1/5. Management of failed intubation in a septic parturient.We describe a case in which regional anaesthesia for Caesarean section was initially avoided because of the presence of systemic infection. However, attempted induction of general anaesthesia resulted in failed tracheal intubation and so an epidural catheter was sited and used for the operation. Awake fibreoptic tracheal intubation was performed after surgery, when it was clear that ventilatory support on the intensive care unit would be needed. The relative risks of regional versus general anaesthesia when infection and difficult laryngoscopy coincide are discussed.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/5. Epidural anaesthesia for caesarean section in a patient with extreme cardiovascular and respiratory disease.A 24-year old booked primigravida, with rheumatic heart disease in heart failure and lobar pneumonia presented in active labour. She was stabilized and prepared for an emergency Caesarean section that was successfully managed with Epidural Anaesthesia. She was admitted into the intensive care unit where the pneumonia and heart failure were managed by the physicians. The importance of proper follow up and treatment and, the need to perform more epidural techniques to meet the ever increasing challenges to the Anaesthetist are highlighted.- - - - - - - - - - ranking = 1.3333333333333keywords = anaesthesia (Clic here for more details about this article) |
3/5. Anaesthetic considerations in a parturient with varicella presenting for Caesarean section.A parturient with varicella (chickenpox) presented for an elective Caesarean section and spinal anaesthesia was employed for surgery. A review of the literature is presented and the anaesthetic issues are discussed.- - - - - - - - - - ranking = 0.33333333333333keywords = anaesthesia (Clic here for more details about this article) |
4/5. Sacro-iliitis in a heroin addict. A contra-indication to spinal anaesthesia.A case is presented of a pregnant heroin addict patient, with a septic sacro-iliitis due to staphylococcus aureus. The incidence of joint infections in heroin addicts and the difficulty of diagnosis is discussed with the potential risks of spinal or extradural anaesthesia when there is infection in joints close to the needle site. Caution is advised with patients addicted to heroin who have low back pain and may have infectious sacro-iliitis.- - - - - - - - - - ranking = 1.6666666666667keywords = anaesthesia (Clic here for more details about this article) |
5/5. maternal death following epidural anaesthesia for caesarean section delivery in a patient with unsuspected sepsis.sepsis in the parturient may be difficult to recognize in light of the physiological changes associated with pregnancy. The purposes of this report are to highlight the signs and symptoms which indicate an underlying septic process and the management of these patients in the peripartum period. This 32-yr-old GII PI woman with twin gestation presented at 36 wk in labour. Her temperature was 35.3 degrees C, she was normotensive and had a normal white blood cell count. After epidural anaesthesia was administered for Caesarean section, she became apnoeic, pulseless and unresponsive. Despite aggressive cardiopulmonary resuscitation, neither she nor her twin babies survived. Post mortem blood work revealed a considerable left shift of her white blood count (> 60% bands) and an anion gap acidosis. autopsy revealed evidence of widespread Group A beta-haemolytic streptococcal sepsis. diagnosis of sepsis in the parturient involves assessment of the patient's temperature, WBC and differential and acid-base status. Evaluation of the intravascular volume must precede anaesthetic intervention. Epidural anaesthesia may be considered in the labouring and Caesarean section patient who has been fluid-resuscitated. Emergency operative delivery may result in cardiovascular compromise in the patient with severe sepsis.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |