Abstract:
:An epidural catheter may be inserted with the patient either in the flexed left lateral or the sitting position. We have studied, non-invasively, the haemodynamic changes associated with these positions, using the thoracic bio-impedance method (BOMED NCCOM3 Monitor). Maternal arterial pressure and fetal heart rate were monitored simultaneously. Twenty healthy pregnant patients at term and 20 non-pregnant healthy controls, matched for age and height, were studied. The pregnant patients were scheduled for elective caesarean section and had singleton healthy fetuses. A significant reduction in stroke index (SI) occurred when the pregnant patients were repositioned from supine 15degrees wedged position to either flexed left lateral (P < 0.01) or sitting positions (P < 0.05). Similar reductions in SI with positioning were observed in the non-pregnant patients: flexed left lateral (P < 0.01); and sitting (P < 0.01). These changes in SI produced significant reductions in cardiac index (CI) in both groups. In the pregnant patients the CI was significantly lower in the flexed left lateral than in the sitting position (P < 0.01). Consequently maternal systolic blood pressure was lower in the flexed left lateral position (P < 0.01).
journal_name
Int J Obstet Anesthjournal_title
International journal of obstetric anesthesiaauthors
Chadwick IS,Eddleston JM,Chandelier CK,Pollard BJdoi
10.1016/0959-289x(93)90046-ksubject
Has Abstractpub_date
1993-01-01 00:00:00pages
197-201issue
4eissn
0959-289Xissn
1532-3374pii
0959289X9390046Kjournal_volume
2pub_type
杂志文章abstract::Headache is a common puerperal complaint. A wide variety of factors can be involved, ranging from hormonal shifts, physiological changes, and peripartum procedures that may precipitate, worsen, or cause troublesome headache. The differential diagnosis of postpartum headache is broad and potentially daunting to the var...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.ijoa.2010.07.009
更新日期:2010-10-01 00:00:00
abstract::We present two cases of neurovascular disease in pregnancy in which transcranial Doppler was used to assess the status of the cerebral circulation during cesarean section under regional anesthesia. One woman had been found to have moyamoya disease, following a series of transient ischemic attacks during her first preg...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1054/ijoa.2002.0947
更新日期:2002-07-01 00:00:00
abstract::The opioid crisis has reached an unprecedented magnitude in the United States and worldwide, and data on opioid use and misuse in the obstetric population are extremely concerning. Despite an abundant number of studies evaluating strategies to prevent neonatal opioid withdrawal syndrome in babies born to mothers who a...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.ijoa.2019.01.011
更新日期:2019-08-01 00:00:00
abstract::In the UK, maternal mortality due to haemorrhage appears to be rising, with obstetric haemorrhage accounting for 3-4% of the red cells transfused. Allogeneic blood transfusion carries risks such as administration errors, transmitted infections and immunological reactions. The supply of blood is decreasing, partly due ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.ijoa.2007.01.014
更新日期:2007-07-01 00:00:00
abstract::We describe a case of unexpected difficult intubation and ventilation during induction of general anaesthesia for caesarean section. This case was particularly challenging as the parturient suffered with particularly severe cord tethering following surgery for spina bifida as a child. The observed change in anticipate...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1054/ijoa.1999.0353
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Epidural analgesia and remifentanil patient-controlled analgesia are two popular techniques for the treatment of labour pain, each with its own efficacy and toxicity. METHODS:Parturients requesting analgesia were randomly assigned to either patient-controlled intravenous remifentanil or epidural analgesia. ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ijoa.2015.06.003
更新日期:2015-11-01 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::In a double-blind placebo-controlled trial we compared perioperative pain relief using different intrathecal opioid regimens given with bupivacaine during spinal anaesthesia for elective caesarean section. One hundred and sixteen patients undergoing elective caesarean section were divided into four groups (A, B, C, D)...
journal_title:International journal of obstetric anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/s0959-289x(97)80051-9
更新日期:1997-01-01 00:00:00
abstract::We report the case of a 37-year-old postpartum patient who developed a contained subacute spinal subdural hematoma causing mass effect on the cauda equina and severe spinal stenosis after undergoing an epidural blood patch for postdural puncture headache. Recovery occurred following administration of oral steroids. ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2011.10.003
更新日期:2012-04-01 00:00:00
abstract::Chiari (or Arnold-Chiari) malformations are a continuum of abnormalities of the hindbrain with the possibility of disordered cerebrospinal fluid flow and craniospinal pressure gradients. We describe the management of a 30-year-old primigravida who presented following a grand mal seizure during the first trimester. A C...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1054/ijoa.2000.0818
更新日期:2001-04-01 00:00:00
abstract::Primary pulmonary hypertension, though uncommon, is found relatively frequently in women of childbearing age and carries a high peripartum mortality. We present a patient with severe primary pulmonary hypertension who underwent two cesarean sections 3 and 6 years after the diagnosis of primary pulmonary hypertension w...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/s0959-289x(96)80072-0
更新日期:1996-01-01 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::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::Current pain and analgesic management strategies apply a standardized one-size-fits-all approach to women undergoing cesarean delivery. These standardized protocols do not account for significant variability in women's pain and may lead to under-treatment in patients with high analgesic needs and overtreatment, associ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.ijoa.2019.02.124
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Onset times and conditions for intubation after rocuronium versus suxamethonium at cesarean section have been evaluated, but no study thus far has examined the influence of these neuromuscular blocking drugs on the surgical conditions or their effect on the duration of surgery and the ease of fetal delivery....
