International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2017
Randomized Controlled TrialSafety and effectiveness of alveolar recruitment maneuvers and positive end-expiratory pressure during general anesthesia for cesarean section: a prospective, randomized trial.
During cesarean section, the supine position reduces functional residual capacity and worsens lung compliance. We tested the hypothesis that alveolar recruitment maneuvers and positive end-expiratory pressure improve lung compliance in women undergoing general anesthesia for cesarean section. ⋯ Compared to standard care, the alveolar recruitment maneuver with positive end-expiratory pressure and low tidal volumes appears safe and effective in improving lung compliance and both intraoperative and postoperative oxygenation in women undergoing general anesthesia for elective cesarean section.
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Int J Obstet Anesth · May 2017
Randomized Controlled TrialOptimal intrathecal hyperbaric bupivacaine dose with opioids for cesarean delivery: a prospective double-blinded randomized trial.
Single-shot spinal anesthesia is commonly used for cesarean delivery. Achieving adequate anesthesia throughout surgery needs to be balanced with associated complications. We investigated the optimal dose of intrathecal hyperbaric bupivacaine, co-administered with opioids, for anesthesia for cesarean delivery. ⋯ Under study conditions, our results suggest that 12.6mg of intrathecal bupivacaine, administered with fentanyl and morphine, is required to achieve adequate intraoperative analgesia without the need for epidural supplemention.
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Int J Obstet Anesth · May 2017
Randomized Controlled TrialThe effect of nefopam on lactation after caesarean section: a single-blind randomised trial.
Nefopam is a centrally acting analgesic which has a theoretical risk of stopping lactation due to its anticholinergic and dopaminergic effects. The aim of this study was to evaluate the effect of nefopam on lactation and to investigate potential adverse effects on newborns. ⋯ Nefopam does not appear to delay the onset of lactation or present any clear risk to the newborn.
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Int J Obstet Anesth · Feb 2017
Randomized Controlled Trial Comparative StudyAn open-label randomized controlled clinical trial for comparison of continuous phenylephrine versus norepinephrine infusion in prevention of spinal hypotension during cesarean delivery.
During spinal anesthesia for cesarean delivery phenylephrine is the vasopressor of choice but can cause bradycardia. Norepinephrine has both β- and α-adrenergic activity suitable for maintaining blood pressure with less bradycardia. We hypothesized that norepinephrine would be superior to phenylephrine, requiring fewer rescue bolus interventions to maintain blood pressure. ⋯ Norepinephrine fixed-rate infusion has efficacy for preventing hypotension and can be considered as an alternative to phenylephrine.
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Int J Obstet Anesth · Feb 2017
Randomized Controlled TrialOptimal hand washing technique to minimize bacterial contamination before neuraxial anesthesia: a randomized control trial.
Infectious complications related to neuraxial anesthesia may result in adverse outcomes. There are no best practice guidelines regarding hand-sanitizing measures specifically for these procedures. The objective of this study was to compare the growth of microbial organisms on the operator's forearm between five common techniques of hand washing for labor epidurals. ⋯ Alcohol-based antiseptic solutions are superior in terms of reducing the incidence of colonization. The results will enable us to develop guidelines to standardize and improve hand-sanitizing practices among epidural practitioners.