Issues in obstetric anesthesia:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2003
|
| Schriftenreihe: | Anesthesiology clinics of North America
21,1 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XV, 206 S. Ill., graph. Darst. |
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| 245 | 1 | 0 | |a Issues in obstetric anesthesia |c Rakesh B. Vadhera ... guest ed. |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 2003 | |
| 300 | |a XV, 206 S. |b Ill., graph. Darst. | ||
| 336 | |b txt |2 rdacontent | ||
| 337 | |b n |2 rdamedia | ||
| 338 | |b nc |2 rdacarrier | ||
| 490 | 1 | |a Anesthesiology clinics of North America |v 21,1 | |
| 650 | 4 | |a Anesthesia in obstetrics | |
| 650 | 4 | |a Anesthesia, Obstetrical | |
| 650 | 4 | |a Anesthesiology | |
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Datensatz im Suchindex
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| adam_text | CONTENTS
Foreword xj
Lee A. Fleisher
Preface xiii
Rakesh B. Vadhera and M. Joanne Douglas
Newer Techniques of Labor Analgesia 1
Michael Paech
An array of nonpharmacologic, inhalational, systemic, and regional
analgesic techniques continues to be used where labor analgesia
services are available. This article reviews recent research and devel¬
opment related to opioid analgesia (evaluation of patient controlled
intravenous analgesia with remifentanil); inhalational analgesia
(combination of isoflurane and nitrous oxide), and regional analgesia
(modification of lumbar sympathetic and paracervical block, and
spinal or epidural analgesia).
New Local Anesthetics: Are They Worth the Cost? 19
Moeen Panni and Scott Segal
Ropivacaine and levobupivacaine are two new local anesthetic
agents that share the distinction of being virtually pure L isomers
rather than racemic mixtures. They are considerably less toxic than
bupivacaine. There is significant controversy regarding the relative
potency of ropivacaine and bupivacaine, and some of the newer
drugs purported advantages may be related to this potency differ¬
ence. Ropivacaine and levobupivacaine are much more expensive
than racemic bupivacaine, and this cost increase does not seem to
justify the routine use of these new agents in obstetric anesthesia.
VOLUME 21 • NUMBER 1 • MARCH 2003 v
Mechanisms and Management of an Incomplete Epidural
Block for Cesarean Section 39
Dmitry Portnoy and Rakesh B. Vadhera
Epidural anesthesia continues to play a considerable role in anes¬
thesia care for parturients undergoing cesarean section. Despite its
multiple advantages, epidural anesthesia is associated with a high
incidence of unsatisfactory block. This article discusses etiology
mechanisms, and clinical patterns of incomplete epidural block.
This article also reviews different management strategies includ¬
ing a detailed discussion on the controversial issue of spinal anes¬
thesia following incomplete epidural block.
Misconceptions About Neuraxial Analgesia 59
Stephen H. Halpern and Barbara L. Leighton
Neuraxial analgesia is the most effective treatment for labor pain.
Although there are known risks and side effects, many problems
have been attributed to the technique without appropriate sci¬
entific assessment. This article presents some of the most preva¬
lent misconceptions and reviews the current evidence concerning
neuraxial analgesia.
Backache, Headache, and Neurologic Deficit After
Regional Anesthesia 71
Uma Murmur and Maya S. Suresh
Back pain, postdural puncture headache, and neurologic deficits
after regional anesthesia are common postpartum complaints. The
relationship of postdural puncture headache to regional anesthesia
is known. Regional anesthesia and the drugs used have been
implicated as causal factors for neurologic deficits or backache,
although the relationship remains unclear. The parturient with any
of these complaints requires early evaluation, rapid diagnosis, and
appropriate treatment.
NPO During Labor: Is There Any Scientific Validation? 87
Geraldine O Sullivan and Mark Scrutton
The benefits of nil by mouth (NPO) policies for low risk parturients
in labor are frequently questioned by persons who argue that the
provision of calories improves maternal well being and obstetric
outcome. Although pulmonary aspiration of gastric contents is no
longer a significant clinical problem in obstetric anesthesia, it is
difficult to determine the role of NPO policies in this change. This
article evaluates current scientific evidence.
