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Caesarean anesthesia

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https://www.readbyqxmd.com/read/29033720/reducing-by-50-the-incidence-of-maternal-hypotension-during-elective-caesarean-delivery-under-spinal-anesthesia-effect-of-prophylactic-ondansetron-and-or-continuous-infusion-of-phenylephrine-a-double-blind-randomized-placebo-controlled-trial
#1
Jose Ramon Ortiz-Gómez, Francisco Javier Palacio-Abizanda, Francisco Morillas-Ramirez, Inocencia Fornet-Ruiz, Ana Lorenzo-Jiménez, Maria Lourdes Bermejo-Albares
BACKGROUND: Prophylactic administrations of ondansetron or phenylephrine have been reported to provide a protective effect against hypotension in women undergoing cesarean delivery under spinal anesthesia (SA). The main hypothesis is that ondansetron improves the hemodynamic response, especially combined with phenylephrine infusion. METHODS: This prospective, double-blind, randomized, placebo-controlled study included 265 healthy pregnant women scheduled for elective cesarean delivery under SA...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28965442/the-impact-of-curve-severity-on-obstetric-complications-and-regional-anesthesia-utilization-in-pregnant-patients-with-adolescent-idiopathic-scoliosis-a-preliminary-analysis
#2
Emily W Chan, Stephen R Gannon, Chevis N Shannon, Jeffrey E Martus, Gregory A Mencio, Christopher M Bonfield
OBJECTIVE Adolescent idiopathic scoliosis (AIS), the most common type of scoliosis, often presents immediately prior to a woman's childbearing years; however, research investigating the impact of AIS on women's health, particularly pregnancy delivery outcomes, is sparse, with existing literature reporting mixed findings. Similarly limited are studies examining the change in scoliotic curve during or after pregnancy. Therefore, this study aims to determine 1) the impact of scoliotic curvature on obstetric complications (preterm births, induction of labor, and urgent/emergency caesarean section delivery), 2) regional anesthetic decision making and success during delivery for these patients, and 3) the effect of pregnancy on curve progression...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28962122/effects-of-dexmedetomidine-in-reducing-post-cesarean-adverse-reactions
#3
Yanshuai Mo, Shuang Qiu
This study evaluated the analgesia effect and the effect on adverse reaction of using dexmedetomidine (Dex) in post-cesarean section. Eighty women who had been performed caesarean delivery with combined spinal and epidural anesthesia were selected. The experimental group (group D) included 40 random patients and the control group (group C) included the other 40 women. Patients in group D were given ropivacaine hydrochloride and Dex while patients in group C were given ropivacaine hydrochloride and morphine...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28928554/study-to-compare-the-effect-of-oral-rectal-and-intravenous-infusion-of-paracetamol-for-postoperative-analgesia-in-women-undergoing-cesarean-section-under-spinal-anesthesia
#4
Lakshmi Mahajan, Vaishali Mittal, Ruchi Gupta, Himani Chhabra, Jyoti Vidhan, Ashreen Kaur
BACKGROUND: Effective pain relief therapy after caesarean section is essential for the parturient's comfort and early ambulation. Paracetamol has an excellent safety profile when compared to opioids. AIM: To assess and evaluate the effect of oral, rectal, and intravenous infusion of paracetamol for post-operative analgesia in women undergoing caesarean section under spinal anaesthesia. SETTINGS AND DESIGN: We conducted a prospective, randomized controlled study (18-35 years of age) of the ASA- I and II parturient scheduled for lower segment caesarean section were included...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28904717/aseptic-meningitis-following-a-bupivacaine-spinal-anesthesia
#5
Nawfal Doghmi, Amine Meskine, Aziz Benakroute, Mustapha Bensghir, Abdelouahed Baite, Charki Haimeur
Spinal anesthesia complicated by meningitis is rare. The diagnosis is difficult and the clinical signs are unspecific. There is a subgroup called aseptic meningitis of a different mechanism (hypersensitive reaction and irritation of the meninges), which must be identified for appropriate care. We report the case of aseptic meningitis resulting from bupivacaine use complicating spinal anesthesia. She is 31 years old and was admitted to the intensive care unit for meningitis following a Caesarean delivery. 10 hours after the procedure, she was found to have severe headache, neck stiffness and was found restless...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28892978/maternal-outcomes-associated-with-caesarean-versus-vaginal-delivery
