Abstract：
:Standard textbooks advocate epidural rather than spinal anaesthesia for caesarean section in severe preeclampsia. The basis for this recommendation is the theoretical risk of severe hypotension but no published scientific studies have been identified to support this assertion. We therefore designed a prospective study to compare spinal versus epidural anaesthesia in severely pre-eclamptic patients requiring hypotensive therapy. Following ethics committee approval, 28 women with preeclampsia requiring hypotensive medication who were scheduled for urgent (not emergency) or elective caesarean section consented to receive epidural or spinal anaesthesia by random assignment. Seven patients were excluded due to protocol violations. Four of these were in the epidural group of which two were excluded due to inadequate analgesia. No spinal patient was excluded because of inadequate analgesia. Mean ephedrine dosage was 5.2 mg (range 0-24 mg) in the spinal group and 6.3 mg (range 0-27 mg) in the epidural group. Six of the 11 patients in the spinal group required no ephedrine as did five of 10 in the epidural group. One patient in the spinal group suffered from mild intraoperative pain. By contrast in the epidural group three patients had mild pain and four others had pain severe enough to warrant intraoperative analgesia. There were no differences in neonatal outcomes. These findings support recent studies suggesting the safety and efficacy of spinal anaesthesia in this group of patients.
journal_name
Int J Obstet Anesthjournal_title
International journal of obstetric anesthesiaauthors
Sharwood-Smith G,Clark V,Watson Edoi
10.1016/s0959-289x(99)80003-xsubject
Has Abstractpub_date
1999-04-01 00:00:00pages
85-9issue
2eissn
0959-289Xissn
1532-3374pii
S0959289X9980003Xjournal_volume
8pub_type
临床试验,杂志文章,随机对照试验abstract：:We report a case of akathisia developed after administration of 2.5 mg metoclopramide for treatment of nausea during cesarean section. The relevant literature as well as options for prevention and treatment of this phenomenon are reviewed. ...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1054/ijoa.1999.0346
更新日期：2000-04-01 00:00:00
abstract：:We conducted a retrospective study of all cases of cesarean section at the KK Women's and Children's Hospital over a one-year period from September 1, 2002 to August 31, 2003, with the aim of evaluating current anesthetic practice. These cases were identified using hospital databases and relevant data was extracted fr...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2004.04.007
更新日期：2004-10-01 00:00:00
abstract：:We describe an uncommon cause of cardiogenic shock following cesarean delivery in a 24-year-old multiparous woman at 26 weeks of gestation. Hemodynamic instability was erroneously attributed to amniotic infection syndrome and sepsis, which resulted in delayed diagnosis and treatment of tuberculous constrictive pericar...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2010.06.002
更新日期：2010-10-01 00:00:00
abstract：BACKGROUND:Failed intubation is relatively common in the obstetric patient. Overall, there has been a decline in experience of general anaesthesia in obstetrics. The level of anaesthetic preparedness in the event of a difficult obstetric intubation is unknown. METHODS:With approval from the Obstetric Anaesthetists' As...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2009.01.015
更新日期：2009-10-01 00:00:00
abstract：:Primary pulmonary hypertension is a fatal disease that frequently becomes evident in pregnancy. The management of pregnant women with primary pulmonary hypertension poses a number of difficult problems, especially where regional anesthesia is considered to be contraindicated. A 30-year-old woman who developed primary ...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2008.08.001
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:There are limited data about spinal dosing for cesarean delivery in preterm parturients. We investigated the hypothesis that preterm gestation is associated with an increased incidence of inadequate spinal anesthesia for cesarean delivery compared with term gestation. METHODS:We searched our perioperative d...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2016.01.007
更新日期：2016-05-01 00:00:00
abstract：BACKGROUND:ChloraPrep® is a skin antiseptic commonly used before neuraxial anesthesia. It is believed that skin must be allowed to dry to prevent nerve damage by seeding ChloraPrep® solution into the neuraxis. We aimed to determine ChloraPrep® drying time in pregnant women before initiation of neuraxial anesthesia. ME...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2018.10.012
更新日期：2019-05-01 00:00:00
