Abstract:
BACKGROUND:This prospective, randomized study was performed to see if intermittent labor epidural analgesia was protective against maternal intrapartum fever, compared to continuous epidural infusion. METHODS:Ninety-two healthy, term, nulliparous women in spontaneous labor were assigned to either intermittent (ILEA) or continuous labor epidural analgesia (CLEA), 46 in each group. In both groups, epidural analgesia was established with fentanyl 100 microg, and 8 mL of either 0.125% bupivacaine with fentanyl 0.0002%, or 0.1% ropivacaine with fentanyl 0.0002%. Maintenance in the CLEA group was with the same bupivacaine/fentanyl or ropivacaine/fentanyl solutions at 10-15 mL/h. In the ILEA group, additional boluses of the same solution were given as needed. Maternal tympanic temperature was measured before epidural insertion, 4-hourly during labor and 4 h post partum. Fever was defined as a temperature of > or =38 degrees C. Newborn temperature was noted within 60 min of birth. RESULTS:The incidence of fever in ILEA was significantly lower at four hours (2/42, vs. 10/44 in CLEA, P=0.036). No significant differences were detected at other time periods. Mean maternal temperatures did not differ between groups at any time. There were no differences in neonatal temperature or neonatal sepsis evaluation rate (CLEA vs. ILEA 0/46 vs. 2/43, P=0.45). CONCLUSIONS:Intermittent epidural injections appear to protect against intrapartum fever in the first 4 hours of labor analgesia, compared to continuous infusion. This may be due to intermittent partial recovery of heat loss mechanisms between injections. Neonatal sepsis evaluation rates were similar in the two groups.
journal_name
Int J Obstet Anesthjournal_title
International journal of obstetric anesthesiaauthors
Mantha VR,Vallejo MC,Ramesh V,Phelps AL,Ramanathan Sdoi
10.1016/j.ijoa.2007.07.006subject
Has Abstractpub_date
2008-04-01 00:00:00pages
123-9issue
2eissn
0959-289Xissn
1532-3374pii
S0959-289X(07)00189-6journal_volume
17pub_type
杂志文章,随机对照试验abstract::A 37-year-old female, gravida 1 para 0, in active labor at term, with a cervical spinal cord stimulator in situ, presented for epidural analgesia for labor. She had received the cervical spinal cord stimulator some 30 months before, to treat chronic regional pain syndrome I. She was taking no medication, and was thin ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2005.08.007
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Previous studies using low-dose spinal anesthesia for cesarean delivery have focused on hypotension and efficacy. This study evaluated whether, using a combined spinal-epidural technique, there was a difference in onset of anesthesia for cesarean delivery between low-dose spinal with an immediate epidural lo...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ijoa.2013.08.009
更新日期:2014-02-01 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:BACKGROUND:Ropivacaine may be the ideal spinal anesthetic for postpartum tubal ligation due to its medium duration of action, low incidence of side effects and possibly reduced post-anesthetic care unit (PACU) stay. METHODS:Two prospective up-down sequential allocation studies were performed using hyperbaric spinal ro...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2010.06.011
更新日期:2010-10-01 00:00:00
abstract::The administration of intravenous dantrolene in a parturient susceptible to malignant hyperthermia has been associated with post partum uterine atony. We examined the effect of dantrolene sodium for injection (Dantrium Intravenous) on spontaneous contractility of uterine smooth muscle from women in term pregnancy in a...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/0959-289x(95)82910-3
更新日期:1995-10-01 00:00:00
abstract::The pressor response is known to be exaggerated in patients with pregnancy-induced hypertension, which can result in increased morbidity and mortality in both mother and newborn. Various pharmacological agents have been used before induction in an attempt to attenuate the adrenergic response but with varying degree of...