#6
Farnaz Zandvakili, Masomeh Rezaie, Roonak Shahoei, Daem Roshani
INTRODUCTION: To choose the best mode of delivery (vaginal versus caesarean section) still remains a contentious issue. Caesarean section is a major abdominal surgery with its related medical, anesthetic and surgical complications. Maternal mortality and morbidity is higher in caesarean section compared with vaginal delivery. The most common causes of maternal mortality during caesarean section are due to anesthesia, bleeding and infection. AIM: The aim of this study was to determine the mode of delivery and maternal outcomes in Sanandaj's hospital, Iran, during one year...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28890560/perfusion-index-as-a-predictor-of-hypotension-following-spinal-anaesthesia-in-lower-segment-caesarean-section
#7
Devika Rani Duggappa, Mps Lokesh, Aanchal Dixit, Rinita Paul, R S Raghavendra Rao, P Prabha
BACKGROUND AND AIMS: Perfusion index (PI) is a new parameter tried for predicting hypotension during spinal anaesthesia for the lower segment caesarean section (LSCS). This study aimed at investigating the correlation between baseline perfusion index and incidence of hypotension following SAB in LSCS. METHODS: In this prospective observational study, 126 parturients were divided into two groups on the basis of baseline PI. Group I included parturients with PI of ≤3...
August 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28730256/advanced-metastatic-breast-cancer-in-pregnancy-the-imperative-of-physical-breast-examination-in-pregnancy
#8
Anca Angela Simionescu, Claudia Valentina Georgescu, Mirela Corina Ghiluşi, Sabrina Ioana Stoica, Mircea Dragoş Median
Breast cancer is the most frequent cancer diagnosed among women; its association with pregnancy is not encountered. As childbearing age is increasing, the diagnosis of breast cancer associated pregnancy tends to be more often than years ago. Here we report a case of a 37-year-old patient, gravida 7, para 7, diagnosed at 30 weeks gestation with metastatic breast cancer. The patient presented to hospital due to an altered performance status. Obstetrical evaluation was within normal range. A metastatic infiltrating breast cancer poorly differentiated (G3) with satellite skin lesions (T4b), ipsilateral axillary and supraclavicular lymph nodes (N3), lung metastasis bilateral with pleural effusion and hepatic metastasis (M1), were diagnosed...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28640100/level-of-sensory-block-after-spinal-anesthesia-as-a-predictor-of-hypotension-in-parturient
#9
Ning Zhang, Liangliang He, Jia-Xiang Ni
When the sensory block level (SBL) is ≥T5 or T4, a high incidence of hypotension occurs in parturients after spinal anesthesia. A rapidly ascending SBL is another risk factor for spinal anesthesia-induced hypotension. However, the relationship between the ascension rate of the SBL and spinal anesthesia-induced hypotension remains unclear.After placement in the left lateral position, combined epidural-spinal anesthesia was performed on 140 parturients undergoing caesarean section using the following procedure: no volume preloading, injection site of L3-4 or L4-5, injection rate of 0...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28604179/bolus-administration-of-intravenous-lidocaine-reduces-pain-after-an-elective-caesarean-section-findings-from-a-randomised-double-blind-placebo-controlled-trial
#10
Afshin Gholipour Baradari, Abolfazl Firouzian, Farshad Hasanzadeh Kiabi, Amir Emami Zeydi, Mohammad Khademloo, Zeinab Nazari, Masoumeh Sanagou, Maedeh Ghobadi, Ensieh Fooladi
We conducted a randomised double-blind, placebo-controlled trial to assess whether a bolus dose of lidocaine during the induction of general anaesthesia would reduce postoperative pain over 24 h. Level of satisfaction with pain control at 48 h after surgery and Apgar score were also examined. A total of 100 women aged 20-35 years, who were candidates for elective caesarean section (CS) were randomised to receive either 1.5 mg/kg lidocaine or placebo during the induction of general anaesthesia. Results showed that lidocaine decreased pain intensity over 24 h after surgery (p < ...
