Ann Acad Med Singap
-
Although epidural and spinal blocks are well-accepted regional techniques in obstetrics, they have several disadvantages. Combined spinal-epidural (CSE) technique reduces or eliminates the risks of these disadvantages. The sequential CSE technique can reduce the incidence and severity of maternal hypotension. ⋯ Before any injection in the epidural catheter, its position should always be confirmed by aspiration test. The technique should be used only by those who are experienced in spinal and epidural blocks. CSE is an important addition to the armamentarium of the obstetric anaesthesiologist.
-
Thirty-nine patients with 46 limbs at risk underwent arterial embolectomy. The overall mortality was 36% (14 patients). Seventeen limbs (37%) had a poor result. ⋯ The delay from onset of symptoms to the operation varied between a few hours to over a week and this was not related to the outcome. Thirteen percent of the arterial occlusions were in the upper limb. All of these were due to embolism and there was no mortality for this group with all affected arms achieving a good outcome.
-
Ann Acad Med Singap · Sep 1994
Occupational burns in the Burns Centre at the Singapore General Hospital.
This study reviewed all work-related burn injuries within the period 1 April 1992 to 31 March 1993 for the purpose of establishing data on occupational burns in Singapore to identify the specific at-risk population and formulate prevention strategies. All 163 patients who were admitted to the Burns Centre, Singapore General Hospital, as a result of burns suffered in the workplace were reviewed using the World Health Organisation Burns Data Protocol. Burns data recorded included demography, industrial sector involved, aetiology, extent of injury and eventual outcome in terms of mortality and morbidity. ⋯ Seven patients died, giving a mortality rate of 4.3%. The average BSA for these patients was 46.4% and all had respiratory burns. In all, occupational burns accounted for 2011 patient-days of hospitalization, 630,637 lost days at work and inpatient treatment costs amounting to S $1.32 million.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Ann Acad Med Singap · Jul 1994
Case ReportsRepeat epidural caesarean section in a patient with cerebral arteriovenous malformation.
Following a previous uneventful pregnancy and caesarean section, a 27-year-old woman with an untreated cerebral arteriovenous malformation presented again with a second pregnancy. While the cerebral haemodynamics during labour and delivery remain unclear, it is best to avoid Valsalva manoeuvres in women with cerebrovascular disease, and therefore caesarean section is usually the preferred method of delivery. ⋯ In the absence of decreased intracranial compliance, epidural anaesthesia is recommended because it avoids the haemodynamic stresses of laryngoscopy and rapid sequence intubation. The anaesthetic management of cerebral arteriovenous malformation in pregnancy is summarised.