International journal of obstetric anesthesia
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Int J Obstet Anesth · Aug 2014
Randomized Controlled Trial Comparative StudySpinal anaesthesia for caesarean section: an ultrasound comparison of two different landmark techniques.
Spinal anaesthesia performed at levels higher than the L3-4 intervertebral space may result in spinal cord injury. Our aim was to establish a protocol to reduce the chance of spinal anaesthesia performed at or above L2-3. ⋯ Our data suggest that when performing spinal anaesthesia in pregnant patients, if the intercristal line intersects an intervertebral space then the space below should be chosen and if the intercristal line intersects a spinous process then the interspace below should be chosen. This will reduce the incidence of spinal anaesthesia performed at or above L2-3.
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Int J Obstet Anesth · Aug 2014
ReviewEstablishing an obstetric neuraxial service in low-resource areas.
The proportion of laboring women utilizing neuraxial techniques for labor analgesia has steadily increased over the past decades in North America, the UK and parts of Europe. Anesthesiologists in many other countries may want to introduce an obstetric neuraxial service but may lack the knowledge and experience necessary to ensure its safety. The focus of this article is to address the necessity, benefit and challenges of establishing such a service in a resource-limited environment. ⋯ Patient education and satisfaction are additional key components of a successful service. Even in financially low-resource settings, proper safety measures must be adopted so that the neuraxial procedure itself does not contribute to morbidity and mortality. A viable and safe neuraxial service can be developed using innovative strategies based on local constraints.
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Int J Obstet Anesth · Aug 2014
Case ReportsSafe extubation of a parturient using an airway exchange technique.
The difficult obstetric airway is a well-recognised anaesthetic challenge but little emphasis is placed on the difficulty of performing a safe tracheal extubation. We report the use of an airway exchange technique to extubate a difficult obstetric airway and discuss the role of these techniques in the obstetric population.