International journal of obstetric anesthesia
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We report a case of adult onset epiglottitis needing emergent tracheal intubation in a parturient at 11 weeks gestational age.
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We report a case of a parturient with documented chronic Chagas' disease with cardiac manifestations presenting for labor management and complicated by the need for emergent hysterectomy after delivery. Chagas' disease is a common human hematogenous trypanosomiasis in Central and South America which is now, because of population migration, appearing in the USA. This disease predominantly affects the heart and the gastrointestinal system. This report discusses the parasite, the acute and chronic phases of Chagas' disease and highlights its medical implications, including maternal-fetal transfer of Trypanosoma cruzi.
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PCEA is an attractive concept with special benefits in the obstetric population. It provides a safe and valuable alternative to other approaches to labour analgesia, with demonstrable advantages when used appropriately by motivated women. ⋯ Despite promising initial results, the full potential of PCEA remains to be explored, and this may be encouraged by ongoing developments in PCA pump technology. Comprehensive comparative studies and large prospective clinical series, further defining its role and safety in various settings, are awaited.
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Int J Obstet Anesth · Apr 1996
Discomfort associated with regional anesthetic placement in obstetrics: does alkalinization help?
Lidocaine is commonly used prior to intravenous catheter insertion as well as before instituting a regional anesthetic[ but it often causes a burning discomfort during injection. We undertook this study to determine if the addition of bicarbonate to lidocaine would decrease the discomfort associated with the initiation of regional anesthesia in obstetrics. Forty patients who were scheduled for elective cesarean section or who were in active labor were selected. ⋯ Pain was assessed using visual analog scales on three occasions, immediately after lidocaine placement, following introducer needle insertion (in the spinal group) or following epidural needle insertion (in the epidural group), and following the successful placement of the local anesthetic (in the spinal group) or the epidural catheter (in the epidural group). There was no difference in the visual analog scale scores at any of the assessment periods. We found no benefit from adding sodium bicarbonate to lidocaine used for infiltration before needle placement when initiating an obstetrical regional anesthetic.