SummaryThe insertion of an epidural catheter for labour analgesia may be challenging. This observational study compared pressures during insertion of an epidural catheter in pregnant (n = 35) and non-pregnant (n = 10) women, using an acoustic device for locating the epidural space that also records and stores pressure data during the procedure. In both groups, we compared the maximum pressure just before loss of resistance, the pressure in the epidural space and the pressure in the inserted epidural catheter. Maximum pressure just before loss of resistance in the pregnant women was significantly lower compared with the non-pregnant women. Pressures in the epidural space and with the disposable tubing connected to the inserted epidural catheter were greater in pregnant women than in non-pregnant women. The results support the hypothesis that physiological changes in the third trimester of pregnancy are the reason why epidural catheters are more difficult to insert in women in labour.
patients. The mean time from the administration of the rocuronium to the administration of the reversal drug was 62 ± 18 minutes (range, 46 to 119 min). Every patient (n = 18) had a TOF of <2 so all received 4 mg/kg sugammadex with a mean dose of 304 ± 62 mg (range, 200 to 400 mg). The average time to reach a TOF ratio of Z90% was 86 seconds (95% confidence interval, 69-104 s); this is a faster mean time than has been reported in nonpregnant patients. Sore throat was reported by 6 patients, and nausea and vomiting was reported by 3 patients during the 12 to 24 hours period.The mean onset time with the administration of rocuronium in this study was similar to that reported in nonpregnant patients. The mean onset times of succinylcholine (1.0 mg/kg) and rocuronium (1.2 mg/kg) were similar, and administration of sugammadex reversed rocuronium blockade more quickly than the offset time of succinylcholine. The authors believe that further prospective controlled studies to compare rocuronium/sugammadex and succinylcholine for RSI during general anesthesia for cesarean delivery should be conducted.
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