Myths And Realities Of Ob Anesthesia-Books Pdf

Myths and Realities of OB ANESTHESIA
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Discussion,Anesthesia related mortality,Labor Epidurals CSE. Early Epidurals Walking Epidural,Late epidurals,Epidural failures. Progress of labor,Motor Block,Epidurals and c sections Others. Anesthesia Related Maternal Mortality,1979 81 1982 84 1985 87 1988 90. 1 7 per million Live Births 1997,1 2 per million Live Births in 2002.
Hawkins 2011,Anesthesia Related Mortality,1979 1984 1985 1990 Current. General Anesthesia 33 32,Regional Anesthesia 19 9,Risk Ratio 2 3 16 7 1 7 5 10. GA Regional,Hawkins JL Anesthesiology 1997,Regional vs General. Regional anesthesia,High or total level,General anesthesia. Difficult airway,Aspiration,Resident training,Associated mortality figures.
Incidence of Difficult Failed Intubations,20 1981 1994. 1 280 1 250,OB population 1 280 0 38,Getting worse. Non OB population 1 2 230 0 05,Hawthorne et al RJA 1996 76 680 684. Anesthesia Related Deaths During Obstetric,Delivery 1979 90. intubation,30 Aspiration,Inadequate Respiratory,ventilation failure.
General Anesthesia,Hawkins et al Anes 86 277 84 1997. Failed Intubations,Time and Urgency of Operation,Cesarean Failed. Time of Operation Sections Intubations,Evening 4 9. Night Weekend 12 69,Elective 56 9,Emergent 44 91,Difficult Airway Facts. Difficult failed intubation a major cause for,maternal morbidity and mortality.
80 anesthetic fatalities during emergency C S,Exposure of anesthesia trainees to GA. Continuing requests by,obstetricians to provide,anesthesia for stat c section. Urgency of situation,precludes proper evaluation,Pregnancy related changes. add to hazard of,difficult failed intubations,Time constraint. Important preanesthetic airway assessment had not occurred in 10 of mortalities reviewed. Confidential Enquiry into Perioperative Death 1997. C section rate,20 7 in a normal weight control group.
33 8 in obese women,47 4 in morbidly obese,Weiss et al Am J Obstet Gynecol 2004. Morbidly obese parturient 136kg,C S rate 62,24 C S received GA. 1 3 intubations difficult,6 failed intubation rate. Hood et al Anesthesiology 1990 73 A952,Labor Epidurals. Myths realities,Early epidurals and progress of labor.
Late epidurals,Failed Epidurals,Increase in forceps cesarean section rate. Contraindications,Motor block,Regional Anesthesia F A Q. Does Epidural work all the time,Myth Yes Will epidural increased cesarean section. Reality Yes rate, Will the epidural slow the progress of Reality Unlikely. Reality Yes,Will the epidural prolonged second stage.
Reality Yes,Will the epidural increase assisted,deliveries. Reality Unlikely,Effect on First Stage,Contractions. First Stage Timing,Conventional Wisdom,Early epidural analgesia in latent phase. May markedly slow cervical dilation,OR even arrest labor. 3 studies Siever 1943 Friedman 1959 1961, Conclusion does not affect the course of labor but.
nonetheless proper administration entails withholding it until. active phase of labor is entered, Carefully proven studies has never proven this fact.

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