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cesarean section spinal anesthesia

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https://www.readbyqxmd.com/read/27890467/use-of-hyperbaric-oxygen-therapy-and-pegylated-carboxyhemoglobin-bovine-in-a-jehovah-s-witness-with-life-threatening-anemia-following-postpartum-hemorrhage
#1
K Thenuwara, J Thomas, M Ibsen, U Ituk, K Choi, E Nickel, M J Goodheart
We present a case of a Jehovah's Witness patient who refused blood products, with the exception of albumin and clotting factors, and underwent cesarean section under spinal anesthesia complicated by postpartum hemorrhage. She was fluid resuscitated and treated with multiple uterotonics and internal iliac artery embolization. Because of agitation she required emergency tracheal intubation. Her hemoglobin concentration dropped from a preoperative value of 12mg/dL to 3mg/dL on postoperative day one. She was acidotic, requiring vasopressors for hemodynamic stability and remained ventilated and sedated...
October 24, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27848124/reversible-cerebral-vasoconstriction-syndrome-and-posterior-reversible-encephalopathy-syndrome-associated-with-intracranial-hypotension
#2
Katharina Feil, Robert Forbrig, Franziska S Thaler, Julian Conrad, Suzette Heck, Franziska Dorn, Hans-Walter Pfister, Andreas Straube
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) and posterior reversible encephalopathy syndrome (PRES) are both rare disorders. The pathophysiology of both diseases is not yet fully understood. METHODS: We report the unique case of a 19-year-old comatose woman who was brought to the ER after a series of generalized tonic-clonic seizures 6 days post peridural anesthesia for cesarean section. Vital signs and initial laboratory testing including urine analysis and drug screening were unremarkable...
November 15, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27847700/the-effect-of-ginger-extract-on-the-incidence-and-severity-of-nausea-and-vomiting-after-cesarean-section-under-spinal-anesthesia
#3
Hossein Zeraati, Javad Shahinfar, Shiva Imani Hesari, Mahnaz Masrorniya, Fatemeh Nasimi
BACKGROUND: Nausea and vomiting are one of the most common complications of cesarean sections under spinal anesthesia. Recently, the use of drugs to treat nausea and vomiting has decreased, and nonpharmaceutical and alternative traditional medicine are often preferred. OBJECTIVES: This study aimed to determine the effect of ginger extract on the incidence and severity of nausea and vomiting after cesarean section under spinal anesthesia. METHODS: In this double-blind randomized clinical trial, 92 pregnant women, each of whom underwent a cesarean section under spinal anesthesia, were divided in two groups: a control group and an intervention group...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27843773/effect-of-position-during-spinal-anesthesia-on-postdural-puncture-headache-after-cesarean-section-a-prospective-single-blind-randomized-clinical-trial
#4
Maryam Davoudi, Masoud Tarbiat, Mohammad Reza Ebadian, Puran Hajian
BACKGROUND: The most common method of anesthesia for cesarean section is spinal anesthesia, and postdural puncture headache (PDPH) remains a major complication of this procedure. Nowadays, PDPH is a major cause of morbidity in parturients after spinal anesthesia. This headache is the third most popular reason for claims against anesthesiologists in obstetrics. The position after spinal anesthesia has been evaluated as a contributory factor in the occurrence of PDPH, but the position before spinal anesthesia has not yet been evaluated...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27793237/sufentanil-in-combination-with-low-dose-hyperbaric-bupivacaine-in-spinal-anesthesia-for-cesarean-section-a-randomized-clinical-trial
#5
Alexandre Dubeux Dourado, Ruy Leite de Melo Lins Filho, Raphaella Amanda Maria Leite Fernandes, Marcelo Cavalcanti de Sá Gondim, Emmanuel Victor Magalhães Nogueira
A double blind randomized clinical trial of sufentanil as an adjunct in spinal anesthesia for cesarean section and, thereby, be able to reduce the dose of bupivacaine, a local anesthetic, with the same result of an anesthetic block with higher doses but with fewer perioperative side effects, such as hypotension.
