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Ebook The clinical anaesthesia vivabook (2/E): Part 2

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Ebook The clinical anaesthesia vivabook (2/E): Part 2

ptime, then optimisation of hypertension, anti-convulsant therapy and fluid balance is indicated prior to delivery.■ Anaesthetic techniques for delive

Ebook The clinical anaesthesia vivabook (2/E): Part 2eryIf an urgent caesarean section is required, and there is no time to establish an epidural, then the choice is limited to spinal or general anaesthe

sia. Spinal anaesthesia theoretically may result in hypotension and uteroplacental insufficiency although several publications in the recent literatur Ebook The clinical anaesthesia vivabook (2/E): Part 2

e describe its successful use and safety. If a regional block is contra-indicated, for example, because of coagulopathy, or there is no time because o

Ebook The clinical anaesthesia vivabook (2/E): Part 2

f severe fetal distress, then general anaesthesia will have to be undertaken. Factors making GA in pre-eclampsia particularly hazardous include a high

ptime, then optimisation of hypertension, anti-convulsant therapy and fluid balance is indicated prior to delivery.■ Anaesthetic techniques for delive

Ebook The clinical anaesthesia vivabook (2/E): Part 2ge secondary to severe hypertension. Invasive monitoring should be established pre-induction if there is time.Post-delivery careConvulsions can occur

up to 23 days after delivery. In the UK, up to 44% of fits occur in the puerperium. Fluid balance can remain difficult in the post-operative period. T Ebook The clinical anaesthesia vivabook (2/E): Part 2

he most common time for pulmonary oedema to occur is in the first 48-72 hours post-delivery. This is probably as a result of large volumes of fluid gi

Ebook The clinical anaesthesia vivabook (2/E): Part 2

ven peri-operatively (in the face of oliguria and capillary-leak syndrome) mobilising from the extravascular space as the patient improves. Platelet c

ptime, then optimisation of hypertension, anti-convulsant therapy and fluid balance is indicated prior to delivery.■ Anaesthetic techniques for delive

Ebook The clinical anaesthesia vivabook (2/E): Part 2by is the 'cure', it may not be the end of the problem. The decision to send a patient to intensive care is made on the basis of her clinical conditio

n (a patient may also be considered for intensive care pre-operatively).BibliographyBrodie H, Malinow AM. (1999). Anaesthetic management of pre-eclamp Ebook The clinical anaesthesia vivabook (2/E): Part 2

sia/edampsia. Review article, International Journal of Obstetric Anaesthesia, April.Engelhardt T, Madennan FM. (1999). Fluid management in pre-edampsi

Ebook The clinical anaesthesia vivabook (2/E): Part 2

a. Review article. International Journal of Obstetric Anaesthesia. October.Mortl MG, Schneider MC. (2000). Key issues in assessing, managing and treat

ptime, then optimisation of hypertension, anti-convulsant therapy and fluid balance is indicated prior to delivery.■ Anaesthetic techniques for delive

Ebook The clinical anaesthesia vivabook (2/E): Part 2ns and Gynaecologists. (2006). The management of severe pre-edampsia. March.Pre-medicationWhat are the indications for pre-medication in modern anaest

hetic practice?This question can be answered in a list fashion in the knowledge that the .ill---I -.1,+-------206 Pre-medicationpr-■\Think of the seve Ebook The clinical anaesthesia vivabook (2/E): Part 2

n AsAnxiolysisAmnesia■Anti-emesis■Analgesia - systemic and topical (for venepuncture)AntacidsAntisialogogues■Additional - oxygen, nebulisers, steroids

Ebook The clinical anaesthesia vivabook (2/E): Part 2

, heparin, etc.\_________________________________________________________________________/Tell me what you would use for: 'anxiolysis/amnesia'It is wo

ptime, then optimisation of hypertension, anti-convulsant therapy and fluid balance is indicated prior to delivery.■ Anaesthetic techniques for delive

Ebook The clinical anaesthesia vivabook (2/E): Part 2ing the anaesthetic technique and answering any questions they may have. Parental anxiety in paediatric practice can also be addressed at this stage.■

Benzodiazepines are probably the most commonly prescribed pre-medicants. They act by enhancing GABA, an inhibitory neurotransmitter that causes an in Ebook The clinical anaesthesia vivabook (2/E): Part 2

flux of chloride ions thereby hyperpolarising the neurone. They produce anxiolysis, amnesia and sedation and can be given orally, intramuscularly or i

Ebook The clinical anaesthesia vivabook (2/E): Part 2

ntranasally. Typical doses are:Temazepam 10-30 mg orally in adults0.5-1 mg/kg orally in children upto 20 mgMidazolam 0.2-0.75 mg/kg orally in children

ptime, then optimisation of hypertension, anti-convulsant therapy and fluid balance is indicated prior to delivery.■ Anaesthetic techniques for delive

ptime, then optimisation of hypertension, anti-convulsant therapy and fluid balance is indicated prior to delivery.■ Anaesthetic techniques for delive

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