July 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28524032/-preoperative-risk-factors-analysis-of-pulmonary-hypertension-crisis-during-perioperative-period-for-caesarean-section-of-woman-with-severe-pulmonary-hypertension
#11
Chunlei Zhang, Yaguang Liu, Enming Qing, Jun Ma
OBJECTIVE: To analyze preoperative risk factors of perioperative pulmonary hypertension crisis (PHC) for pregnant woman with severe pulmonary artery hypertension (PAH), and approach its clinical value. METHODS: A retrospective analysis was conducted. The clinical data from 152 pregnant women with severe PAH underwent cesarean delivery admitted to Beijing Anzhen Hospital from January 1st 2008 to December 31st 2016 was collected. The patients were divided into two groups according to with perioperative PHC or not...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28419979/clinical-profile-of-persistent-genito-pelvic-postpartum-pain
#12
Jaclyn Cappell, Caroline F Pukall
OBJECTIVE*: the primary aim was to describe the pain characteristics of persistent genito-pelvic postpartum pain (PPP) and compare these characteristics by mode of delivery. The secondary aim was to incorporate psychosocial variables into the conceptualization of PPP by exploring the relationship among postpartum depressive symptoms, fatigue, and PPP. DESIGN: cross-sectional study design. SETTING: online survey. PARTICIPANTS: 106 women recruited from the community who gave birth within twelve months prior to completing the survey...
April 8, 2017: Midwifery
https://www.readbyqxmd.com/read/28396687/successful-treatment-of-caesarean-scar-pregnancies-by-local-treatment-only
#13
Shinji Tanigaki, Chie Nagata, Kazunori Ueno, Nobuaki Ozawa, Shinichi Nagaoka, Kei Tanaka, Haruhiko Sago, Mitsutoshi Iwashita
Background. Caesarean scar pregnancy (CSP) is a rare ectopic pregnancy associated with life-threatening complications. To date, no therapeutic protocols have been established. Sono-guided local methotrexate (MTX) injection is a relatively easy and low-invasive treatment. Additional systemic MTX is sometimes needed for CSP cases, especially when β-subunit human chorionic gonadotropin (β-hCG) levels are >20,000 mIU/ml at diagnosis. We report on six cases of CSP treated with local MTX injection, five of which received combined local treatment...
2017: Obstetrics and Gynecology International
https://www.readbyqxmd.com/read/28301889/geburtshilfe-an%C3%A3-sthesie-bei-exit-prozedur
#14
REVIEW
Alexander Torossian
The ex utero intrapartum treatment (EXIT) procedure is performed as a part of an extended caesarean section for example to treat fetal airway disorders. For treatment, optimal uterine relaxation is necessary, however utero-placental supply of the fetus has to be guaranteed as well. "Balanced" anesthesia, tocolysis and tight maternal arterial blood pressure control are recommended. Standard fetal monitoring comprises pulse oxymetry and echocardiography. The article describes the physiology and anesthestic goals of the EXIT procedure, discusses alternative anesthesia techniques and gives an outlook on emerging progress...
March 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28277324/risk-factors-for-severe-postpartum-hemorrhage-after-cesarean-delivery-case-control-studies
#15
Alexander J Butwick, Bharathi Ramachandran, Priya Hegde, Edward T Riley, Yasser Y El-Sayed, Lorene M Nelson
BACKGROUND: Women who undergo intrapartum caesarean delivery (CD) are at increased risk of postpartum hemorrhage (PPH) compared with those undergoing prelabor CD. To determine whether the presence and strength of the associations between individual risk factors and severe PPH vary among women undergoing prelabor CD or intrapartum CD, stratified analyses are needed according to CD subtype. METHODS: To identify risk factors for severe PPH within 2 distinct CD populations, prelabor CD and intrapartum CD, we performed 2 case-control studies...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28256306/clinical-follow-up-of-pregnancy-in-myasthenia-gravis-patients
#16
Renata D Ducci, Paulo J Lorenzoni, Claudia S K Kay, Lineu C Werneck, Rosana H Scola
This study aimed to analyze the outcome and impact of pregnancy in women with myasthenia gravis (MG). Obstetric and clinical data were retrospectively analyzed before, during and after pregnancy. Predictors of outcome were studied. We included 35 pregnancies from 21 MG patients. In the course of MG symptoms in 30 pregnancies with live births, 50% deteriorated (mainly during the second trimester, p = 0.028), 30% improved, and 20% remained unchanged. The deterioration group had more frequent abnormal repetitive nerve stimulation (RNS) (p = 0...
