A biased coin up-and-down sequential allocation trial to determine the optimum programmed intermittent epidural bolus time interval between 5 mL boluses of bupivacaine 0.125% with fentanyl 2 µg·mL.

Purpose: The optimal epidural mixtures and settings for programmed intermittent epidural bolus (PIEB) labour analgesia have yet to be determined. A previous study by our group demonstrated that 10 mL boluses of bupivacaine 0.0625% with fentanyl 2 µg·mL administered every 40 min provided effective analgesia during the first stage of labour for 90% of women, without breakthrough pain.

Mode of anesthesia and clinical outcomes of patients undergoing Cesarean delivery for invasive placentation: a retrospective cohort study of 50 consecutive cases.

Purpose: Invasive placentation is one of the most important causes of postpartum hemorrhage and Cesarean hysterectomies (CHyst). The optimal mode of anesthesia in the management of these patients remains uncertain. The purpose of this study was to review the impact of mode of anesthesia on maternal and neonatal outcomes in women with invasive placentation undergoing Cesarean delivery (CD).

Carbetocin at Cesarean delivery for labour arrest: a sequential allocation trial to determine the effective dose.

Purpose: The aim of this study was to estimate the effective dose 90% (ED90) of carbetocin to provide adequate uterine tone at Cesarean delivery (CD) for labour arrest.

Methods: We conducted a double-blind dose-finding study of carbetocin using a biased-coin up-and-down design in women undergoing CD for labour arrest under epidural anesthesia. Forty healthy term pregnant women who had received at least three hours of oxytocin infusion during labour were recruited for the study.

Non-invasive hemodynamic assessment of non-pregnant, healthy pregnant and preeclamptic women using bioreactance. [corrected].

Background And Objectives: We compared hemodynamic profiles of healthy and mildly preeclamptic pregnant women at term, as well as those of non-pregnant controls, using a new non-invasive cardiac output monitor (NICOM) based on bio-reactance.

Methods: We studied healthy term pregnant women at term (Preg, n = 10), mildly preeclamptic pregnant women at term (PregPE, n = 10), and healthy non-pregnant female volunteers (NonPreg, n = 10). With the subjects in the semi left lateral position, 4 electrodes of the NICOM device were applied to their chest wall, followed by a 15-minute rest period.

Ultrasound-facilitated epidurals and spinals in obstetrics.

Regional anesthesia is currently the gold standard of practice for pain control in obstetrics. Failures and complications of regional anesthesia can be related to many causes, one of the most important being the blind nature of such techniques. The practice of epidurals and spinals relies primarily on the palpation of anatomic landmarks that are not always easy to find.

[Anesthesia for cesarean section in a patient with congenital adrenal hyperplasia: case report.].

Background And Objectives: The purpose of this case report is to illustrate the anesthetic management of a Cesarean section in a patient with non-classic congenital adrenal hyperplasia (CAH) and to review the clinical features and management of various forms of CAH during pregnancy.

Case Report: A 32-year-old primigravida, diagnosed with non-classic CAH, was admitted with intrauterine growth retardation at 28 weeks of gestation. Clinical features included morbid obesity, mild hypertension and chronic use of glucocorticoids.

[Spinal sufentanil associated to hyperbaric bupivacaine: Is it possible to decrease opioid dose?].

Background And Objectives: The association of isobaric bupivacaine to lower spinal sufentanil dose provides satisfactory analgesia and lower incidence of side effects. This study aimed at evaluating quality of analgesia and incidence of side effects of decreased spinal sufentanil doses associated to hyperbaric bupivacaine for labor analgesia.

Methods: Participated in this study 69 healthy term pregnant patients in active labor.

Extraconal block for cataract extraction surgery with implantation of intraocular lens: contribution of fentanyl associated to local anesthetics for quality of block and postoperative analgesia.

Background And Objectives: Loco-regional anesthesia for cataract extraction surgery offers as advantages minimum physiological changes, complete anesthesia, eye reflexes blockade, lower incidence of nausea and vomiting and shorter recovery time, in addition to postoperative analgesia. Continuous concern with blockade quality as well as with postoperative analgesia is responsibility of the anesthesiologist. This study aimed at evaluating whether fentanyl has contributed to blockade quality and postoperative analgesia in cataract extraction surgery with implantation of intraocular lens.

[Extraconal block for cataract extraction surgery with implantation of intraocular lens: influence of access way (upper or lower) in anesthetic outcome].

Background And Objectives: There is no completely safe anesthetic technique for ophthalmic surgery. The introduction of extraconal anesthesia has increased the number of ophthalmic surgeries with blockade since the incidence of severe complications is lower, as reported by Hay in 1991. Extraconal blockades may be induced by several access ways, among them upper and lower ways.

[Intramuscular versus rectal diclofenac associated with low dose spinal morphine for post-cesarean analgesia.].

Background And Objectives: Diclofenac has been used in combination with spinal opioids to control postoperative pain; however, the best regimen of its administration is not known. This study evaluated the quality of postoperative analgesia of different regimens of diclofenac administration, in patients submitted to Cesarean section under spinal anesthesia with bupivacaine and morphine.

Methods: After the end of surgery, patients were randomly allocated into three groups that received diclofenac as follows: G50VR(n=62), 50 mg rectally; G50IM(n=62), 50 mg intramuscularly and G75IM (n=62), 75 mg intramuscularly.