Epidural Volume Extension in Combined Spinal-epidural Anesthesia for Elective Cesarean Section

2012 ◽  
Vol 32 (2) ◽  
pp. 137
Author(s):  
C. Loubert ◽  
P. J. O’Brien ◽  
R. Fernando ◽  
N. Walton ◽  
S. Philip ◽  
...  
2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Danielle Levin

We would like to present the first report of severe acute dystonic reaction after a single administration of metoclopramide during cesarean section under combined spinal-epidural anesthesia.  During elective cesarean section, a 30-year-old female vomited four times and was treated with 10mg intravenous metoclopramide and 8mg intravenous ondansetron.  Nausea subsided with the antiemetic treatment, but two minutes later, patient had rapid eye blinking, uncontrollable head movement, and became unresponsive.  Bolus of 50mg intravenous diphenhydramine resolved the acute dystonic symptoms within seconds.  Patient was again oriented times three, with no recollection of symptoms, and remained symptom free for the rest of admission. 


2019 ◽  
Vol 47 (9) ◽  
pp. 4442-4453 ◽  
Author(s):  
Jing Sun ◽  
Zhao Zheng ◽  
Yi-Lu Li ◽  
Li-Wei Zou ◽  
Ge-Hui Li ◽  
...  

Objective This study aimed to compare the clinical efficacy and side effects of nalbuphine and dexmedetomidine for treatment of combined spinal-epidural anesthetic shivering in women after cesarean section. Methods A total of 120 pregnant women, who underwent elective cesarean section under combined spinal-epidural anesthesia, were enrolled in a double-blind, randomized study. These women were randomized into three groups of 40 pregnant women each to receive either saline (group C), nalbuphine 0.07 mg/kg (group N), or dexmedetomidine 0.5 µg/kg (group D) for treatment of shivering after anesthesia. The main outcome measure was a significant reduction in the time required for shivering after intervention. Results The mean time to cessation of shivering in groups N and D was significantly shorter than that in group C (3.5±2.7 and 4.2±3.7 versus 14.5±1.4 minutes). The success rate of shivering treatment and Observer’s Assessment of Alertness/Sedation scores in groups N and D were significantly higher than those in group C, while the recurrence rate was lower than that in group C. Conclusion Nalbuphine 0.07 mg/kg can be used safely and effectively for shivering in pregnant women under combined spinal-epidural anesthesia.


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