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 pulmonary hypertension at 23 weeks of pregnancy was transferred to our hospital. Systolic pulmonary artery pressure and plasma brain natriuretic peptide levels were markedly elevated. Nitric oxide inhalation and prostacyclin prevented the progression of cardiac failure and reduced both plasma brain natriuretic peptide and pulmonary artery pressure. Cesarean section was performed at 32 weeks under general anesthesia. A combination of nitric oxide, prostacyclin, nitroglycerin, and dobutamine were administered during surgery. Intravenous dexmedetomidine was specifically used during emergence and recovery from anesthesia. This provided effective pain relief and hemodynamic stability. Throughout the clinical course, brain natriuretic peptide levels was monitored and used as an indicator of cardiac failure.
journal_name
Int J Obstet Anesthjournal_title
International journal of obstetric anesthesiaauthors
Toyama H,Wagatsuma T,Ejima Y,Matsubara M,Kurosawa Sdoi
10.1016/j.ijoa.2008.08.001subject
Has Abstractpub_date
2009-07-01 00:00:00pages
262-7issue
3eissn
0959-289Xissn
1532-3374pii
S0959-289X(08)00139-8journal_volume
18pub_type
杂志文章abstract::Patients with dystrophia myotonica requiring caesarean section pose significant problems for the anaesthetist. This report describes the successful use of a combined spinal-epidural technique for anaesthesia and postoperative analgesia in such a patient. ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/s0959-289x(96)80051-3
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Early studies suggested that ropivacaine had clinical advantages over bupivacaine with respect to cardiotoxicity and motor block, and that it was suitable for epidural caesarean section. This study was set up to compare epidural 0.75% ropivacaine with a popular bupivacaine/fentanyl mixture for elective caesa...
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/j.ijoa.2005.01.002
更新日期:2005-07-01 00:00:00
abstract:INTRODUCTION:Accurately predicting cesarean delivery case duration is an integral component of designing appropriate workflow protocols and ensuring adequate provider availability. Our primary objective was to describe the variability of case duration, based on factors that we hypothesized would be influential, such as...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2018.01.002
更新日期:2018-05-01 00:00:00
abstract::Pregnancy has been reported to enhance the sensitivity of nerves to local anesthetics and to decrease anesthetic requirements during regional anesthesia. In this study, whether pregnancy increased the efficacy of lumbar epidural anesthesia was evaluated. Two populations (14 pregnant and 14 non-pregnant women) undergoi...
journal_title:International journal of obstetric anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/j.ijoa.2003.10.008
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:We investigated the correlation between lumbar epidural analgesia onset time and pain intensity at 60 and 120 min after initiation. METHODS:We conducted a prospective observational study of nulliparous women receiving lumbar epidural analgesia (initial bolus 15 mL bupivacaine 0.1% with fentanyl 3.33 μg/mL),...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2019.05.008
更新日期:2019-11-01 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::Any convulsion during labour requires immediate action, but before this can occur a correct diagnosis must be made. Here we describe a case where a 'fit' was wrongly attributed to epidural analgesia. This was in fact a dystonic reaction secondary to undeclared self-medication with metoclopramide. It is therefore impor...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/0959-289x(93)90088-y
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:In South Africa, hypertensive disorders of pregnancy are the leading cause of maternal mortality. More than 50% of anaesthesia-related maternal deaths are attributed to complications of airway management. We compared the prevalence and risk factors for hypoxaemia during induction of general anaesthesia in pa...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2020.10.012
更新日期:2020-11-04 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::Recent work suggests that preoperative skin infiltration with local anesthetic may lead to reduced postoperative pain. We have studied this in a randomised, prospective, double-blind trial of 40 women having cesarean section under spinal anesthesia. After establishment of the spinal block, the incision line was infilt...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/0959-289x(94)90068-x
更新日期:1994-10-01 00:00:00
abstract::At the Royal Women's Hospital, Queensland, between 1993 and 1997 there were 56 vaginal and 22 caesarean deliveries involving 68 women with heart disease. Over half of those women required anaesthetic input, in particular, the women who had the most serious cardiac compromise. There were two maternal deaths, four unboo...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/S0959-289X(02)00198-X