..; CONTENTS
Thrombocytopenia, Low Molecular Weight Heparin, and
Obstetric Anesthesia 99
Sharon Abramovitz and Yaakov Beilin
Neuraxial anesthesia is routinely administered to the parturient; how¬
ever, there are some contraindications to its use. Thrombocytopenia
is the most common hematologic disorder seen during pregnancy.
This article addresses the implications of anesthesia in the parturi¬
ent who presents with disorders of hemostasis and discusses the
minimum platelet count necessary for safe neuraxial anesthesia.
This article also discusses the role of low molecular weight heparin
in pregnancy and its implications for labor analgesia options also
are addressed.
Obstetric Emergencies 111
Chantal Crochetiere
Obstetric emergencies present a challenge for the anesthesiologist
who is confronted with a life threatening situation for either the
mother or the fetus. This article focuses on the critical events that
may present as an emergency. These events include hemorrhage,
fetal compromise, and specific maternal problems, such as diffi¬
cult airway, morbid obesity, pregnancy induced hypertension, and
cardiac arrest.
Planning for Hemorrhage: Steps an Anesthesiologist Can Take
to Limit and Treat Hemorrhage in the Obstetric Patient 127
Mark D. Esler and M. Joanne Douglas
Obstetric hemorrhage continues to be a significant cause of maternal
mortality and morbidity. Blood transfusion in such circumstances
may be life saving but involves exposing the patient to additional
risks. Limiting blood transfusion and using autologous blood when
possible may reduce some of these risks. This article outlines the
techniques that may be used to limit and more effectively treat
hemorrhage in the obstetric patient, with particular attention paid
to reducing the use of allogeneic blood transfusion.
Pre Eclampsia: Fluids, Drugs, and Anesthetic Management 145
Jaya Ramanathan and Kelly Bennett
Pre eclampsia is a pregnancy specific syndrome of unknown etio¬
logy. Severe pre eclampsia is associated with increased maternal
and fetal morbidity and mortality. In terms of anesthetic manage¬
ment, there is overwhelming evidence attesting to the safety and
efficacy of regional analgesia and anesthesia. A detailed preopera
tive evaluation, a thorough preanesthetic preparation, and meticu¬
lous anesthetic management ensures a successful outcome.
CONTENTS *
Embolism During Pregnancy: Thrombus, Air, and
Amniotic Fluid 165
Alfredo F. Gei, Rakesh B. Vadhera, and Gary D.V. Hankins
Embolism during pregnancy is the most common cause of acute
cardiovascular and respiratory collapse, as well as maternal mor¬
tality in the Western world. This article reviews the most relevant
clinical aspects of embolism presenting during the peripartum
period, by outlining their differences, describing the most common
methods of evaluation and diagnosis, and providing guidelines for
treatment and management.
ASA Closed Claims in Obstetrics: Lessons Learned 183
Brian K. Ross
Anesthesiologists must be aware of basic medico legal issues in the
performance of obstetrical anesthesia. With information on these
issues, anesthesiologists may practice risk management strategies
designed to minimize both patient dissatisfaction and the legal
consequences in the event of an unanticipated adverse outcome.
This article outlines the high risk areas of medico legal liability in
the specialty of obstetrical anesthesia. Particular attention is paid
to two areas: (1) causes of maternal mortality and (2) liability
profiles in obstetric care as revealed in the American Society of
Anesthesiology Committee on Professional Liability of Closed
Claims database.
Index 199
viii CONTENTS
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| spelling | Issues in obstetric anesthesia Rakesh B. Vadhera ... guest ed. Philadelphia [u.a.] Saunders 2003 XV, 206 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Anesthesiology clinics of North America 21,1 Anesthesia in obstetrics Anesthesia, Obstetrical Anesthesiology Geburtshilfe (DE-588)4019604-5 gnd rswk-swf Anästhesie (DE-588)4001833-7 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Geburtshilfe (DE-588)4019604-5 s Anästhesie (DE-588)4001833-7 s DE-604 Vadhera, Rakesh B. Sonstige oth Anesthesiology clinics of North America 21,1 (DE-604)BV000600896 21,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=010297649&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| title | Issues in obstetric anesthesia |
| title_auth | Issues in obstetric anesthesia |
| title_exact_search | Issues in obstetric anesthesia |
| title_full | Issues in obstetric anesthesia Rakesh B. Vadhera ... guest ed. |
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| title_short | Issues in obstetric anesthesia |
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