1/5. Remifentanil in emergency caesarean section in pre-eclampsia complicated by thrombocytopenia and abnormal liver function.We describe the use of remifentanil in a woman with severe pre-eclampsia who presented for emergency caesarean section. Remifentanil was effective in obtunding the hypertensive response to laryngoscopy and intubation. Previous studies have found no significant adverse effects of remifentanil on the neonate. With its short duration of action, the use of this new opioid has several potential advantages in the above setting. Further studies are required to explore the use of remifentanil as an adjunct to obstetric general anaesthesia.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/5. Anaesthetic dilemma: spinal anaesthesia in an eclamptic patient with mild thrombocytopenia and an "impossible" airway.We present our anaesthetic management of a 27-year-old woman with antepartum eclampsia, mild thrombocytopenia, difficult airway and clinical evidence of impending upper airway obstruction. She required urgent delivery by caesarean section, which was conducted uneventfully under spinal anaesthesia. We discuss the management conundrums presented by this case and why we chose spinal anaesthesia over other anaesthetic options.- - - - - - - - - - ranking = 6keywords = anaesthesia (Clic here for more details about this article) |
3/5. acupuncture for acute postoperative pain relief in a patient with pregnancy-induced thrombocytopenia--a case report.A 39 year old woman, scheduled for elective caesarean section in her second pregnancy, developed thrombocytopenia. Therefore, at the time of surgery, spinal anaesthesia and non-steroidal analgesic drugs were avoided and she was given a standard general anaesthetic procedure including fentanyl 100 microg and morphine 10 mg. In the early postoperative period she received tramadol 100 mg and a further 10 mg of morphine. These drugs did not control her pain, but caused side effects--in particular nausea and retching. acupuncture to LI4 and PC6 on the right side produced dramatic pain relief within minutes.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
4/5. Anaesthesia for caesarean delivery in a patient with May-Hegglin anomaly.The anaesthetic management for Caesarean delivery is described in a patient with May-Hegglin anomaly. The condition, which is inherited as an autosomal dominant characteristic, has features of thrombocytopenia and a bleeding diathesis. Labour was induced and she received type specific platelet transfusion. Spinal anaesthesia, using five per cent lidocaine, 75 mg, with epinephrine and 0.5 mg morphine sulphate produced satisfactory operating conditions, excellent postoperative analgesia, and uncomplicated initial recovery.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
5/5. Epidural anaesthesia and thrombocytopenia.A case is presented of a mother with unanticipated profound thrombocytopenia who received a continuous epidural anaesthetic for labour. No neurological sequelae or excessive bleeding occurred. It is clear, after a review of the literature, that more information is needed to define the lower limits of platelet count at which it is safe to proceed with epidural anaesthesia.- - - - - - - - - - ranking = 5keywords = anaesthesia (Clic here for more details about this article) |