April 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28183565/minimum-effective-fluid-volume-of-colloid-to-prevent-hypotension-during-caesarean-section-under-spinal-anesthesia-using-a-prophylactic-phenylephrine-infusion-an-up-down-sequential-allocation-study
#17
Christian Loubert, Pierre-Olivier Gagnon, Roshan Fernando
STUDY OBJECTIVE: The aim of this study was to de termine the minimum effective fluid volume (MEFV) of hydroxyethyl starch 130/0.4 (HES) infused in a preload fashion which would prevent hypotension in 50% of parturients undergoing caesarean section. A secondary objective was to measure the hemodynamic effect of fluid loading on the subjects. DESIGN: This is a prospective, double-blinded, dose-finding study using an up-down sequential allocation design. SETTING: In the operating room...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28033693/comparison-of-morphine-suppository-and-diclofenac-suppository-for-pain-management-after-elective-caesarean-section
#18
RANDOMIZED CONTROLLED TRIAL
Atossa Mahdavi, Zeinab Telkabadi, Ashraf Aleyasin, Marzieh Agha Hosseini, Leili Safdarian, Ali Momenzadeh
This study investigated efficacy and side effects of Morphine suppository for pain management after the first elective caesarean delivery in comparison to Diclofenac suppository. One hundred women aged 18-40 with term pregnancies undergoing elective caesarean section for the first time participated in this prospective project. Exclusion criteria included drug sensitivity, fetal malformations or defects, and complications during the cesarean operation. After same spinal anesthesia and same surgical techniques and in the recovery room patients consecutively received 100 mg diclofenac suppository or 10 mg morphine suppository...
November 2016: Acta Medica Iranica
https://www.readbyqxmd.com/read/27917806/comparison-of-intrathecal-plain-articaine-and-levobupivacaine-with-fentanyl-for-caesarean-section
#19
RANDOMIZED CONTROLLED TRIAL
Rüveyda I Demircioglu, Muhammet Gozdemir, Burhanettin Usta, Hüseyin Sert, Safinaz Karabayirli, Bünyamin Muslu, Esra A Keskin
PURPOSE: Articaine is used as a local anesthetic for outpatient surgery because it offers rapid onset of anesthesia and short duration motor block. Levobupivacaine is often preferred for Caesarean section. We evaluated the anesthetic characteristics of fentanyl-supplemented plain articaine and levobupivacaine for Caesarean section under combine spinal epidural anesthesia. METHODS: Patients undergoing Caesarean section received in random order plain articaine 40 mg (Group A, n=50) or plain levobupivacaine 10 mg (Group L, n=50) mixed with fentanyl 20 µg intrathecally...
December 1, 2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/27906937/transversus-abdominis-plane-block-in-the-management-of-acute-postoperative-pain-syndrome-after-caesarean-section-a-randomized-controlled-clinical-trial
#20
RANDOMIZED CONTROLLED TRIAL
Pierfrancesco Fusco, Vincenza Cofini, Emiliano Petrucci, Paolo Scimia, Tullio Pozone, Giuseppe Paladini, Gaspare Carta, Stefano Necozione, Battista Borghi, Franco Marinangeli
BACKGROUND: The international literature is unclear regarding the analgesic efficacy of the transversus abdominis plane block (TAPB) after a Caesarean section (CS). OBJECTIVES: The aim of this study was to determine whether a correctly performed ultrasound-guided TAPB (USG-TAPB) could provide better control of acute postoperative pain during the first 72 hours after CS and if it could provide a faster postoperative recovery. STUDY DESIGN: A double-blind, randomized, controlled clinical trial on pregnant women who underwent CS...
November 2016: Pain Physician
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