The evaluated data of the anaesthesia protocols of 91 caesarean sections are presented. The narcosis of caesarean sections was introduced by using 1 mg/kg ketamine. Relaxation was achieved by administration of 1 mg/kg fazadinium. To maintain anaesthesia, fentanyl or repeated doses of histamine, were used after removal of the fetus. Anaesthesia was adequate in each case, the patients were amnesic concerning the operation. They recovered well. During anaesthesia, circulation was characterized by the elevation of pulse rate and of systolic pressure. The mean value of the above parameters kept on differing significantly from the initial values throughout the anaesthesia. However, the extent of increase had not reached the difference observed by other authors. The method is considered to be safe and easy to perform since ketamine and fazadinium are anaesthetics well adaptable for use just in this sort of patient material. The analgetic, anaesthetic and amnestic effect of ketamine is fairly good. It does not generally produce circulatory depression rather acts inversely. It does not depress the vital functions of the fetus either and, at the same time, due to its long action, it provides adequate anaesthesia for prolonged removals as well. The rapidly acting fazadinium produces fast relaxation similar to that produced by succinylcholine, while its effect is not associated with the side-effects of the former agent, i.e. hyperkalaemia, fasciculations. As a result of the latter, it is a useful aid in preventing the always threatening aspiration in the anaesthesia of caesarean sections.
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Best Pract Res Clin Anaesthesiol
September 2024
Department of Anesthesiology, University Hospital Basel, Basel, Switzerland.
The issue of obesity continues to reach new levels globally, affecting individuals across the age continuum. Obesity in pregnancy is associated with myriad comorbidities which may negatively impact the fetus, particularly dysfunctional labor and failure to progress ending in unplanned cesarean delivery. Neuraxial anesthesia represents the gold standard for cesarean delivery anesthesia and is increasingly beneficial for obese patients due to the risk of difficult airway.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
September 2024
Department of Anesthesiology, University Hospital Leuven, Belgium.
Caesarean delivery is the most performed inpatient surgery worldwide, with rates expected to rise. Optimising maternal recovery benefits not only the mother, but also the newborn and society. Enhanced Recovery After Caesarean delivery (ERAC) protocols standardize the approach to perioperative management of patients in order to accelerate early postoperative maternal rehabilitation.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
September 2024
K. Bicetre School of Medicine, Paris-Saclay University, Département d'Anesthésie, Hôpital Antoine Béclère - APHP.Université Paris-Saclay, 157 rue de la porte de Trivaux, 92140, CLAMART, France. Electronic address:
This article offers a comprehensive clinical update on best practices for neuraxial and general anesthesia in cesarean delivery, the most frequently performed major surgical procedure globally. Current evidence-based strategies to address common anesthetic challenges, such as maternal hypotension and intraoperative breakthrough pain, are discussed in detail. Practical approaches for optimizing maternal hemodynamic stability, including the use of vasopressors, fluid management and maternal positioning, are reviewed.
View Article and Find Full Text PDFCureus
December 2024
Obstetrics and Gynecology, Maternity and Children Hospital, Hail, SAU.
Globally, obesity prevalence has progressively increased and is now at epidemic levels; this trend is mirrored in women of childbearing age. There is a high level of evidence that maternal obesity is associated with a range of adverse pregnancy complications and neonatal outcomes, such as hypertensive disorders of pregnancy, gestational diabetes mellitus (GDM), large for gestational age (LGA) fetuses, premature birth, stillbirth, cesarean section, and postpartum hemorrhage, among certain others. This systematic review aimed to comprehensively evaluate the relationship between maternal obesity and health outcomes for both mothers and infants.
View Article and Find Full Text PDFBirth injury occurs when the delivery process is not appropriately attended, and the use of improper techniques or maneuvers while conducting the delivery. Cesarean delivery is considered safe as compared to vaginal for the breech presentation. However, this case reports a case of femur fracture of a newborn that occurred during an emergency cesarean section performed for breech presentation.
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