International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 2013
Randomized Controlled TrialA dose-response study of remifentanil for attenuation of the hypertensive response to laryngoscopy and tracheal intubation in severely preeclamptic women undergoing caesarean delivery under general anaesthesia.
Remifentanil is known to attenuate the cardiovascular responses to tracheal intubation. We determined effective doses (ED(50)/ED(95)) of remifentanil to prevent the pressor response to tracheal intubation in patients with severe preeclampsia. ⋯ The ED(95) of remifentanil for attenuating the hypertensive response to tracheal intubation during induction of anaesthesia in severely preeclamptic patients undergoing caesarean delivery under general anaesthesia was 1.34 μg/kg.
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Int J Obstet Anesth · Jan 2013
Efficacy and side effects of intravenous remifentanil patient-controlled analgesia used in a stepwise approach for labour: an observational study.
Remifentanil has a suitable pharmacological profile for labour analgesia. In this prospective, observational study, intravenous patient-controlled analgesia with remifentanil, using stepwise bolus doses without background infusion, was examined during the first and second stages of labour. Outcomes were pain reduction, maternal satisfaction, maternal and neonatal side effects and remifentanil metabolism in the neonate. ⋯ Remifentanil intravenous patient-controlled analgesia provides adequate pain relief and high maternal satisfaction during the first and second stages of labour. Maternal sedation and respiratory depression may occur, but no serious neonatal side effects were recorded. Careful monitoring is mandatory.
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Int J Obstet Anesth · Jan 2013
The impact of spinal anaesthesia for caesarean delivery on coagulation assessed by thromboelastography.
Pregnancy and puerperium are associated with a hypercoagulable state. The aim of the study was to assess the impact of spinal anaesthesia on coagulation using thromboelastography in healthy term pregnant women undergoing elective caesarean delivery. ⋯ In women undergoing caesarean delivery under spinal anaesthesia, enhanced coagulation thromboelastography parameters were observed in blood collected from hand veins. No changes were detected in the majority of parameters collected from the foot. Spinal anaesthesia has different effects on coagulation parameters in the hand and foot in pregnant women undergoing caesarean delivery.