International journal of obstetric anesthesia
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Int J Obstet Anesth · Jan 1999
Administration of drugs outside of Product Licence: awareness and current practice.
An interactive audience response system was used to collect information from members of the Obstetric Anaesthetists' Association at the 1997 Annual Meeting about the drug use that is unsupported by the Product Licence. The responses confirm that both licensed and unlicensed drugs are widely used in clinical practice outside the limitations imposed by Product Licence. ⋯ A majority of audience members expressed a view that the OAA should play a pro-active role, either by polling members about their current practice, or by issuing guidelines on reasonable drug practice in obstetric anaesthesia, or both. Potential implications of these are discussed.
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Int J Obstet Anesth · Jan 1999
Long-term neurological complication following traumatic damage to the spinal cord with a 25 gauge whitacre spinal needle.
Neurological complications following regional anaesthesia may arise due to compression of the spinal cord or nerve roots secondary to haematoma or abscess, trauma, neurotoxicity or ischaemia. We report a patient who developed prolonged left lower limb paresis following combined spinal epidural (CSE) anaesthesia for emergency caesarean section. Magnetic resonance imaging (MRI) showed marked swelling of the lower end of the spinal cord suggesting traumatic damage of the cord by the spinal needle.
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Int J Obstet Anesth · Oct 1998
Operative obstetric mortality at Harare Central Hospital 1992-1994: an anaesthetic view.
A prospective review of anaesthetic-associated deaths (AAD) was undertaken at the maternity unit of Harare Central Hospital, Zimbabwe, for the triennium 1992-1994. AAD was defined as death within 24 h of anaesthesia or failure to regain consciousness. Three groups of avoidable factors (obstetric, anaesthetic and administrative) were considered, and a scoring system used to allocate one avoidability point for each death with avoidable factors. ⋯ The problems are discussed and also viewed in the context of overall maternal mortality (outcome period 42 days). The mortality data are compared with those from the UK and some hospitals in South Africa. It is concluded that improvements in resources, education, guidelines and monitoring are necessary if the mortality rate is to be reduced.