Subglottic tracheal stenosis in pregnancy: anaesthetic implications.

We present the first reported case of a pregnant patient with severe subglottic tracheal stenosis who required elective surgical tracheostomy prior to administration of labour analgesia.

Social drug use in the parturient: implications for the management of obstetrical anaesthesia.

Maternal use of social drugs in pregnancy continues to increase--worldwide. Although a great deal has been learned regarding the implications of illicit drug abuse in pregnancy (cocaine, amphetamines, hallucinogens), the use of social drug in pregnancy has received far less attention. This article reviews the consequences of the social drug use in pregnancy including ethanol, tobacco and caffeine and offers recommendation for anaesthetic management of these potentially complicated pregnancies.

Anesthetic implications of drug abuse in pregnancy.

Substance abuse has crossed social, economic, and geographic borders and--throughout the world--remains one of the major problems facing society today. The prevalence of substance abuse in young adults (including women) has increased markedly over the past 20 years. Nearly 90% of drug-abusing women are of childbearing age.

An initially unnoticed piece of nasal jewelry in a parturient: implications for intraoperative airway management.

The literature documenting the anesthetic implications of body piercing consists only of a few case reports that focus exclusively on interference with airway management by oral jewelry. To date, no case reports documenting anesthetic problems resulting from the presence of nasal jewelry have been reported. We present a case of a parturient who presented for an emergency cesarean section with nasal jewelry in situ, which was unnoticed preoperatively and then became externally loosened intraoperatively.

Rebound hyperkalemia after cessation of intravenous tocolytic therapy with terbutaline in the treatment of preterm labor: anesthetic implications.

Beta-adrenergic agents have been widely used in obstetrics to attenuate premature labor (termed tocolytic therapy), delay delivery, allow fetal maturation, and thereby reduce neonatal morbidity and mortality. Hypokalemia is a common side effect during beta-adrenergic tocolytic therapy for the treatment of preterm labor. Although rebound hyperkalemia after cessation of tocolytic therapy with ritodrine has been reported, there have been no reports of hyperkalemia occurring after the cessation of beta-adrenergic tocolytic therapy with terbutaline for preterm labor; we report such a case.

Post-dural puncture headache, intracranial air and obstetric anesthesia.

Recently, a controversy has arisen as to whether air or saline should be recommended for the correct localization of the epidural space with the loss of resistance technique. I report a case of a previously healthy parturient who developed pneumocephalus and severe headache following the use of the loss of resistance to air (LORA) technique to identify the epidural space. This case report raises one more time the question about the safety of the LORA technique for labor analgesia.

Labor analgesia for the drug abusing parturient: is there cause for concern?

Unlabelled: Drug abuse has crossed geographic, economic and social borders, and it remains one of the major problems facing our society today. The prevalence of recreational drug abuse among young adults (including women) has increased markedly over the past two decades. Nearly 90% of drug abusing women are of childbearing age.

Once a post-dural puncture headache patient always post-dural puncture headache patient?

It is well known that symptoms of post-dural puncture headache (PDPH) are more likely if there has been a preceding PDPH. We herein present a patient who developed a PDPH following each of two dural punctures separated by 9 years.

Amphetamine abuse in pregnancy: anesthetic implications.

The prevalence of recreational substance abuse amongst young adults (including women in child-bearing age) has markedly increased over the past two decades and it remains one of the major problems facing our society today--worldwide. Amphetamine is one of the most common substances abused in pregnancy and one of the most potent sympathomimetic amines with respect to stimulatory effects on the central nervous system. The following case report illustrates the problems that may arise during anesthesia in the parturient with recent amphetamine intake.

Human immunodeficiency virus in the parturient.

Over the last 20 years, the acquired immune deficiency syndrome (AIDS) has grown from a small case series of Pneumocystis carinii infection in four homosexual men to one of the major health problems facing the world today. In the next 5 years, human immunodeficiency virus (HIV) infection is expected to kill more than 2.2 million people.