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.2001.0918
更新日期:2002-01-01 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::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::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 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::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::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 wer...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/0959-289x(93)90046-k
更新日期:1993-01-01 00:00:00
abstract::The Analgesia in Childbirth Bill (1949) remains the only attempt in British history to give mothers the legal right to pain relief in childbirth. It provides a useful introduction to the major themes in the history of British obstetric anaesthesia and analgesia under the National Health Service. This paper places the ...
journal_title:International journal of obstetric anesthesia
pub_type: 历史文章,杂志文章
doi:10.1016/j.ijoa.2006.08.007
更新日期:2007-01-01 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::Stiff person syndrome is a rare neurologic disorder with an estimated incidence of 1:1000000. The underlying pathophysiology is truncal and proximal limb muscle stiffness resulting from continuous co-contracture of agonist and antagonist muscle groups concomitant with superimposed episodic muscle spasms. Loss of gamma...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2016.05.006
更新日期:2016-08-01 00:00:00
abstract::Varicella (chicken pox) infection is associated with a significant risk of maternal and fetal morbidity and mortality. The choice of anesthetic technique, either neuraxial or general anesthesia, in such patients remains controversial. Anesthetic management depends not only on the extent of disease involvement and asso...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2016.06.002
更新日期:2016-12-01 00:00:00
abstract::Morquio syndrome, a congenital mucopolysaccharidosis, presents several challenges for the provision of effective labor analgesia. We report the case of a woman admitted for induction of labor who received an early epidural and subsequently required cesarean delivery. Optimal bilateral labor analgesia was not achieved ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2015.08.015
更新日期:2015-11-01 00:00:00
abstract::A 30-year-old woman was admitted to the labour ward at term complaining of symptoms suggestive of raised intracranial pressure which were overlooked. Epidural analgesia was administered following induction of labour and was associated with a clear exacerbation of symptoms. After delivery a CT scan revealed a large cer...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/0959-289x(95)83004-2
更新日期:1995-04-01 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: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:BACKGROUND:Inserting an intrathecal catheter after accidental dural puncture in parturients to prevent postdural puncture headache is becoming increasingly popular. We aimed to identify relevant published articles investigating this intervention and subject data to a meta-analysis. METHODS:A systematic literature sear...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,meta分析
doi:10.1016/j.ijoa.2012.10.004
更新日期:2013-01-01 00:00:00
abstract::Urticaria pigmentosa is a cutaneous variant of mastocytosis. This is a complex group of diseases distinguished by abnormal aggregation of mast cells within the skin and other organs. Mast cell degranulation and subsequent release of vasoactive amines may occur in response to a variety of non-immune triggers leading to...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/s0959-289x(98)80049-6
更新日期:1998-10-01 00:00:00
abstract::A case is described of a previously healthy obese woman in her fourth pregnancy who presented for caesarean section due to cephalopelvic disproportion (CPD). Forty minutes after a spinal anaesthetic a healthy child was delivered. Shortly after the injection of ergometrine and Syntocinon into the uterus, the patient de...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/0959-289x(93)90012-7
更新日期:1993-01-01 00:00:00
abstract::Congenital complete heart block is a rare phenomenon that may be discovered during pregnancy in patients who were previously asymptomatic. Peripartum management of these patients mandates a multidisciplinary approach with careful planning regarding indications for pacing, appropriate anesthetic technique, and continge...
journal_title:International journal of obstetric anesthesia
pub_type:
doi:10.1016/j.ijoa.2020.07.012
更新日期:2020-11-01 00:00:00
abstract::It is generally believed that bolus injections of local anesthetic through an epidural needle produce a more rapid onset of blockade, but at the expense of an increased incidence and severity of hypotension, whereas intermittent injections through a catheter take longer to achieve adequate anesthesia but with a lower ...
journal_title:International journal of obstetric anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0959-289x(97)80006-4
更新日期:1997-04-01 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::We report a case of H1N1 2009 influenza A, in a previously fit woman at 24 weeks of gestation, who presented atypically with abdominal pain. The infection was complicated by severe respiratory failure and acute respiratory distress syndrome, requiring ventilatory support, including extra-corporeal membrane oxygenation...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2010.04.010
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Adequate analgesia following caesarean section decreases morbidity, hastens ambulation, improves patient outcome and facilitates care of the newborn. Intrathecal magnesium, an NMDA antagonist, has been shown to prolong analgesia without significant side effects in healthy parturients. We therefore studied th...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ijoa.2009.08.007
更新日期:2010-04-01 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
abstract:BACKGROUND: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. METHODS:Sixty patients undergoing bupivacaine...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ijoa.2018.09.006
更新日期:2019-02-01 00:00:00