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27789074/prediction-of-hypotension-during-spinal-anesthesia-for-elective-cesarean-section-by-altered-heart-rate-variability-induced-by-postural-change
#6
K Sakata, N Yoshimura, K Tanabe, K Kito, K Nagase, H Iida
BACKGROUND: Maternal hypotension is a common complication during cesarean section performed under spinal anesthesia. Changes in maternal heart rate with postural changes or values of heart rate variability have been reported to predict hypotension. Therefore, we hypothesized that changes in heart rate variability due to postural changes can predict hypotension. METHODS: A total of 45 women scheduled to undergo cesarean section under spinal anesthesia were enrolled...
September 22, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27755488/quadratus-lumborum-block-versus-transversus-abdominis-plane-block-for-postoperative-pain-after-cesarean-delivery-a-randomized-controlled-trial
#7
Rafael Blanco, Tarek Ansari, Waleed Riad, Nanda Shetty
BACKGROUND AND OBJECTIVES: Effective postoperative analgesia after cesarean delivery enhances early recovery, ambulation, and breastfeeding. In a previous study, we established the effectiveness of the quadratus lumborum block in providing pain relief after cesarean delivery compared with patient-controlled analgesia (morphine). In the current study, we hypothesized that this method would be equal to or better than the transversus abdominis plane block with regard to pain relief and its duration of action after cesarean delivery...
October 11, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27746565/evaluation-of-antihypotensive-techniques-for-cesarean-section-under-spinal-anesthesia-rapid-crystalloid-hydration-versus-intravenous-ephedrine
#8
Kalpana Rajendra Kulkarni, Amruta Girish Naik, Sunetra Girish Deshpande
BACKGROUND: Spinal anesthesia is a preferred technique over general anesthesia for cesarean delivery. It avoids maternal airway related complications, aspiration and neonatal depression. However hypotension following spinal anesthesia can lead to decrease in uterine blood flow and neonatal hypoxia. AIMS: We aimed to evaluate the efficacy of 15 mL.kg- 1of crystalloid preloading versus prophylactic intravenous bolus of 10 mg ephedrine as an antihypotensive measure for cesarean section...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746564/premedication-with-midazolam-prior-to-cesarean-delivery-in-preeclamptic-parturients-a-randomized-controlled-trial
#9
Ali M Mokhtar, Ahmed I Elsakka, Hassan M Ali
BACKGROUND: Anxiety is a concern in obstetrics, especially in preeclamptic mothers. Sedation is not commonly used in parturients for fear of adverse neonatal effect. We investigated maternal and neonatal outcome of midazolam as an adjuvant to spinal anesthesia for elective cesarean delivery. METHODS: A prospective randomized controlled trial, in which eighty preeclamptic parturients received either an intravenous dose of 0.035 mg/kg of midazolam or an equal volume of normal saline, 30 min before spinal anesthesia...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746526/efficacy-of-lipophilic-vs-lipophobic-opioids-in-addition-to-hyperbaric-bupivacaine-for-patients-undergoing-lower-segment-caeserean-section
#10
Amit Agrawal, Veena Asthana, J P Sharma, Vineeta Gupta
BACKGROUND: Subarachnoid block is the preferred technique for providing anesthesia for patients undergoing cesarean section. Various pharmacological agents in added to local anesthetics (LA) modify their original effects in terms of block characteristics and quality of analgesia. However, there is ongoing debate about this practice of using adjuncts with LA. We tested whether addition of lipophilic versus lipophobic opioids to LA gives any clinical benefits to maternal and fetal outcome when used in these patients requiring spinal anesthesia...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27723068/costs-of-the-use-of-carbetocin-in-the-prevention-of-uterine-atony-following-delivery-of-the-infant-by-caesarean-section-retrospective-multicenter-study
#11
Maciej Sobkowski, Zbigniew Celewicz, Jarosław Kalinka, Krzysztof Szymanowski, Marcin Serafin, Katarzyna Śmieja, Anna Grzymała-Figura, Kinga Pacocha, Izabela Pieniążek, Jacek Walczak, Agnieszka Żyła, Adam Bierut
OBJECTIVES: The aim of this study was to compare the costs of using carbetocin in the prevention of uterine atony following delivery of the infant by Cesarean section (C-section) under epidural or spinal anesthesia with standard methods of prevention (SMP). MATERIAL AND METHODS: This retrospective multicenter study was based on data from three medical centers. A questionnaire was developed to gather patient records on consumption and costs of resources related to C-section, prevention of uterine atony and postpartum hemorrhage (PPH) treatment...
