Anaesthesia
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Epinephrine and sodium bicarbonate may be added to local anaesthetic solutions in order to reduce the onset time and enhance the quality of epidural anaesthesia for Caesarean section. Such mixtures are sometimes prepared several hours in advance for subsequent use in emergency Caesarean section through a pre-existing epidural catheter. ⋯ Bupivacaine and lidocaine concentrations in all mixtures did not decrease over time regardless of alkalinisation. We do not recommend adding epinephrine to alkalinised epidural solutions that are to be stored for a prolonged period before clinical use.
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Two case histories of pregnant women with Guillain Barré syndrome (acute demyelinating polyradiculoneuritis) are reported. The first required anaesthesia during the second trimester for a minor surgical procedure. ⋯ A review of the management of Guillain Barré syndrome in pregnancy discusses anaesthetic management, intensive care and the use of plasmapheresis and gamma-globulins. The care of pregnant women recovered from Guillain Barré syndrome is also discussed.
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Letter Case Reports
Failed ventilation due to breakage of a tracheal tube connector.