International journal of obstetric anesthesia
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Obstetric audit is multidisciplinary, but maternal mortality data represent the only national obstetric anaesthetic audit currently available in the UK. Maternity and neonatal audit is progressing towards the collection of both numerator and denominator data in order to compare local, regional and national figures. Obstetric anaesthetists as a professional group play a significant role in maternity care and have in the past developed a minimum data set. ⋯ Since local and regional obstetric anaesthesia data collection systems are available, albeit in various manual or computerized forms, this is an achievable target. A standard maternity and neonatal data set which incorporates obstetric anaesthetic clinical items could offer a qualitative comparison of process variables and outcome, but should be under professional anaesthetic control. In addition, the process may enable professional standards to be defined and tested so that high quality obstetric anaesthetic care can be maintained.
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A new technique is described for delivering combined spinal epidural anaesthesia. The disadvantages of the needle-through-needle technique and the two-needle techniques are discussed. The new technique is a modification of the two-needle technique. ⋯ The spinal needle obturator is then removed and intrathecal injection performed. This technique avoids problems associated with placing an epidural catheter after an intrathecal injection and the potential problem of placing a spinal needle when an epidural catheter has already been placed. This technique requires further evaluation.