Anaesthesia for non-obstetric surgery

2020 ◽  
pp. 569-576
Author(s):  
Martin Garry
Keyword(s):  
Pregnant Woman ◽  
General Anaesthesia ◽  
Emergency Surgery ◽  
Fetal Loss ◽  
Fetal Monitoring ◽  
Anaesthetic Management ◽  
Management Plan ◽  
Premature Labour ◽  
Obstetric Surgery

It is not uncommon for a woman to require urgent or emergency surgery for many differing co-incidental reasons during pregnancy. It invariably causes a degree of concern to both the woman and the responsible anaesthetist, particularly if general anaesthesia is necessary, as surgery can precipitate onset of premature labour and fetal loss. This chapter highlights the anaesthesia and surgical issues for the pregnant woman, recommendations for fetal monitoring and the effect of anaesthesia drugs on the developing fetus. An anaesthetic management plan is set out based on the pregnancy trimester, with postpartum considerations highlighted.

scholarly journals Jet Ventilation for the Excision of Vocal Cord Polyps in a Pregnant Patient

2011 ◽  
Vol 39 (6) ◽  
pp. 1136-1138 ◽  
Author(s):  
H. EL Shobary ◽  
M. Gauthier ◽  
T. Schricker
Keyword(s):  
Pregnant Woman ◽  
Airway Obstruction ◽  
General Anaesthesia ◽  
Vocal Cord ◽  
Pregnant Patient ◽  
Anaesthetic Management ◽  
Surgical Removal ◽  
Jet Ventilation ◽  
Laryngeal Tumours

The anaesthetic management of patients presenting with laryngeal tumours and airway obstruction is difficult. We present the case of a pregnant woman at 30 weeks gestation who underwent surgical removal of two vocal cord polyps under general anaesthesia using jet ventilation

scholarly journals Perioperative anaesthetic management of patients with or at risk of acute distress respiratory syndrome undergoing emergency surgery

2019 ◽  
Author(s):  
Denise Battaglini ◽  
Chiara Robba ◽  
Patricia Rieken Macêdo Rocco ◽  
Marcelo Gama De Abreu ◽  
Paolo Pelosi ◽  
...  
Keyword(s):  
At Risk ◽  
Mechanical Ventilation ◽  
Emergency Surgery ◽  
Unit Length ◽  
Peep Level ◽  
Anaesthetic Management ◽  
Plateau Pressure ◽  
High Morbidity ◽  
Postoperative Pulmonary Complication ◽  
The Impact

Abstract ABSTRACT Patients undergoing emergency surgery may present with the acute respiratory distress syndrome (ARDS) or develop this syndrome postoperatively. The incidence of ARDS in the postoperative period is relatively low, but the impact of ARDS on patient outcomes and healthcare costs is relevant [1]. The development of ARDS as a postoperative pulmonary complication (PPC) is associated with prolonged hospitalisation, longer duration of mechanical ventilation, increased intensive care unit length of stay and high morbidity and mortality [2]. In order to mitigate the risk of ARDS after surgery, the anaesthetic management and protective mechanical ventilation strategies play an important role. In particular, a careful integration of general anaesthesia with neuraxial or locoregional techniques might promote faster recovery and reduce opioid consumption. In addition, the use of low tidal volume, minimising plateau pressure and titrating a low-moderate PEEP level based on the patient’s need can improve outcome and reduce intraoperative adverse events. Moreover, perioperative management of ARDS patients includes specific anaesthesia and ventilator settings, hemodynamic monitoring, moderately restrictive fluid administration and pain control. The aim of this review is to provide an overview and evidence- and opinion-based recommendations concerning the management of patients at risk of and with ARDS who undergo emergency surgical procedures.

scholarly journals Successful obstetric and anaesthetic management of a pregnant woman with achondroplasia

2017 ◽  
pp. bcr-2017-221238 ◽  
Author(s):  
Rauf Melekoglu ◽  
Ebru Celik ◽  
Sevil Eraslan
Keyword(s):  
Pregnant Woman ◽  
Anaesthetic Management

