International journal of obstetric anesthesia
-
Int J Obstet Anesth · Jul 1994
Anesthetic management of a parturient with mixed mitral valve disease and uncontrolled atrial fibrillation.
This case report describes the anesthetic management of a 32-year-old parturient with combined severe mitral regurgitation and moderate mitral stenosis, complicated by fast atrial fibrillation. The advantageous effects of epidural analgesia during labor and vaginal delivery and the importance of invasive monitoring are discussed. We also report the rare complication of right bundle branch block related to the use of a pulmonary artery catheter.
-
Int J Obstet Anesth · Jul 1994
Acid aspiration prophylaxis in 202 obstetric anaesthetic units in the UK.
A postal survey of obstetric anaesthetic units in the UK was conducted by questionnaire to gain information about current acid aspiration prophylaxis. Information regarding the delivery rate and the caesarean section rate under regional techniques was also requested. ⋯ Sodium citrate and the H(2) antagonist ranitidine remain the drugs most commonly used for acid aspiration prophylaxis. However, the number of departments carrying out routine prophylaxis for patients in active labour has fallen from 75% in 1988 to 57% in the current survey.
-
Int J Obstet Anesth · Jul 1994
A survey of airway management during induction of general anaesthesia in obstetrics: are the recommendations in the confidential enquiries into maternal deaths being implemented?
Recommendations were made in the last two triennial reports on maternal deaths regarding airway management prior to obstetric general anaesthesia. Forty-four hospitals were surveyed to determine departmental practice. Our survey suggests that obstetric anaesthetic practice varies widely between departments and several of the recommendations in the above reports have yet to be implemented.
-
Int J Obstet Anesth · Jul 1994
The association between foot temperature and asymmetrical epidural blockade.
This study was designed to explore the correlation between sensory block asymmetry and a disparity in foot temperature following epidural bupivacaine administration in labour. Sixty parturients requesting epidural analgesia had epidural catheters sited at L 3/4 while in the lateral position. A test dose was followed 5 min later by a main dose of 25-30 mg of plain bupivacaine. ⋯ Most staff were able to detect a foot temperature difference > 1 degrees C. Our findings indicate a clear association between sensory block asymmetry and the difference between the temperature of the feet. This difference can be detected simply by feeling the feet.