abstract：BACKGROUND:Superficial bleeding after labor epidural catheter placement is a common phenomenon. In addition to delaying securing the epidural catheter, it may loosen the adhesive catheter dressing. The primary aim of this study was to determine whether skin infiltration with epinephrine-containing rather than plain lid...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ijoa.2006.09.006
更新日期：2007-04-01 00:00:00
abstract：:Pulmonary atresia witha ventricular septal defect and major aortopulmonary collateral arteries is an extremely rare congenital disorder characterized by a high risk of maternal mortality. We present the case of a 24-year-old primigravid woman with uncorrected pulmonary atresia, ventricular septal defect and major aort...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2018.05.009
更新日期：2018-11-01 00:00:00
abstract：:In order to estimate how long a medication can remain prepared before the integrity or concentration of the drug is compromised, we assessed the sterility and potency of medications commonly used in our obstetric anesthesia practice. Our goal was to evaluate the following drugs over a 30-day period: epinephrine, atrop...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1054/ijoa.2002.0983
更新日期：2002-10-01 00:00:00
abstract：BACKGROUND:Postpartum depression (PPD) is the most common complication after childbirth, affecting 10-15% of women. It is associated with serious long-term consequences for the mother and family. Whether or not neuraxial labor analgesia mitigates the risk is uncertain and controversial. The purpose of this review was t...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.ijoa.2020.10.004
更新日期：2020-10-17 00:00:00
abstract：:We present our own single-space method for performing combined spinal epidural anaesthesia. A spinal introducer and a Tuohy needle are sited in the same interspace. After insertion of the epidural catheter the introducer is used as a guide for a 25 gauge spinal needle. The advantages of this technique over other metho...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/0959-289x(95)82972-d
更新日期：1995-07-01 00:00:00
abstract：:The haemodynamic effects of oxytocin receive scant attention in pharmacology texts, but may be clinically significant in vulnerable patients. Despite prescriber information recommending a dose of 5 international units by slow i.v. injection, it is the authors' experience that it is very common practice in the UK to gi...
journal_title：International journal of obstetric anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1054/ijoa.2002.0970
更新日期：2002-07-01 00:00:00
abstract：BACKGROUND:Neurological deficits noted immediately after childbirth are usually various obstetric neuropathies, but prospective studies are limited. The main study aim was to quantify and describe immediate postpartum neurological deficits of the lower extremity, including the buttocks. METHODS:A prospective observati...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2017.04.002
更新日期：2017-05-01 00:00:00
abstract：:Neurofibromatosis type 2 is an extremely rare form of neurofibromatosis characterized by central nervous system involvement with bilateral vestibular schwannomas and spinal tumors. Anesthetic management of a parturient with neurofibromatosis type 2 has not been fully reported, and the condition is challenging to obste...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2005.02.007
更新日期：2005-10-01 00:00:00
abstract：:This study explores which concentrations of local anesthetics might be expected to inhibit the growth of Staphylococcus aureus. Serial dilutions were made of 0.5% and 0.75% bupivacaine, 2% and 5% lidocaine, 2% and 3% chloroprocaine, and 0.2% and 1% ropivacaine. To each concentration of local anesthetic solution, Muell...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1054/ijoa.2001.0934
更新日期：2002-04-01 00:00:00
abstract：:We present a case of a severe systemic (paradoxical) air embolism occurring during spinal anesthesia for cesarean delivery in an otherwise healthy 35-year-old parturient. Uncomplicated spinal anesthesia and satisfactory surgical anesthesia were obtained; no sedatives were used and the patient was awake and alert and t...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2005.08.003
更新日期：2006-04-01 00:00:00
abstract：:Anaphylactoid reaction to Syntocinon is rare, but has been described in the literature. The reactions described include patchy erythema, hypotension, bronchospasm and oxygen desaturation, but pulseless electrical activity following Syntocinon has not been reported. We present the case of a 34-year-old primigravida wit...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2008.09.004