Obstetric anaesthesia and analgesia

2021 ◽  
pp. 837-898
Author(s):  
James Eldridge ◽  
Nicola Cox ◽  
Alisha Allana ◽  
Heidi Lightfoot
Keyword(s):  
Pregnant Patient ◽  
Anaesthetic Management ◽  
Labour Analgesia ◽  
Failed Intubation ◽  
Obstetric Anaesthesia ◽  
Obstetric Haemorrhage ◽  
Elevated Liver Enzymes ◽  
Maternal Sepsis ◽  
Obstetric Surgery ◽  
In Pregnancy

This chapter discusses the anaesthetic management of the pregnant patient, for labour analgesia as well as surgical intervention. It begins with a description of the physiological and pharmacological changes of pregnancy. It describes methods of labour analgesia, including remifentanil, and epidural analgesia and its complications, such as post dural puncture headache (PDPH). It describes anaesthesia for Caesarean section (both regional and general); failed intubation; antacid prophylaxis; postoperative analgesia; retained placenta; in utero fetal death; hypertensive disease of pregnancy (pre-eclampsia, eclampsia and the hypertension, elevated liver enzymes and low platelets (HELLP) syndrome); massive obstetric haemorrhage; placenta praevia and morbidly adherent placenta (placenta accreta, increta and percreta); amniotic fluid embolism (AFE); maternal sepsis, and maternal resuscitation. It discusses comorbidity in pregnancy such as obesity and cardiac disease, and the patient who requires non-obstetric surgery while pregnant. It provides information on safe prescribing in pregnancy and breast-feeding.

scholarly journals Maffucci syndrome: Anaesthetic management and review of literature

2015 ◽  
Vol 02 (02) ◽  
pp. 136-138
Author(s):  
Gyaninder Singh ◽  
Barkha Bindu ◽  
Mihir Pandia ◽  
Parmod Bithal
Keyword(s):  
Tracheal Intubation ◽  
General Anaesthesia ◽  
Anaesthetic Management ◽  
Long Bones ◽  
Review Of Literature ◽  
Maffucci Syndrome ◽  
Rule Out

AbstractMaffucci syndrome is a rare, nonhereditary disorder manifesting early in life. The syndrome is characterized by presence of multiple hemangiomas and enchondromas mostly affecting the extremities. Haemangiomas are usually cutaneous, but may sometimes be visceral as well. Enchondromas commonly affect the long bones of the extremities. However, other areas including skull, ribs, vertebrae, larynx and trachea may also be involved. The presence of these lesions in the trachea and/or oropharynx may compromise the airway and cause difficulty during tracheal intubation. Complete airway examination and investigation is important to rule out any such lesion in a patient of Maffucci syndrome before planning for general anaesthesia with tracheal intubation.

Intraoperative fetal monitoring during non-obstetric surgery after fetal viability

2006 ◽  
Vol 195 (6) ◽  
pp. S88 ◽  
Author(s):  
Carl Rose ◽  
Wade Schwendemann ◽  
William Watson ◽  
Brian Brost ◽  
Norman Davies ◽  
...  
Keyword(s):  
Fetal Monitoring ◽  
Obstetric Surgery

Anaesthesia for non-obstetric surgery

2016 ◽  
Author(s):  
Vegard Dahl ◽  
Ulrich J. Spreng
Keyword(s):  
Pregnant Woman ◽  
Preventive Measure ◽  
Well Being ◽  
Mortality And Morbidity ◽  
Anaesthetic Agents ◽  
Haemodynamic Stability ◽  
Life Threatening ◽  
Short Time ◽  
Obstetric Surgery ◽  
Emergency Diagnostic Imaging

