Current opinion in anaesthesiology
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In the absence of abnormal placentation, perioperative management of repeat cesarean section is almost the same as for primary cesarean section.
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Curr Opin Anaesthesiol · Jun 2020
ReviewCombined spinal epidural for labour analgesia and caesarean section: indications and recommendations.
The combined spinal-epidural offers faster-onset and superior labour analgesia.
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Curr Opin Anaesthesiol · Jun 2020
ReviewHypotension after spinal anesthesia for cesarean section: how to approach the iatrogenic sympathectomy.
Hypotension during cesarean section remains a frequent complication of spinal anesthesia and is associated with adverse maternal and fetal events. ⋯ Current evidence favors a combined approach of low-dose spinal anesthesia, adequate fluid therapy and vasopressor support to address maternal spinal-induced hypotension. As none of the available vasopressors is associated with relevantly impaired maternal and fetal outcomes, none of them should be abandoned from obstetric practice. Rapid crystalloid co-loading is of equivalent efficacy as compared with colloids and should be preferred because of a more favorable risk profile.
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Curr Opin Anaesthesiol · Jun 2020
ReviewPreoperative considerations for Jehovah's Witness patients: a clinical guide.
Jehovah's Witnesses have religious beliefs that preclude transfusion of blood products and certain medical interventions. This presents a unique dilemma and ethical challenge to healthcare providers, especially in a surgical setting. ⋯ Anticipating the challenges associated with managing and optimizing patients who refuse blood products allows for more favorable outcomes in the preoperative period.
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Curr Opin Anaesthesiol · Jun 2020
ReviewPoint-of-care ultrasound in pregnancy: gastric, airway, neuraxial, cardiorespiratory.
This review focuses on the use of point-of-care ultrasound (PoCUS) in the obstetric context for airway management and assessment of aspiration risk, the placement of neuraxial blocks and the diagnosis and follow-up of cardiorespiratory dysfunction. ⋯ Owing to its noninvasiveness, ease of accessibility and lack of exposure to radiation, PoCUS plays an increasing and essential role in aspiration risk assessment, airway management, neuraxial anaesthesia and cardiorespiratory diagnosis and decision-making during pregnancy.