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Preston P. G.; Rosen, M. A.; Hughes, S. C.; Glosten, B.; Ross, B. K.; Daniels, D.; Shnider, S. M.; Dailey, P. A.; James, Francis M. III M.D.
Obstetric Anesthesia Digest: January 1989

Thirty healthy parturients undergoing nonemergent cesarean section were prehydrated and maintained with left uterine displacement at all times. Following assurance that a lumbar epidural catheter was properly placed, patients received 8 cc of 2% lidocaine with 1:200,000 epinephrine with 2 ml of saline or the same dose of lidocaine with 2 ml of saline containing 1 μg/kg of fentanyl. Continuance of the block was then performed with fentanyl-free lidocaine. Intraoperative pain was treated with analgesics and sedatives and was assessed as none to severe at skin incision, bladder retraction, neonatal delivery, uterine exteriorization, and peritoneal closure. Note was made of side effects such as nausea, vomiting, pruritus, sedation, and respiratory depression. Fentanyl levels were determined in maternal blood and cord blood at delivery. Neonatal condition was determined by Apgar scores and NACS at 15 minutes, 2 hours and 24 hours.

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