scholarly journals Epidural catheter migration during cesarean

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Aboud AlJa’bari
Keyword(s):  
Cesarean Section ◽  
Epidural Catheter ◽  
Cricoid Pressure ◽  
Rapid Sequence Induction ◽  
Vital Signs ◽  
Test Dose ◽  
Fetal Distress ◽  
Skin Incision ◽  
Lower Limbs ◽  
Catheter Migration

Abstract Background Early detection and vigilance of high spinal anesthesia post epidural catheter migration in cesarean section leads to safe conduct of anesthesia. Our case describes the migration of a previously functioning epidural catheter in the subarachnoid space. This migration can be explained by patient posture changes and movements. Case presentation A 32 year – old G2P0 medically free female parturient (height 160cm, weight 65 kg), admitted to the labor ward with a 4 cm cervical dilatation, an epidural catheter was inserted in the L3-4 space, and an aspiration test was negative for CSF/blood through epidural catheter. Epidural catheter was fixed on her back using sterile dressings. Epidural mixture of 0.1% bupivacaine and fentanyl 2 mcg/ml started. Due to fetal distress, cesarean section was urgently planned. She was given a bolus dose through the epidural catheter,10 minutes after skin incision, the patient suddenly started to complain of difficulty of breathing and drowsiness. Moreover, her oxygen saturation suddenly started to drop so rapid sequence induction with cricoid pressure applied and was performed till she was intubated. Her pupils were reactive and dilated. She had stable vital signs. She was reversed with neostigmine and atropine after the use of nerve stimulator. Aspiration from the epidural catheter was performed. A clear 10mls fluid was aspirated. The fluid was sent to the lab for analysis and found to be CSF. Upon extubation, the patient was conscious and obeying commands. She completely recovered the motor power of her upper and lower limbs while she was admitted to ICU for observation and she was discharged the next day without any residual anesthesia. Conclusion Aspiration test and epinephrine test dose is always recommend to be performed prior to local epidural anesthetic for cesarean section even if the function of the epidural catheter was previously established. Careful observation of neurologic signs is also important.

scholarly journals Unintentional epidural catheter migration to subarachnoid space followed by continuous spinal anaesthesia: a case report

2014 ◽  
Vol 23 (1) ◽  
pp. 37-39
Author(s):  
K Sardar ◽  
AKMN Chowdhury ◽  
MK Rahman
Keyword(s):  
Epidural Catheter ◽  
Spinal Anaesthesia ◽  
Epidural Space ◽  
Test Dose ◽  
Hemodynamic Instability ◽  
Hanging Drop ◽  
Continuous Spinal Anaesthesia ◽  
Catheter Migration ◽  
Severe Hypotension ◽  
Drop Technique

Among the complications of epidural anaesthesia catheter migration is a very rare one. A 45 years old lady was scheduled for repairing of post caesarean incisional hernia. We prefer the hanging drop technique for epidural space identification, and 3 ml air injection to reconfirm the epidural space. After a test dose of 2% lignocaine 2 ml with 10 microgram adrenaline, the catheter was secured with at 3 cm of its length within the epidural space. Immediately after test dose, she complained of lower limb motor lost. On monitor, bradycardia and severe hypotension was shown. Hemodynamic instability was corrected promptly. After proper resuscitation, we aspirate through epidural catheter. CSF was coming freely. We decided to continue with continuous spinal anaesthesia. We assembled a syringe pump. Continuous spinal anaesthesia was maintained with 0.125% bupivacaine @ 3ml/hour DOI: http://dx.doi.org/10.3329/jbsa.v23i1.18158 Journal of BSA, 2010; 23(1): 34-36

scholarly journals Manajemen Anestesi untuk Seksio Sesarea pada Pasien Eklampsia dengan Perdarahan Intrakranial

2021 ◽  
Vol 10 (2) ◽  
pp. 119-126
Author(s):  
Chrismas Gideon Bangun ◽  
◽  
Sudadi Sudadi ◽  
Siti Chasnak Saleh ◽  
◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intracranial Pressure ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Intracranial Hemorrhage ◽  
Rapid Sequence Induction ◽  
Fetal Distress ◽  
Definitive Treatment ◽  
Increased Intracranial Pressure ◽  
Post Surgery

Intracranial haemorrhage in pregnancy is the leading cause of death in eclampsia patients. Hypertension, which is associated with both ischemic and hemorrhagic strokes, is the main feature. Definitive treatment is termination of pregnancy with cesarean section. However, it is not appropriate to start labor in an unstable mother, despite fetal distress. Once seizures can be controlled, severe hypertension is treated and hypoxia is corrected, labor may begin. The first anesthesia management goals are seizure control, blood pressure control, and prevention of increased intracranial pressure. General anesthesia is an option in the unconscious patient, or decreased consciousness with signs of increased intracranial pressure. Anesthesia is achieved with inhalation, opioids, relaxation and hyperventilation techniques carefully. In this case a 31-year-old mother, 55 kg, 36-37 weeks' gestation comes to the hospital with a decrease in consciousness and a history of seizures. Found sensorium E2M5V2, blood pressure 180/100mmHg and proteinuria 3+. Immediately, a cesarean section with general anesthesia and rapid sequence induction with fentanyl 50 mcg, propofol 100 mg and rocuronium 50 mg intravenously were performed. Post surgery the patient was treated in the ICU, head CT-Scan was performed and intracranial hemorrhage in the right temporoparietal was encountered. Management of intracranial hemorrhage was decided conservatively. The 3rd day postoperative the patient was extubated and on the 5th day the patient was transferred with E3M5V2 sensorium.

scholarly journals Rapid sequence induction: where did the consensus go?