Anaesthesia for non-obstetric reasons is performed in 1–2% of all pregnant women. Although the chances of complications like miscarriage, preterm labour, and abortion are higher when surgery is performed during gestation, careful evaluation, preparation, and a multidisciplinary approach will minimize these risks. There are no methods of anaesthesia that are preferable to others during pregnancy. The most important preventive measure is to maintain maternal haemodynamic stability and normoventilation in order to ensure fetal well-being. Extensive knowledge of the profound anatomical and physiological changes that a pregnancy induces is mandatory for the team when operating on a pregnant woman. Short time exposure to anaesthetic agents in clinically relevant doses during surgery has never been demonstrated to have teratogenic effects. Lately, focus has been made on the possible behavioural teratogenic properties of anaesthesia, especially on the use of NMDA receptor antagonists and GABA receptor agonists. Emergency diagnostic imaging during pregnancy is considered safe and should be performed if necessary. Electroconvulsive therapy for the treatment of serious psychiatric disorders during pregnancy is a possibility that should be considered if necessary. Electric cardioversion seems safe for the fetus if life-threatening arrhythmias occur during pregnancy. Trauma is one of the leading non-obstetric causes of maternal mortality and morbidity. When treating a traumatized pregnant woman one should initially focus on the mother’s safety and haemodynamic stability.

A Comparative Study Between Efficacy Of Esmolol And Lignocaine For Attenuating Haemodynamics Response Due To Laryngoscopy And Endotracheal Intubation

1970 ◽  
Vol 5 (1) ◽  
pp. 25-28 ◽  
Author(s):  
M Begum ◽  
P Akter ◽  
MM Hossain ◽  
SMA Alim ◽  
UHS Khatun ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Endotracheal Intubation ◽  
Anaesthetic Management ◽  
Management Plan ◽  
Mean Blood Pressure ◽  
Rate Pressure Product ◽  
Plasma Norepinephrine ◽  
Mean Values ◽  
The Mean

Haemodynamic stability is an integral and essential goal of any anaesthetic management plan. Laryngoscopy and intubation can cause striking changes in haemodynamics. Increase in blood pressure and heart rate occurs most commonly from reflex sympathetic and vagal discharge in response to laryngotracheal stimulation, which in turn leads to increased plasma norepinephrine concentration. This study was designed to compare efficacy of esmolol and lignocaine for attenuating haemodynamics response due to laryngoscopy and endotracheal intubation. The aim of this study was to compare the effects of Esmolol with that of Lignocaine to attenuate the detrimental rise in heart rate and blood pressure during laryngoscopy and tracheal intubation. One hundred and twenty adult patients randomized into group-L and group-E, were received lignocaine 1.5 mg/kg and Esmolol 1.5 mg/kg I.V. respectively. Heart rate and blood pressure in each minutes for the 10 minutes after intubation was recorded. Time span around intubation up to 4 minutes has been looked specifically to isolate the effect of the study drugs at the time of intubation. For statistical analysis Student's 't' test was used for comparing means of quantitative data and chi-square test was used for qualitative data. Difference was considered statistically significant if p<0.05. The mean heart rate, systolic, diastolic, and mean blood pressure, and rate-pressure product before starting anesthesia were similar in group-L (Lignocaine group) and in group-E (Esmolol group) (p>0.05). The mean values of heart rate, systolic, diastolic, and mean blood pressure, and rate-pressure product at 2, 3 and 4 minutes after intubation were significantly lower in group-E than group-L (p<0.05). In conclusion, esmolol 1.5 mg/kg is superior to lignocaine (1.5 mg/kg) for attenuation of haemodynamic response to laryngoscopy and endotracheal intubation. Key words: Haemodynamics; heart rate; intubation; esmolol; lignocaine DOI: 10.3329/fmcj.v5i1.6810Faridpur Med. Coll. J. 2010;5(1):25-28

General anaesthesia for emergency surgery during acute organophosphate poisoning

2002 ◽  
Vol 19 (2) ◽  
pp. 150-152 ◽  
Author(s):  
C. D. A. Goonasekera ◽  
C. J. B. Pethiyagoda ◽  
C. L. K. Attapattn ◽  
M. D. Nagarathne
Keyword(s):  
General Anaesthesia ◽  
Emergency Surgery ◽  
Organophosphate Poisoning
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