2016: Ginekologia Polska
https://www.readbyqxmd.com/read/27710984/the-effect-of-parturient-height-on-the-median-effective-dose-of-intrathecally-administered-ropivacaine
#12
Xiangdi Yu, Fangxiang Zhang
BACKGROUND: Pain during cesarean delivery is one of the more common reasons for a successful medicolegal claim. However, creating an extensive block area can result in hypotension, so determining the precise dose of local anesthetic is critical. OBJECTIVES: Investigate effects of parturient height on the median effective dose (ED50) of intrathecally-administered ropivacaine. DESIGN: Prospective cross-sectional analytic study. SETTING: Anesthesiology department in a provinicial hospital in China...
September 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27703393/effectiveness-of-low-dose-intravenous-ketamine-to-attenuate-stress-response-in-patients-undergoing-emergency-cesarean-section-with-spinal-anesthesia
#13
Tjokorda Gde Agung Senapathi, I Made Gede Widnyana, Made Wiryana, I Gusti Ngurah Mahaalit Aribawa, I Wayan Aryabiantara, I Gusti Agung Gede Utara Hartawan, I Ketut Sinardja, I Putu Pramana Suarjaya, I Ketut Wibawa Nada, Aa Gde Putra Semara Jaya
PURPOSE: Cesarean section is a surgical procedure. Surgical procedures will induce stress responses, which may have negative impact on postoperative recovery. Ketamine plays a role in the homeostatic regulation of inflammatory response in order to attenuate stress response. We tried to determine the effectiveness of low-dose intravenous ketamine to attenuate stress response in patients undergoing emergency cesarean section with spinal anesthesia. PATIENTS AND METHODS: Thirty-six pregnant women undergoing emergency cesarean section with spinal anesthesia were randomly divided into two groups (n=18)...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27703328/effect-of-low-dose-of-intrathecal-pethidine-on-the-incidence-and-intensity-of-shivering-during-cesarean-section-under-spinal-anesthesia-a-randomized-placebo-controlled-double-blind-clinical-trial
#14
Shoaleh Shami, Karim Nasseri, Mousa Shirmohammadi, Farzad Sarshivi, Negin Ghadami, Ebrahim Ghaderi, Mokhtar Pouladi, Arvin Barzanji
INTRODUCTION: Shivering is among the unpleasant and potentially harmful side effects of spinal anesthesia. The aim of this randomized double-blind clinical trial was to compare the antishivering effect of two different doses of intrathecal pethidine on the incidence and intensity of shivering and other side effects in patients who underwent cesarean section. METHODS: In this study, 150 parturient females scheduled for nonemergent cesarean section were randomly allocated to three groups...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/27678496/inadvertent-spinal-injection-of-ondansetron
#15
May-Han Loh, Lyn Li Lean, Bryan Su Wei Ng, Will Ne-Hooi Loh
Cesarean sections under spinal anesthesia are now a daily occurrence in most tertiary hospitals. We report the first published case of inadvertent spinal injection of ondansetron without any neurological sequelae in a patient undergoing elective Cesarean section under spinal anesthesia. She did not experience any permanent neurological sequelae, and also did not exhibit any central neuraxial opioid side effects-nausea, vomiting or pruritus. Vigilance is essential to reduce the risk of wrong route delivery of drugs, especially when presented in very similar-looking 2 mL ampules as in our institution...
