Anesthetic complications require immediate recognition and intervention. With the many options and high anesthesia rates among laboring women, today's perinatal nurses need education not only in the choices of anesthesia but also in the complications that can result from these choices. Most orientation programs briefly discuss the subject, leaving the amount of information and training insufficient for the nurses to feel confident in their understanding of the complications and competent to respond. This educational need could also extend to experienced staff who lack current knowledge and appropriate competence in responding to obstetric anesthesia emergencies. The purpose of this article is to address the major complications of obstetric anesthesia and how nurses need to respond, with the goal of improving patient safety in these rare but high-risk situations. Recommendations in didactic content are presented to assist hospital educators in achieving this goal.
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http://dx.doi.org/10.1097/JPN.0b013e3181967f33 | DOI Listing |
Reg Anesth Pain Med
January 2025
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
Background: Intrathecal morphine is the standard for post-cesarean analgesia but often causes pruritus and may be unavailable in resource-limited settings. This study assessed whether a combination of bilateral transversus abdominis plane (TAP) block and intrathecal fentanyl provides non-inferior analgesia compared with intrathecal morphine following cesarean delivery within the multimodal analgesia context.
Methods: Eighty mothers were randomized to receive either intrathecal fentanyl 10 µg with bilateral TAP block using 15 mL of 0.
Br J Anaesth
January 2025
Department of Obstetrics and Gynaecology, Mie University School of Medicine, Mie, Japan.
Cureus
December 2024
Department of Anaesthesiology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Introduction Spinal anesthesia, a commonly used technique for lower abdominal, pelvic, and lower extremity surgeries, involves injecting a local anesthetic into the subarachnoid space to temporarily block sensory, motor, and sympathetic nerves. Despite its high success rate, the failure of spinal anesthesia, which can lead to adverse patient outcomes, remains a concern. The failure rate varies widely, from 1% to 17%, influenced by factors such as technical challenges, patient anatomy, and practitioner experience.
View Article and Find Full Text PDFBMC Anesthesiol
January 2025
Department of Scienze Dell'Emergenza, Anestesiologiche e Della Rianimazione, IRCCS Fondazione Policlinico A. Gemelli, Rome, Italy.
Background: Improvements in diagnostics and clinical care have allowed more women of childbearing age, suffering from neurological diseases, to safely have pregnancy, reducing peripartum complications. However, these patients remain at risk and are a constant challenge for anesthesiologists in the delivery room.
Methods: To assess the type of anesthesiologic management performed for delivery in obstetric patients with preexisting neurological disease and who reported significant neurological symptoms during pregnancy, a retrospective observational study was carried out between 1 October 2008 and 30 September 2021.
Br J Hosp Med (Lond)
December 2024
Department of Anaesthesia, University College London Hospital NHS Foundation Trust, London, UK.
Placenta accreta spectrum (PAS) disorders pose significant challenges in the anaesthetic management of elective caesarean section. This article explores the anaesthetic considerations for patients with PAS focusing on the optimal techniques to ensure maternal safety and surgical success. The analysis examines the advantages and disadvantages of general anaesthesia, neuraxial anaesthesia, and combined techniques to inform considerations of anaesthetic management in this high-risk population.
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