Publications by authors named "S C Ragbourne"
Anaesthetic considerations for impacted fetal head at caesarean delivery: a focused review.
Int J Obstet Anesth
September 2024
Article Synopsis
- Impacted fetal head is a complication during caesarean deliveries, occurring in about 1.5% of elective and 2.9-18.4% of emergency cases, requiring additional surgical techniques or medication to assist in delivery.
- Risk factors include advanced cervical dilation, use of oxytocin, prolonged labor, fetal malposition, and the experience level of the operating obstetrician.
- Effective management involves collaboration with a multidisciplinary team and may include adjusting the operating table, changing the patient's position, administering medications like nitroglycerin, and preparing for potential complications such as postpartum hemorrhage.
Purpose: Impacted fetal head (IFH) can be defined as the deep engagement of the fetal head in the maternal pelvis at the time of cesarean delivery that leads to its difficult or impossible extraction with standard surgical maneuvers. In this narrative review, we aimed to ascertain its incidence, risk factors, management and complications from the perspective of the anesthesiologist as a multidisciplinary team member.
Methods: Databases were searched from inception to 24 January 2023 for keywords and subject headings associated with IFH and cesarean delivery.
Study Objective: In labor, programmed intermittent epidural bolus (PIEB) can be defined as the bolus administration of epidural solution at scheduled time intervals. Compared to continuous epidural infusion (CEI) with or without patient controlled epidural analgesia (PCEA), PIEB has been associated with decreased pain scores and need for rescue analgesia and increased maternal satisfaction. The optimal volume and dosing interval of PIEB, however, has still not been determined.
View Article and Find Full Text PDFBackground: The COVID-19 pandemic has highlighted the importance of respiratory protective equipment for clinicians performing airway management.
Aim: To evaluate the impact of powered air-purifying respirators, full-face air-purifying respirators and filtering facepieces on specially trained anaesthesiologists performing difficult airway procedures.
Methods: All our COVID-19 intubation team members carried out various difficult intubation drills: unprotected, wearing a full-face respirator, a filtering facepiece or a powered respirator.