Current opinion in anaesthesiology
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Obesity is a growing healthcare problem worldwide, which also affects the pregnant population. Obesity occurs with increasing frequency during pregnancy. Obesity increases the maternal, fetal and neonatal risks. Also, the anesthesiologist is confronted with significantly more problems when the parturient is overweight or obese. The present review focuses on the anesthetic implications of obesity in pregnancy. ⋯ Anesthesia-related complications are more frequent in obese parturients. Most authors and opinion leaders agree that regional anesthesia is the preferred technique for Cesarean section in obese patients, and that efforts to place early labor epidural analgesia should be optimized in order to be able to avoid general anesthesia when unplanned Cesarean section is required.
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Curr Opin Anaesthesiol · Jun 2009
ReviewTattooing and various piercing: anaesthetic considerations.
Body art is increasing since the 1990s. Anaesthesiologists would be more and more confronted to patient with tattooing or piercing, or both. This review discusses the anaesthetic potential risks and complications observed with tattooing and piercing, their management and prevention. ⋯ Oral and nasal piercing is of particular concern because of the risks of swallowing and aspiration. Consequently, patients should be advised to remove piercing before anaesthesia. Emergency situations are especially risky and anaesthesiologists should be aware of the piercing removal techniques. In case of piercing loss, radiographies and fiberoptic endoscopy of the upper airways and digestive tracts should be performed to eliminate aspiration or swallowing of the foreign body. Epidurals should not be denied to parturients with lumbar tattooing. However, it seems still prudent to avoid direct tattoo puncture or when unavoidable, to nick the skin prior to inserting the needle through the tattoo.