Annales françaises d'anesthèsie et de rèanimation
-
The application and documentation of foetal surveillance in labour that will decrease the incidence of birth asphyxia while maintaining the lowest possible rate of obstetrical intervention remains discussed. The occurrence of abnormal foetal heart rate is a frequent indication for urgent Caesarean section and subsequent associated risks. ⋯ Definitions of safe standards of equipment and practices to prevent Mendelson's syndrome and to cope with a failed intubation drill are of major importance. Comprehensive communication between well-coordinated anaesthetic and obstetrical teams is one of the most important elements in the care of a compromised foetus.
-
Ann Fr Anesth Reanim · Jul 2007
[Ultrasound-guided infraclavicular block: a preliminary study of feasibility].
To assess the feasibility of neurostimulation and ultrasound guidance combination for infraclavicular brachial plexus block (ICB) technique. ⋯ Combination of neurostimulation and ultrasound guidance is feasible. Combination of neurostimulation and ultrasound guidance secured ICB. Ultrasound-evidenced spread of local anaesthetics increased the success rate of ICB.
-
To describe the effects of anaesthetic techniques and agents on the risk of fetal distress during labour pain relief and anaesthesia for caesarean section. ⋯ All obstetric anaesthesia and analgesia techniques are associated with a theoretical risk of fetal distress, but given the fact that regional anaesthesia techniques are also associated with well-demonstrated benefits for the mother and the newborn, the latter remain the preferred choice in obstetric practice.
-
Ann Fr Anesth Reanim · Jul 2007
Review[Is a biological assessment necessary to realize an obstetrical epidural anaesthesia in a patient whose interrogation and clinical examination are strictly normal?].
In France, coagulation blood tests are usually ordered before performing an epidural anaesthesia. This French habit obeys to the fear of triggering an epidural haematoma induced by neuraxial anaesthesia. This analysis of literature shows that these practices do not protect anaesthesiologists against this clinical risk or its medico-legal consequences. ⋯ This recommendation is valid only for normal pregnancy. The clinician must ensure that pregnancy is still normal by seeking for symptoms of pregnancy-induced pathology such as preeclampsia or HELLP syndrome before setting an epidural anaesthesia. The possibly late occurrence of these complications during the per- or post-partum explain why a coagulation test performed even a few days before anaesthesia may not allow to detect any coagulation defect favouring the risk of epidural haematoma.