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Pascale Avery ◽  
Sarah Morton ◽  
James Raitt ◽  
Hans Morten Lossius ◽  
David Lockey
Keyword(s):  
Cricoid Pressure ◽  
Rapid Sequence Induction ◽  
Hospital Environment ◽  
Training Technique ◽  
Rapid Sequence ◽  
Gastric Aspiration ◽  
Sequence Induction ◽  
The Uk ◽  
Key Aspects ◽  
Risk Of Aspiration

Abstract Background Rapid Sequence Induction (RSI) was introduced to minimise the risk of aspiration of gastric contents during emergency tracheal intubation. It consisted of induction with the use of thiopentone and suxamethonium with the application of cricoid pressure. This narrative review describes how traditional RSI has been modified in the UK and elsewhere, aiming to deliver safe and effective emergency anaesthesia outside the operating room environment. Most of the key aspects of traditional RSI – training, technique, drugs and equipment have been challenged and often significantly changed since the procedure was first described. Alterations have been made to improve the safety and quality of the intervention while retaining the principles of rapidly securing a definitive airway and avoiding gastric aspiration. RSI is no longer achieved by an anaesthetist alone and can be delivered safely in a variety of settings, including in the pre-hospital environment. Conclusion The conduct of RSI in current emergency practice is far removed from the original descriptions of the procedure. Despite this, the principles – rapid delivery of a definitive airway and avoiding aspiration, are still highly relevant and the indications for RSI remain relatively unchanged.

THE RELATIONSHIP OF AMNIOTIC FLUID VISCOSITY TO RESPIRATORY DISTRESS IN LAMBS

PEDIATRICS ◽  
1966 ◽  
Vol 38 (5) ◽  
pp. 858-864
Author(s):  
Arthur J. Moss ◽  
Ovidio Rettori ◽  
Norman S. Simmons
Keyword(s):  
Cesarean Section ◽  
Respiratory Distress ◽  
Amniotic Fluid ◽  
Fetal Distress ◽  
In Utero ◽  
Fluid Viscosity ◽  
Lung Expansion ◽  
Relationship Of ◽  
The Relationship ◽  
Length Of Gestation

The viscosity of amniotic fluid was measured in 52 ewes and the results correlated with the postnatal course of the lambs delivered by cesarean section. Viscosity was not related to length of gestation or to the immediate prepartum condition of the ewe, but a definite relationship was found between amniotic fluid viscosity (AFV) and the postnatal course of the fetus. Of 22 lambs considered viable, 9 failed to survive. In 10 of the 13 survivors, AFV was less than 1.6; whereas in the nonsurvivors, AFV varied between 1.6 and 4.4. All of the nonsurvivors experienced respiratory difficulty associated with copious amounts of extremely viscous secretions in the mouth and oropharynx. The substance responsible for the high AFV was a mucoprotein and was detectable in all samples with a viscosity of 1.24 or more but in none with a viscosity below 1.24. The data suggest the possibility that fetal distress may induce qualitative or quantitative alterations of fetal mucous secretions in utero which subsequently could impede lung expansion at birth.

Management of cesarean delivery in a parturient with osteogenesis imperfecta：A case report

2020 ◽  
pp. 1-3
Keyword(s):  
Cesarean Section ◽  
Vital Signs ◽  
Bone Fragility ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Mother And Daughter ◽  
Blue Sclera ◽  
Written Informed Consent

Osteogenesis imperfecta (OI) is characterized by bone fragility, defects in the teeth, blue sclera, and deficits in hearing and vision [1,2]. Because of an anticipated difficult airway and back anatomy, there is a high risk of choosing either general or spinal anesthesia, especially in critically ill obstetric patients. It is still controversy about the anesthesia method in patients with OI. Ultrasound-guided transversus abdominis plane block (TAPB) has been used for analgesia after cesarean section, but rarely for anesthesia in this operation [3-5]. We describe a critically parturient with OI who underwent cesarean section under ultrasound guided TAPB with spontaneous breathing general anesthesia. The patient's vital signs have remained stable during the operation, and a live female infant was delivered successfully by cesarean section. The mother and daughter were safe at last. Written informed consent was provided by the patient for publication of this report with photos.created.

scholarly journals Prelabour Rupture of Membranes: Mode of Delivery and Outcome

2015 ◽  
Vol 3 (2) ◽  
pp. 237-240 ◽  
Author(s):  
Vlora Ademi Ibishi ◽  
Rozalinda Dusan Isjanovska
Keyword(s):  
Cesarean Section ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Maternal Complications ◽  
Cephalopelvic Disproportion ◽  
Cesarean Section Delivery ◽  
Clinical Center ◽  
Failed Induction ◽  
The University

BACKGROUND: Pre-labour Rupture of Membranes (PROM) is an important cause of maternal and fetal morbidity and increased rate of cesarean section delivery. AIM: The aim of this study is to investigate the clinical characteristics, PROM-delivery interval, mode of delivery, and early maternal neonatal outcome among pregnant patients presenting with pre-labour rupture of membranes.MATERIAL AND METHODS: This prospective case control study is implemented at the Obstetric and Gynecology Clinic of the University Clinical Center of Kosovo. The study included 100 pregnant patients presenting with prelabour rupture of membranes of which 63 were primigravida and 37 patients were multigravida.RESULTS: The incidence of cesarean section in this study is 28 % and the most common indications for cesarean delivery were fetal distress, malpresentation, cephalopelvic disproportion, and failed induction. The most common maternal complications in this study are chorioamnionitis, retained placenta and postpartum hemorrhage. Neonatal infectious morbidity was present in 16 % of cases.CONCLUSION: PROM is a significant issue for obstetricians and an important cause of maternal and neonatal morbidity and increased rate of cesarean section delivery.

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