Abstract：
BACKGROUND:Clinically overt infections of the epidural catheter skin entry site occur in approximately 1-5% of patients after a few days of catheterization but serious complications such as deep tissue infection or epidural abscess appear rare in the obstetric population. In recent years, sporadic reports and small series suggest that the incidence may be higher than previously estimated. METHODS:A retrospective chart review was conducted to identify epidural catheter-related infections occurring between January 2002 and December 2005 in a tertiary referral maternity hospital delivering between 4000 and 6000 women per annum. Cases were identified using International Statistical Classification of Diseases coding. RESULTS:In total 9482 women (52.8%) who delivered had an epidural catheter inserted. There were 258 cases with the relevant code identified and 49 (0.52%, 95% CI 0.37-0.66%) had epidural catheter-related infection. Four women had deep tissue infection (incidence 0.04%, 95% CI 0.01-0.11%; rate 1 in 4741), represented by paraspinous and epidural abscess formation (incidence of both 0.02%, 95% CI 0-0.08%; rate 1 in 2371). Three of the cases are described. CONCLUSIONS:Serious epidural catheter-related infection in obstetric patients is rare, but our incidence of serious deep tissue infection was at the upper extreme of figures quoted in other studies.
journal_name
Int J Obstet Anesthjournal_title
International journal of obstetric anesthesiaauthors
Green LK,Paech MJdoi
10.1016/j.ijoa.2009.06.001subject
Has Abstractpub_date
2010-01-01 00:00:00pages
38-43issue
1eissn
0959-289Xissn
1532-3374pii
S0959-289X(09)00127-7journal_volume
19pub_type
杂志文章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：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: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：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：: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：: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：:Two cases of severe respiratory depression in the obstetric population are presented. The first occurred after intrathecal injection of a modest dose (50 mg) of meperidine. The second followed intrathecal administration of 10 microg of sufentanil after intravenous fentanyl. These cases illustrate the potential gravity...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/s0959-289x(97)80086-6
更新日期：1997-07-01 00:00:00
abstract：:Supraventricular tachycardia is uncommon in pregnancy. It is defined as intermittent pathological and usually narrow complex tachycardia >120 beats/min which originates above the ventricle, excluding atrial fibrillation, flutter and multifocal atrial tachycardia. It is usually self-limiting or relatively easily treate...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2013.08.012
更新日期：2014-02-01 00:00:00
abstract：:The aim of the 2012 "What's new in obstetric anesthesia?" review is to highlight important scientific and medical advances in the fields of obstetric anesthesiology, obstetrics and perinatology from literature published in 2011. This review will consider advances in the prevention and treatment of important obstetric ...
journal_title：International journal of obstetric anesthesia
pub_type：
doi：10.1016/j.ijoa.2012.08.005
更新日期：2012-10-01 00:00:00
abstract：BACKGROUND:Administration of packed red blood cells (PRBC) and fresh frozen plasma (FFP) to women with postpartum hemorrhage (PPH) before and after introduction of a massive transfusion protocol. METHODS:The retrospective PPH study cohort of two tertiary centers was identified using blood bank records, verified by pat...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章,多中心研究
doi：10.1016/j.ijoa.2018.08.001
更新日期：2018-11-01 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：BACKGROUND:This systematic review and meta-analysis evaluates evidence for seven risk factors associated with failed conversion of labor epidural analgesia to cesarean delivery anesthesia. METHODS:Online scientific literature databases were searched using a strategy which identified observational trials, published bet...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.ijoa.2012.05.007
更新日期：2012-10-01 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: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：:Velocardiofacial or 22q11 deletion syndrome is a genetic condition caused by deletion 22q11, the deletion of a small segment of the long arm of chromosome 22. To our knowledge this is the first case report of a woman with Velocardiofacial syndrome presenting in late pregnancy for caesarean delivery. She had undergone ...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2010.12.007
更新日期：2011-07-01 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：: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：: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: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：: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：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：:Two patients with Type I Klippel-Feil syndrome presented at the antenatal clinic. The first patient, who suffered from sleep apnoea, was delivered of a healthy infant by vacuum extraction. The second, who was profoundly deaf and had marked kyphoscoliosis, developed pregnancy-induced hypertension and urinary tract infe...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/s0959-289x(96)80032-x
更新日期：1996-07-01 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：:We review the evidence base for fluid management in pre-eclampsia. Current understanding of the relevant pathophysiology and the possible impact of styles of fluid management on maternal and fetal outcome are presented. There is little evidence upon which to base the management of fluid balance in pre-eclampsia. Repor...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/s0959-289x(99)80106-x
更新日期：1999-10-01 00:00:00
abstract：:We describe a case of spontaneous intracranial hypotension in a 36-year-old woman. This condition shares many of the features of post dural puncture headache, but without a dural puncture having been performed. The aetiology and management of this rare condition are discussed. We believe from experience within our own...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1054/ijoa.2001.0902
更新日期：2002-01-01 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：: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: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：: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：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
