International journal of obstetric anesthesia
-
Int J Obstet Anesth · Oct 2008
Difficult and failed intubation in obstetric anaesthesia: an observational study of airway management and complications associated with general anaesthesia for caesarean section.
Recent developments in anaesthesia and patient demographics have potentially changed the practice of obstetric general anaesthesia. There are few contemporary data on Australasian practice of general anaesthesia for caesarean section, especially relating to airway management, anaesthetic techniques and complications. ⋯ General anaesthesia is most commonly used in emergency situations. Tracheal intubation after rapid-sequence induction remains the predominant approach to airway management in Australasia. The incidence of failed intubation is consistent with previous studies. Aspiration prophylaxis is not routinely used for emergency surgery.
-
Int J Obstet Anesth · Oct 2008
A retrospective case-controlled study of the association between request to discontinue second stage labor epidural analgesia and risk of instrumental vaginal delivery.
Epidural dose is often reduced in the second stage of labor with the intention of improving maternal expulsive efforts and decreasing the need for instrumental vaginal delivery (IVD). We conjectured that parturients requiring IVD would have had more analgesic interventions and requests to decrease analgesic density in the second stage. ⋯ These results support an association between a request to reduce epidural dose in the second stage of labor, as well as supplemental analgesia for treatment of breakthrough pain, with IVD. It is unclear whether administration of more local anesthetic to treat breakthrough pain results in more dense motor blockade, and hence increases risk of IVD, or whether the decrease in infusion rate reflects obstetricians' dissatisfaction with the progress of obstructed labor.
-
In May 2005 the Obstetric Anaesthetists' Association (OAA) and Association of Anaesthetists of Great Britain and Ireland published a document entitled Guidelines for Obstetric Anaesthetic Services. This survey investigated if standards recommended in this document were being met more than six months after its release. ⋯ This national survey illustrates to what extent UK departments meet national guidelines for provision of obstetric anaesthesia services. It also highlights areas for improvement nationally and could be used by individual units to plan resources in the future.