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2019.08.005
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Most pregnant women who self-report penicillin allergy are not truly penicillin-allergic and this misunderstanding often leads to administration of inappropriate antibiotic therapy. Decision algorithms have been developed to guide antibiotic selection but major discrepancies have been reported between guidel...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2019.07.005
更新日期:2020-02-01 00:00:00
abstract::The marked reduction in the number of cases related to the provision of anaesthesia, included in the triennial Reports on Confidential Enquiries into Maternal Deaths in the UK, may limit the educational value of such reports for anaesthetists in the future. The collection, analysis and reporting of untoward events rel...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/s0959-289x(96)80041-0
更新日期:1996-10-01 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::Rupture of an aneurysm of the renal or splenic arteries remains a rare but catastrophic complication of pregnancy with a generally dismal prognosis for both mother and fetus. Improvements in abdominal imaging for incidental conditions are unlikely to lead to earlier diagnosis of such abnormalities antenatally, hence c...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/S0959-289X(02)00187-5
更新日期:2003-04-01 00:00:00
abstract::Cystic fibrosis affects 1 in 1600-2500 live births and is inherited in an autosomal recessive manner. It primarily involves the respiratory, gastrointestinal and reproductive tracts, with impaired clearance of, and obstruction by, increasingly viscous secretions. Severe respiratory disease, diabetes and gastro-oesopha...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2013.10.006
更新日期:2014-02-01 00:00:00
abstract::Gastro-oesophageal reflux (GOR) and regurgitation were investigated with an oesophageal pH electrode, inserted after the induction of general anaesthesia with methohexitone, in 100 patients undergoing termination of pregnancy, 50 in the first trimester and 50 in the second. GOR occurred in 17 patients, 8 in the first ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/0959-289x(92)90015-v
更新日期:1992-05-01 00:00:00
abstract::The experiences of 890 parturients were studied across Finland during one week to determine how they experienced labour pain and how effective they regarded the means to alleviate it. The majority of women (72%) had been afraid of labour and 88% had intended to request some pharmacological pain relief. 84% of primipar...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/0959-289x(94)90172-4
更新日期:1994-04-01 00:00:00
abstract::The 2009-12 MBRRACE-UK report highlighted the deaths of two women in whom dural puncture had occurred during insertion of a labour epidural catheter. One woman received an epidural blood patch, the other did not, but both suffered with chronic headaches following discharge from hospital. Neither woman was adequately f...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.ijoa.2018.12.006
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Although persistent pain has been described to occur after various types of surgery, little is known about this entity following caesarean section or vaginal birth. We sought to examine the association between mode of delivery and development of persistent pain, as well as the nature and intensity of the pai...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2009.03.013
更新日期:2010-01-01 00:00:00
abstract::A parturient who was 35 weeks' pregnant by her husband who was known to be susceptible to malignant hyperthermia, required anaesthesia for caesarean section for bleeding placenta praevia. The patient was considered to be haemodynamically stable and the procedure was carried out uneventfully under subarachnoid block. A...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1054/ijoa.2000.0394
更新日期:2000-10-01 00:00:00
abstract::A 70 kg, 34-year-old woman at 29 weeks-of-gestation required intrauterine transfusion for Rh (D) alloimmunization. In the ambulatory treatment clinic, 19 mg of rocuronium was administered intramuscularly in split doses into the fetal buttock. The fetus moved and inadvertent maternal neuromuscular blockade occurred, le...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2019.01.002
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Epidural labor analgesia inclusive of high-dose fentanyl has been thought to affect breastfeeding in multiparous patients. In our experience, this effect is not as significant as quoted in the literature. This study was designed to evaluate breastfeeding success in women receiving epidural analgesia with fen...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2010.02.001
更新日期:2010-07-01 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
abstract::We present a case of presumed amniotic fluid embolism in a 33-year-old parturient at 30 weeks of gestation, which occurred just before she was due to receive spinal anaesthesia for urgent caesarean section. While sitting, the woman suddenly lost consciousness, started having convulsions and finally suffered cardioresp...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2009.02.014
更新日期:2010-01-01 00:00:00
abstract::We present the case of a 30-year-old parturient diagnosed in the first trimester of her first pregnancy as having paroxysmal nocturnal haemoglobinuria. Pancytopenia necessitated regular transfusion of blood products. The risks of infection, haemorrhage and thrombosis, in the presence of severe thrombocytopenia, mild n...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2004.02.003
更新日期:2004-07-01 00:00:00