Anesthesia Key

        III.Surgical considerations A. Technical aspects 1.   CD involves the delivery of the fetus through an incision created in the maternal abdomen. For CD, either neuraxial or general anesthesia is used. Anesthetic…

         II.Obstetric management (see Fig. 31.3) A. Risks of opioid dependence in pregnancy 1.   Opioid dependence in pregnancy is associated with poor maternal and fetal outcomes including miscarriage, preterm labor, preterm delivery,…

2.   Oral hypoglycemic agents a.   Women with pregestational type 2 DM who require oral agents for glucose control should ideally be changed to insulin before pregnancy. Although there is no evidence to…

B. Local anesthetics with an ester bond linking the aromatic ring to the hydrocarbon chain are classified as amino-ester local anesthetics. These include procaine, 2-chloroprocaine, tetracaine, and cocaine (see Table…

A. Anatomic and physiologic changes. Maternal anatomic and physiologic changes occur during pregnancy to ensure enough blood flow is delivered to the uterus. Uterine blood flow occurs through two routes. 1.  …

g.   The demand-only IV PCA incorporates several safety features to minimize the possibility of a patient receiving unsafe doses of IV opioid. First, the PCA pump is programmed to limit the…

4.   Route of administration/dose a.   Terbutaline can be administered intravenously (IV) or subcutaneously (SC). However, it is most commonly administered by intermittent injection in doses of 0.25 mg every 20 to 30…

I. Scope of the problem II. Pathophysiology A. Meningeal traction B. Cerebral vasodilation III. Risk factors for postdural puncture headache A. Unmodifiable risk factors B. Modifiable risk factors IV. Diagnosis…

CLINICAL PEARLNeuraxial analgesia provides superior pain relief to the mother during labor and delivery and conveys other significant benefits.          II.Effects of neuraxial analgesia on the progress of labor A. Observational…