September 27, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27668205/aortic-dissection-accompanied-by-preeclampsia-in-a-postpartum-young-woman
#16
Jin-Wan Park, Su-Mi Kim, Gyu-Bong Yu, Yun-Dan Kang
Aortic dissection is very rare in obstetrics, but it is a fatal disease. A 37-weeks primigravida woman with dyspnea and pitting edema presented to our emergency room. The patient was diagnosed with preeclampsia and underwent an emergency cesarean section under spinal anesthesia. The patient complained of severe dyspnea after the cesarean section, and the chest computed tomography scan was done. With the finding of aortic dissection, cardiopulmonary arrest occurred 5 hours after the cesarean section, and the patient died without reaction to cardio-pulmonary resuscitation...
September 2016: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/27662063/delayed-neuraxial-hematoma-in-parturient-with-fontan-circulation-following-neuraxial-anesthesia-for-cesarean-section
#17
Chukwudi O Chiaghana, Justin M Bremer, Joshua W Sappenfield, Adam L Wendling
OBJECTIVE: Neuraxial hematoma is a rare complication of spinal or epidural anesthesia. However, variable coagulation factor defects are relatively common in patients with Fontan circulation, and may predispose such patients to either increased risk of thrombosis or coagulopathy. These defects may indirectly increase their risk of neuraxial hematoma. CASE REPORT: We report a case of delayed neuraxial hematoma after the start of full-dose anticoagulation for pulmonary embolus on a postpartum patient with Fontan physiology who had continuous spinal anesthesia for cesarean delivery 4 days earlier...
September 22, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27642568/comparing-the-hemodynamic-effects-of-spinal-anesthesia-in-preeclamptic-and-healthy-parturients-during-cesarean-section
#18
Mahshid Nikooseresht, Mohamad Ali Seif Rabiei, Pooran Hajian, Razieh Dastaran, Nasim Alipour
BACKGROUND: Despite controversies about the safest anesthetic technique for cesarean delivery in severely preeclamptic women, there is evidence that supports the use of spinal anesthesia in this group of patients. OBJECTIVES: This prospective randomized clinical trial was designed to determine the hemodynamic effects of low-dose spinal bupivacaine and the incidence of spinal anesthesia-associated hypotension in severely preeclamptic and healthy parturients undergoing cesarean sections...
June 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27605955/a-randomised-controlled-trial-comparing-weight-adjusted-dose-versus-fixed-dose-prophylactic-phenylephrine-infusion-on-maintaining-systolic-blood-pressure-during-caesarean-section-under-spinal-anaesthesia
#19
Lucy Mwaura, Vitalis Mung'ayi, Jimmie Kabugi, Samina Mir
BACKGROUND: Spinal anaesthesia is the standard of care for elective caesarean delivery. It has advantages over general anaesthesia. However the sympathetic blockade induced by spinal anaesthesia results in an 80 percent incidence of hypotension without prophylactic management. Current evidence supports co-loading with intravenous fluids in conjunction with the use of vasopressors as the most effective way to prevent and treat the hypotension. Phenylephrine is the accepted vasopressor of choice in the parturient...
June 2016: African Health Sciences
https://www.readbyqxmd.com/read/27591457/perioperative-warming-with-a-thermal-gown-prevents-maternal-temperature-loss-during-elective-cesarean-section-a-randomized-clinical-trial
#20
Ricardo Caio Gracco de Bernardis, Monica Maria Siaulys, Joaquim Edson Vieira, Lígia Andrade Silva Telles Mathias
BACKGROUND AND OBJECTIVES: Decrease in body temperature is common during general and regional anesthesia. Forced-air warming intraoperative during cesarean section under spinal anesthesia seems not able to prevent it. The hypothesis considers that active warming before the intraoperative period avoids temperature loss during cesarean. METHODS: Forty healthy pregnant patients undergoing elective cesarean section with spinal anesthesia received active warming from a thermal gown in the preoperative care unit 30min before spinal anesthesia and during surgery (Go, n=20), or no active warming at any time (Ct, n=20)...
September 2016: Brazilian Journal of Anesthesiology
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