Effect of dexamethasone on prevention of postoperative nausea, vomiting and pain after caesarean section: a randomised, placebo-controlled, double-blind trial.

Context: Spinal morphine is a common form of postoperative analgesia after caesarean section, but it is associated with postoperative nausea and vomiting.

Objective: To evaluate the hypothesis that dexamethasone reduces nausea and vomiting in patients undergoing caesarean section under spinal anaesthesia with morphine.

Design: Interventional, randomised, double-blinded, placebo-controlled study to evaluate a preoperative single dose of dexamethasone.

Clinical evaluation of the flotrac/Vigileo system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section: a pilot study.

Background: Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo system in patients undergoing spinal anesthesia for elective cesarean section.

Effects of the addition of subarachnoid clonidine to the anesthetic solution of sufentanil and hyperbaric or hypobaric bupivacaine for labor analgesia.

Background And Objectives: The addition of subarachnoid clonidine (alpha-agonist) prolongs the analgesia produced by the combination of sufentanil and isobaric bupivacaine in combined labor analgesia(1). The objective of this study was to compare the quality of analgesia and the prevalence of side effects after the addition of subarachnoid clonidine to the anesthetic solution in labor analgesia.

Methods: After approval by the Ethics Commission, 22 pregnant women in labor were randomly assigned to the subarachnoid administration of either 2.

[Oxytocin in cesarean sections: what is the best way to use it?].

Background And Objectives: Oxytocin is the uterotonic used in obstetric anesthesia, and its prophylactic and therapeutic administration is justified because it reduces the incidence of post-partum hemorrhage. However, the ideal infusion regimen in elective cesarean sections has not been determined yet. The objective of this study was to review the main physiological and pharmacological characteristics of oxytocin and to discuss its rational use by anesthesiologists in view of its side effects.

[The effect of adding subarachnoid clonidine to hyperbaric bupivacaine and sufentanil during labor analgesia.].

Background And Objectives: Adding subarachnoid clonidine (an alpha -agonist) prolongs the analgesic effect of the combination of sufentanil and isobaric bupivacaine when combined during labor analgesia. The aim of this study was to compare the quality and duration of the analgesia as well as the incidence of side-effects after the addition of subarachnoid clonidine to hyperbaric bupivacaine and sufentanil in a combined spinal-epidural analgesia during labor.

Methods: Twenty-six patients, physical status ASA I in full-term pregnancy were studied.

[Preload during spinal anesthesia for cesarean section: comparison between crystalloid and colloid solutions.].

Background And Objectives: Maternal hypotension is the most common complication following spinal anesthesia for cesarean section. This study aimed at comparing the incidence of hypotension and the need for vasopressors in patients submitted to cesarean section under spinal anesthesia following preload with either crystalloid or colloid (modified fluid gelatin).

Methods: Participated in this prospective study 50 term pregnant patients, physical status ASA I, submitted to cesarean section under spinal anesthesia.

[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.

Fluid preload in obstetric patients. How to do it?

Background And Objectives: In has been shown in non-obstetric patients, that a fast acute fluid preload immediately after spinal anesthesia was more effective than a slow preload before regional block to decrease the incidence and severity of arterial hypotension after spinal anesthesia. This study aimed at comparing the incidence of arterial hypotension and vasopressants consumption in parturients submitted to C-section under spinal anesthesia with different fluid preload regimens.

Methods: Sixty term pregnant women submitted to C-section under spinal anesthesia.

[Post-cesarean section analgesia with low spinal morphine doses and systemic nonsteroidal anti-inflammatory drug: diclofenac versus ketoprofen.].

Background And Objectives: The association of low spinal morphine doses and muscular diclofenac is effective to control postoperative pain after Cesarean section under spinal anesthesia. Ketoprofen, also an NSAID, may be advantageous over diclofenac because it may be intravenously administered. This study aimed at comparing the analgesic efficacy of diclofenac and ketoprofen in association to low spinal morphine doses in the immediate postoperative period of patients submitted to Cesarean section under spinal anesthesia.

[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.