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:A common polymorphism of the μ-opioid receptor gene (OPRM1, p.118A/G), which has been shown to effect the response to neuraxial opioids, occurs in 30% of Caucasian women. This double-blind up-down sequential allocation study was designed to examine the effect of p.118A/G on the ED50 of epidural sufentanil fo...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2011.10.001
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND:China has one of the highest rates of caesarean delivery in the world. The aim of this study was to investigate the incidence and risk factors for chronic pain after caesarean delivery in a Chinese cohort. METHODS:Patients undergoing elective caesarean delivery with a Pfannenstiel incision under spinal anae...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2018.01.009
更新日期：2018-05-01 00:00:00
abstract：:A case is described of a 30-year-old insulin-dependent diabetic woman who presented at 25 weeks gestation with frontal headache. Contrast tomography revealed an aneurysm of the middle cerebral artery with no evidence of subarachnoid bleeding. Although elective caesarean section at term was planned, it was performed at...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/0959-289x(93)90031-c
更新日期：1993-01-01 00:00:00
abstract：:We report the management of a morbidly obese parturient suffering from narcolepsy with cataplexy who presented for caesarean section. Her symptoms were controlled by modafinil and fluoxetine. We administered epidural anaesthesia successfully; surgery was uneventful and recovery was uncomplicated. We discuss some of th...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2010.07.015
更新日期：2010-10-01 00:00:00
abstract：BACKGROUND:Ketamine at subanesthetic doses has analgesic properties that have been shown to reduce postoperative pain and morphine consumption. We hypothesized that intravenous ketamine 10mg administered during spinal anesthesia for cesarean delivery, in addition to intrathecal morphine and intravenous ketorolac, would...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ijoa.2010.10.002
更新日期：2011-01-01 00:00:00
abstract：:In December 2014, the latest UK Confidential Enquiry into Maternal Deaths report was published, covering the surveillance period from 2009 to 2012. This is the first report since a significant change in the organisational structure of the body responsible for surveillance and dissemination of reports. The Confidential...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.ijoa.2015.03.004
更新日期：2015-05-01 00:00:00
abstract：BACKGROUND:Intrathecal tramadol combined with local anaesthetics has been used for postoperative analgesia following lower abdominal and perineal surgery. The present study evaluated the effect of intrathecal tramadol on spinal block characteristics and neonatal outcome after elective caesarean section. METHODS:Eighty...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ijoa.2013.05.009
更新日期：2013-11-01 00:00:00
abstract：BACKGROUND:Epidural dose is often reduced in the second stage of labor with the intention of improving maternal expulsive efforts and decreasing the need for instrumental vaginal delivery (IVD). We conjectured that parturients requiring IVD would have had more analgesic interventions and requests to decrease analgesic ...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2007.10.007
更新日期：2008-10-01 00:00:00
abstract：BACKGROUND: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. METHODS:Forty parturients who ...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ijoa.2018.02.004
更新日期：2018-08-01 00:00:00
abstract：:Paracetamol is the most frequently used analgesic during pregnancy and the most common drug involved in suicidal overdose in the UK. Manifestation of toxicity classically occurs over four phases with clinical and laboratory features resembling HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome. We repo...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2014.01.006
更新日期：2014-05-01 00:00:00
abstract：:Intracranial subdural hematoma is an exceptionally rare but life-threatening complication of spinal anesthesia. We report a case of intracranial subdural hematoma following spinal anesthesia for cesarean section in a 27-year-old woman. She developed a diffuse headache after surgery with a blood pressure of 220/140 mm ...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2004.08.005
更新日期：2005-04-01 00:00:00
abstract：:Pre-existing epidural analgesia was rapidly extended in 36 consecutive patients presenting for emergency caesarean section by using 20 ml of 2% lignocaine + 1/200,000 adrenaline freshly prepared given by slow bolus injection. Despite a wide range of initial analgesic sensory levels the technique produced blocks that w...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/0959-289x(91)90024-k
更新日期：1991-09-01 00:00:00
