifestations may easily be overlooked.