scholarly journals Herpes Simplex Labialis after Epidural or Parenteral Morphine: A Randomized Prospective Trial in an Australian Obstetric Population

1995 ◽  
Vol 23 (4) ◽  
pp. 433-437 ◽  
Author(s):  
R. K. Boyle
Keyword(s):  
Herpes Simplex ◽  
Caesarean Section ◽  
Epidural Morphine ◽  
Past History ◽  
Controlled Trial ◽  
Elective Caesarean Section ◽  
Prospective Trial ◽  
Herpes Labialis ◽  
Oral Herpes ◽  
To Receive

A prospective randomized controlled trial was conducted in women undergoing emergency and elective caesarean section to determine whether epidural morphine predisposes to postoperative herpes simplex labialis and whether the risk is increased or decreased by previous oral herpes or pruritus. Following cannulation of the epidural space, analgesia for labour and/or caesarean section was induced in two groups of similar age, parity, preoperative status and anaesthetic. According to tables of random numbers, 386 were allocated to receive parenteral morphine and 425 to receive epidural morphine. Postoperative herpes labialis was diagnosed by laboratory culture and microscopy. Patients who received epidural morphine were 11.5 times (95% CI 2.6–49.4) more likely than the parenteral morphine group to suffer herpes labialis. A past history of oral herpes increased the risk of herpes labialis by 8.6 times (95 % CI 3.3–22.0). When the influence of past herpes infection and route of morphine were taken into account, no separate association between pruritus and herpex simplex labialis could be demonstrated.

scholarly journals Comparison of Epidural and Intravenous Opioid Analgesia after Elective Caesarean Section

1992 ◽  
Vol 20 (1) ◽  
pp. 41-45 ◽  
Author(s):  
L. Cade ◽  
J. Ashley ◽  
A. W. Ross
Keyword(s):  
Caesarean Section ◽  
Epidural Morphine ◽  
Elective Caesarean Section ◽  
Patient Acceptance ◽  
Opioid Analgesia ◽  
Intravenous Morphine ◽  
To Receive

Patient acceptance is a particularly relevant method of assessing currently employed epidural and intravenous techniques of opioid analgesia after elective caesarean section. We have prospectively studied 71 such patients, randomised postoperatively to receive epidural morphine, intravenous morphine or intravenous pethidine. When compared with either intravenous opioid, epidural morphine provided twofold better average or excellent analgesia with 30% less drowsiness but with about 50% more pruritus. In spite of this troublesome complication, more patients (83% vs 74%) preferred epidural to intravenous opioid analgesia.

scholarly journals A rare case report: successful outcome of a patient at near term pregnancy with maternal chronic obstructive hydrocephalus due to tubercular meningitis

2019 ◽  
Vol 8 (11) ◽  
pp. 4626
Author(s):  
Sowmya Mahesh ◽  
Himshweta Srivastava
Keyword(s):  
Caesarean Section ◽  
Past History ◽  
Obstructive Hydrocephalus ◽  
Elective Caesarean Section ◽  
Rare Event ◽  
Supportive Therapy ◽  
Successful Outcome ◽  
Chronic Obstructive ◽  
Tubercular Meningitis ◽  
Shunt Insertion

The incidence of tubercular meningitis leading to obstructive hydrocephalus is extremely rare accounting for 1% cases and is even rarer during pregnancy. A 20-year-old 2nd Gravida presented at 32 weeks gestation with complaints of intermittent headache, decreased vision since 3 months and irrelevant talks and agitated behavior since 1 day. On examination patient had stable vital signs but constant irritable behavior. Obstetric examination revealed a pregnancy corresponding to 32 weeks with a live fetus. Patient had a past history of Anti-tubercular therapy taken 2 years back for tubercular meningitis. Neurological examination revealed a GCS of 12/15 and Ophthalmologic examination revealed patient to be having only Perception of Light with optic atrophy on fundoscopy. NCCT head revealed moderate dilatation of bilateral ventricles and 3rd ventricle without any periventricular ooze suggestive of Chronic Obstructive Hydrocephalus. Supportive therapy was instituted with Dexamethasone and Mannitol infusion after Neurosurgical consultation along with antenatal care. Decision for termination of pregnancy was taken at 35 weeks by an elective caesarean section with simultaneous ventriculo-peritoneal shunt insertion by neurosurgical team under general anesthesia. A live male baby of 2.25 kg was delivered. Patient with baby was discharged on 10th post-operative day. Obstructive hydrocephalous developing post tubercular meningitis in pregnancy is a rare event. Caesarean section was done along with shunt surgery in our case. Very few cases have been reported in the medical literature so far.

scholarly journals Addition of Adrenaline to Chloroprocaine Provides a Moderate Duration Time for Epidural Anaesthesia in Elective Caesarean Section

2012 ◽  
Vol 40 (3) ◽  
pp. 1099-1107 ◽  
Author(s):  
Sw Feng ◽  
Y Cao ◽  
Wg Wang ◽  
Ys Liu ◽  
Xf Shen
Keyword(s):  
Caesarean Section ◽  
Epidural Anaesthesia ◽  
Analogue Scale ◽  
Elective Caesarean Section ◽  
Onset Time ◽  
Attractive Alternative ◽  
Cold Sensation ◽  
Time Duration ◽  
Duration Time ◽  
To Receive

OBJECTIVE: Epidural anaesthesia using chloroprocaine with or without adrenaline and lidocaine with adrenaline were compared. METHODS: Sixty parturients undergoing elective caesarean section under epidural anaesthesia were randomized to receive 3% chloroprocaine (group C), 3% chloroprocaine with adrenaline (group CA) or 2% lidocaine with adrenaline (group LA). Onset time, duration time and various maternal, fetal and neonatal parameters were monitored. Pain was assessed using a visual analogue scale. RESULTS: The onset time of analgesia in group CA was similar to that in group C but was shorter than that in group LA. Duration of analgesia, loss of cold sensation and motor blockade in group CA were prolonged compared with group C, but were shorter than those in group LA. No differences in maternal, fetal or neonatal effects were seen. A higher pain score was reported in group C than in groups CA or LA at the end of surgery. CONCLUSIONS: Epidural anaesthesia using chloroprocaine with adrenaline has a quick onset and moderate duration and is an attractive alternative to lidocaine and adrenaline or chloroprocaine alone for caesarean section.

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