Publications by authors named "H H Nixon"

The ED50 and ED95 of spinal bupivacaine for cesarean delivery has been well described in the literature; however, parturients with extremes of stature have been excluded. Parturients of short stature are a height of ≤ 148 cm. This retrospective, case-control study evaluated anesthetic outcomes for parturients of short stature and controls who underwent cesarean delivery over a 10-year period.

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Article Synopsis
  • Timely response to obstetrical emergencies focuses on achieving a decision-to-incision time of ≤30 minutes in cesarean deliveries to reduce risks of neonatal complications.
  • A study analyzed 610 cesarean sections, revealing that while 68% of emergent cases met the ≤15 minutes target, urgent cases struggled, with only 48% achieving the ≤30 minutes goal.
  • Findings indicate higher instances of newborn acidosis and low Apgar scores in emergent deliveries, highlighting that while adherence to DTI targets is challenging, the need for neonatal resuscitation is more linked to surgery urgency rather than the actual DTI time.
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Pharmacologic thromboprophylaxis from venous thromboembolism (VTE) and thrombocytopenia in pregnancy results in conditions that may preclude the use of neuraxial anesthesia due to a perceived risk of spinal/epidural hematoma. Spinal epidural hematoma is a recognized complication in patients who are hypocoagulable and may lead patients to undergo general anesthesia for delivery or other procedures, which carries numerous complications in obstetric care. A robust understanding of maternal physiologic changes in coagulation status, review of consensus statements, and safety bundles may help to maximize the use of neuraxial anesthesia in obstetric patients who might otherwise be denied these anesthetic techniques.

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Surgical repair of Tetralogy of Fallot has excellent outcomes, with over 90% of patients alive at 30 years. The ideal time for surgical repair is between 3 and 11 months of age. However, the symptomatic neonate with Tetralogy of Fallot may require earlier intervention: either a palliative intervention (right ventricular outflow tract stent, ductal stent, balloon pulmonary valvuloplasty, or Blalock-Taussig shunt) followed by a surgical repair later on, or a complete surgical repair in the neonatal period.

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