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An up-down determination of the required seated duration after intrathecal injection of bupivacaine and fentanyl for the prevention of hypotension during Cesarean delivery

AbstractPurposeA prolonged seated time after intrathecal injection of hyperbaric bupivacaine and morphine is related to the incidence of hypotension during Cesarean delivery, but results in a high incidence of pain during peritoneal closure. We conducted this study to determine the effect of the addition of intrathecal fentanyl on the relationship between seated time and hypotension and intraoperative analgesia requirements.MethodsWomen undergoing Cesarean delivery were randomized to receive an intrathecal injection of either 11.25 or 15 mg of hyperbaric bupivacaine with morphine 150 µg and fentanyl 15 µg using a combined spinal-epidural technique. The seated duration following intrathecal injection was assigned using up-down methodology. If the preceding patient was hypo- or normotensive, the next patient sat for 15 sec more or less, respectively. A systolic blood pressure
Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research

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Source: Medscape Anesthesiology Podcast - Category: Anesthesiology Authors: Source Type: podcasts
Drs Beckman and Soffin from Hospital for Special Surgery share a spine surgery case that embodies recent shifts in managing pain.Hospital for Special Surgery
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Anesthesiology Commentary Source Type: news
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Source: Acta Orthopaedica Belgica - Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research
Objectives: Intrathecal morphine is used in the postoperative management of pain after caesarean section (CS), but might not be optimal for intraoperative analgesia. We hypothesized that intrathecal fentanyl could supplement intraoperative analgesia when added to a local anesthetic and morphine without affecting management of postoperative pain. Methods: This prospective, randomized, double-blind, parallel-group study included 60 parturients scheduled for elective CS. Spinal anesthesia consisted of bupivacaine with either morphine 100 μg (M group), or fentanyl 25 μg and morphine 100 μg (FM group). The f...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research
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Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research
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Source: Clinical Autonomic Research - Category: Research Source Type: research
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Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
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Source: PMandR - Category: Rehabilitation Source Type: research
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