更新日期:2003-07-01 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 a case of a parturient with documented chronic Chagas' disease with cardiac manifestations presenting for labor management and complicated by the need for emergent hysterectomy after delivery. Chagas' disease is a common human hematogenous trypanosomiasis in Central and South America which is now, because of...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/s0959-289x(96)80005-7
更新日期:1996-04-01 00:00:00
abstract::A 34-year-old multiparous woman with a breech presentation, intrauterine growth restriction and premature rupture of membranes was transferred to our referral unit at 33 weeks of gestation. She was diagnosed with Alagille syndrome soon after birth because of cholestasis and pruritus. Her condition was later complicate...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2011.07.012
更新日期:2011-10-01 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:INTRODUCTION:The 2000-2002 triennial UK Report on Confidential Enquiries into Maternal Deaths concluded that over 50% of maternal deaths involved substandard care and that many could have been prevented. Catastrophic events leading to cardio-respiratory arrest may necessitate the resuscitation of pregnant women in vari...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2007.10.002
更新日期:2008-01-01 00:00:00
abstract::Acute lung disease may originate in pregnancy because of the pregnancy itself or because of an intercurrent etiology. The purpose of this study was to describe the effect of prolonged antepartum mechanical ventilatory support on the mother and the neonate when the strategy was to prolong the pregnancy rather than deli...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2006.10.015
更新日期:2007-07-01 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::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::Magnesium is one of the most abundant cations in the human body. It is utilised extensively within the medical world and its role in the treatment of various conditions in both mother and fetus is increasing. This review focuses on the importance of magnesium for the obstetric anaesthetist and looks at the most recent...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.ijoa.2012.10.003
更新日期:2013-01-01 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::A nation-wide survey of pain relief in childbirth in Hungary was carried out in 1993. Information was provided on 104 137 deliveries in 98 units. The frequencies of different methods of pain relief for vaginal delivery were as follows: systemic opiates in 7387 cases (8.3%), epidural analgesia in 4611 cases (5.2%) and ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/s0959-289x(97)80029-5
更新日期:1997-10-01 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:BACKGROUND:A national survey of current practice and preferred drug choices for both induction and maintenance of general anaesthesia for caesarean section was undertaken. METHODS:Following approval by the Obstetric Anaesthetists' Association, all UK consultant members were invited to respond to an electronic survey. ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2012.09.001
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Cesarean birth is known as both cesarean section (CS) and cesarean delivery (CD). The International Journal of Obstetric Anesthesia (IJOA) is the leading obstetric anesthesia journal, and a barometer of attitudes within the profession. The journal recently published the hundredth issue, spanning 25 years (to...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2017.09.005
更新日期:2018-05-01 00:00:00
abstract::HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome is an obstetric complication with heterogeneous presentation, multisystem involvement and variable prognosis, but which usually resolves after delivery. We report a case of HELLP syndrome with subcapsular hematoma of the liver causing extrapericardia...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/j.ijoa.2012.04.007
更新日期:2012-07-01 00:00:00
abstract::The incidence of obesity in pregnancy has increased rapidly in the last decade. Obesity is a risk factor for venous thromboembolism outside of pregnancy and previous studies of maternal death in the UK have identified obesity as a risk factor in pregnancy. As a result the Royal College of Obstetricians and Gynaecologi...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章,评审
doi:10.1016/j.ijoa.2012.01.002
更新日期:2012-07-01 00:00:00
abstract::In the following case there was delay in diagnosing uterine rupture in a patient with an epidural in situ. The danger of using large doses of local anaesthetics and opioids epidurally in patients who have had previous caesarean sections is discussed. ...
journal_title:International journal of obstetric anesthesia
pub_type: 杂志文章
doi:10.1016/0959-289x(95)82920-6
更新日期:1995-10-01 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::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