International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2019
Randomized Controlled TrialUltrasound guided L5-S1 placement of labor epidural does not improve dermatomal block in parturients.
Based on their experience or training, anesthesiologists typically use the iliac crest as a landmark to choose the L3-4 or L2-3 interspace for labor epidural catheter placement. There is no evidence-based recommendation to guide the exact placement. We hypothesized that lower placement of the catheter would lead to a higher incidence of S2 dermatomal block and improved analgesia in late labor and at delivery. ⋯ Placement of an epidural catheter at the L5-S1 interspace using ultrasound did not improve sacral sensory block coverage when compared with an epidural catheter placed at a higher lumbar interspace, without using ultrasound guidance.
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Int J Obstet Anesth · May 2019
Letter Randomized Controlled TrialIn vitro intravenous fluid co-load rates with and without an intravenous fluid warming device.
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Int J Obstet Anesth · Feb 2019
Randomized Controlled TrialProphylactic infusion of phenylephrine is effective in attenuating the decrease in regional cerebral blood volume and oxygenation during spinal anesthesia for cesarean section.
Hypotension induced by spinal anesthesia for cesarean section causes a decrease in maternal regional cerebral blood volume and oxygenation. We used near-infrared spectroscopy to determine whether prophylactic infusion of phenylephrine attenuates these decreases. ⋯ Prophylactic infusion of phenylephrine, especially at 25 µg/min, can effectively suppress decreases in regional cerebral blood volume and regional cerebral blood oxygenation after induction of spinal anesthesia for cesarean section.
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Int J Obstet Anesth · Nov 2018
Randomized Controlled TrialAcupuncture for reducing pruritus induced by intrathecal morphine at elective cesarean delivery: a placebo-controlled, randomized, double-blind trial.
Intrathecal morphine is a standard postoperative analgesic administered after cesarean delivery, but frequently causes pruritus. Acupuncture reportedly resolves refractory pruritus in certain patients. The aim of the study was to investigate the effectiveness of acupuncture in preventing pruritus induced by intrathecal morphine. ⋯ Preoperatively administered acupuncture using press needles did not decrease intrathecal morphine-induced pruritus or the requirement for treatment.
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Int J Obstet Anesth · Aug 2018
Randomized Controlled TrialPruritus after intrathecal morphine for cesarean delivery: incidence, severity and its relation to serum serotonin level.
Pruritus is the most common side effect of intrathecal morphine, especially in parturients. The exact mechanism is not clear and many possible mechanisms have been suggested. Among these is the activation of the 5-hydroxytryptamine sub-type-3 receptors by intrathecal morphine. ⋯ The serum serotonin level increased significantly in the postoperative period in both groups, suggesting a role of serotonin in the genesis of intrathecal morphine-induced pruritus.