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Pregnancy with a Left Ventricular Assist Device: A Narrative Review.
Ann Card Anaesth
January 2025
Department of Cardiothoracic Anesthesiology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
This narrative review discusses the various challenges associated with the presence of a left ventricular assist device (LVAD) during pregnancy. Given the hemodynamic and coagulation changes associated with pregnancy, the presence of an LVAD adds a layer of complexity with respect to optimal management. This review will discuss the anesthetic considerations when dealing with this subset of patients who may have other comorbidities alongside their advanced heart failure.
View Article and Find Full Text PDFTransversus abdominis plane block combined with intrathecal fentanyl versus intrathecal morphine for post-cesarean analgesia: a randomized non-inferiority clinical trial.
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.
Anesthesia for pregnant patients with symptomatic neurological disease: 13 years' experience from a tertiary care center.
BMC 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.
Beyond the Scalpel: Unravelling the Anaesthetic Maze in Elective C-Section for Placenta Accreta Spectrum.
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.
View Article and Find Full Text PDFChallenges in practice and training structure of residents in obstetric anaesthesia: A perspective from teaching hospitals in Sindh province of Pakistan.
J Pak Med Assoc
January 2025
Department of Anaesthesiology, Dow Medical University and Hospital, Karachi, Pakistan.
Objectives: To document information on the available obstetric anaesthesia services and structure of resident training in a Pakistani setting.
Methods: The survey was conducted from June to September 2018 across the Sindh province of Pakitan after approval from the ethics reiew committee of the Pakistan Society of Anaesthesiology, and covered all teaching hospitals in both public and private sectors recognised for residents' training for fellowship in Anaesthesiology by the College of Physician and Surgeons of Pakistan. A standardised questionnaire was filled by either the department chairperson or a senior designated faculty member in each institution regarding obstetric anaesthesia services and structure of resident training.
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