General anesthesia for cesarean section in a Singapore maternity hospital: a retrospective survey.

Abstract:

:We conducted a retrospective study of all cases of cesarean section at the KK Women's and Children's Hospital over a one-year period from September 1, 2002 to August 31, 2003, with the aim of evaluating current anesthetic practice. These cases were identified using hospital databases and relevant data was extracted from clinical notes. There were 14244 deliveries during the study period with a cesarean section rate of 25.2% (3583 cases). Of these, 20.4% (732 cases) were performed under general anesthesia. Maternal request was the chief reason for general anesthesia, especially among elective cases. Regional block failure accounted for 16% of the general anesthesia cases performed or 4.0% of the total regional techniques attempted. Regional block failure rate was highest for emergency cases in which an indwelling labor epidural catheter was used to provide surgical anesthesia via a bolus top-up. General anesthesia still has a definite place for cesarean delivery despite the predominant use of regional techniques in our institution.

journal_name

Int J Obstet Anesth

authors

Kan RK,Lew E,Yeo SW,Thomas E

doi

10.1016/j.ijoa.2004.04.007

subject

Has Abstract

pub_date

2004-10-01 00:00:00

pages

221-6

issue

4

eissn

0959-289X

issn

1532-3374

pii

S0959-289X(04)00067-6

journal_volume

13

pub_type

杂志文章
  • Perioperative analgesia for caesarean section: comparison of intrathecal morphine and fentanyl alone or in combination.

    abstract::In a double-blind placebo-controlled trial we compared perioperative pain relief using different intrathecal opioid regimens given with bupivacaine during spinal anaesthesia for elective caesarean section. One hundred and sixteen patients undergoing elective caesarean section were divided into four groups (A, B, C, D)...

    journal_title:International journal of obstetric anesthesia

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0959-289x(97)80051-9

    authors: Sibilla C,Albertazz P,Zatelli R,Martinello R

    更新日期:1997-01-01 00:00:00

  • Blood pressure assessment and first-line pharmacological agents in women with eclampsia.

    abstract:BACKGROUND:Eclampsia is a life-threatening complication of pregnancy. Timely blood pressure assessment and administration of magnesium sulphate are essential management. In this retrospective single-centre study we examined the timing and magnitude of maternal blood pressure before eclampsia, and whether magnesium sulp...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2015.01.007

    authors: Dennis AT,Chambers E,Serang K

    更新日期:2015-08-01 00:00:00

  • The use of remifentanil infusion to facilitate epidural catheter placement in a parturient: a case report with pharmacokinetic simulations.

    abstract::We present a case in which remifentanil infusion was used to provide analgesia during epidural catheter placement in a parturient who was experiencing great difficulty staying motionless because of extremely painful uterine contractions. Remifentanil may provide certain advantages in this setting, including improved a...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/s0959-289x(98)90009-7

    authors: Brada SA,Egan TD,Viscomi CM

    更新日期:1998-04-01 00:00:00

  • A retrospective case-controlled study of the association between request to discontinue second stage labor epidural analgesia and risk of instrumental vaginal delivery.

    abstract:BACKGROUND:Epidural dose is often reduced in the second stage of labor with the intention of improving maternal expulsive efforts and decreasing the need for instrumental vaginal delivery (IVD). We conjectured that parturients requiring IVD would have had more analgesic interventions and requests to decrease analgesic ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2007.10.007

    authors: Toledo P,McCarthy RJ,Ebarvia MJ,Wong CA

    更新日期:2008-10-01 00:00:00

  • High dose alfentanil as sole anaesthetic induction agent for caesarean section in a patient with severe ischaemic heart disease.

    abstract::A 43-year-old woman presented at 34 weeks' gestation with pre-eclampsia and intra-uterine growth restriction. She had a past medical history of myocardial infarction and had angina on moderate effort. She also had non-insulin dependent diabetes mellitus, chronic obstructive airways disease and hypercholesterolaemia. T...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1054/ijoa.1999.0368

    authors: Duggan M,Carey M

    更新日期:2000-07-01 00:00:00

  • Maternal respiratory distress and successful reversal with sugammadex during intrauterine transfusion with fetal paralysis.

    abstract::A 70 kg, 34-year-old woman at 29 weeks-of-gestation required intrauterine transfusion for Rh (D) alloimmunization. In the ambulatory treatment clinic, 19 mg of rocuronium was administered intramuscularly in split doses into the fetal buttock. The fetus moved and inadvertent maternal neuromuscular blockade occurred, le...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2019.01.002

    authors: Munro A,McKeen D,Coolen J

    更新日期:2019-08-01 00:00:00

  • Catheter failure rates and time course with epidural versus combined spinal-epidural analgesia in labor.

    abstract:BACKGROUND:The combined spinal-epidural technique for labor analgesia has several advantages over the traditional epidural technique, including faster onset, greater maternal satisfaction, and decreased need for physician boluses. Proponents of the epidural technique criticize the combined spinal-epidural technique, ar...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2016.01.004

    authors: Groden J,Gonzalez-Fiol A,Aaronson J,Sachs A,Smiley R

    更新日期:2016-05-01 00:00:00

  • Amniotic fluid embolism during caesarean section.

    abstract::Amniotic fluid embolism occurs rarely but is a leading cause of maternal mortality. A high index of clinical suspicion is necessary to make an early diagnosis to reduce morbidity and mortality. We report a non-fatal case of amniotic fluid embolism occurring during a caesarean section, with special emphasis on the mode...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2004.03.002

    authors: Tramoni G,Valentin S,Robert MO,Sergeant MV,Branche P,Duperret S,Clement HJ,Lopez F,Boisson C,Audra P,Rudigoz RC,Viale JP

    更新日期:2004-10-01 00:00:00

  • Persistent pain after caesarean section and vaginal birth: a cohort study.

    abstract:BACKGROUND:Although persistent pain has been described to occur after various types of surgery, little is known about this entity following caesarean section or vaginal birth. We sought to examine the association between mode of delivery and development of persistent pain, as well as the nature and intensity of the pai...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2009.03.013

    authors: Kainu JP,Sarvela J,Tiippana E,Halmesmäki E,Korttila KT

    更新日期:2010-01-01 00:00:00

  • Immediate postpartum neurological deficits in the lower extremity: a prospective observational study.

    abstract:BACKGROUND:Neurological deficits noted immediately after childbirth are usually various obstetric neuropathies, but prospective studies are limited. The main study aim was to quantify and describe immediate postpartum neurological deficits of the lower extremity, including the buttocks. METHODS:A prospective observati...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2017.04.002

    authors: Richards A,McLaren T,Paech MJ,Nathan EA,Beattie E,McDonnell N

    更新日期:2017-05-01 00:00:00

  • Incidence and risk factors for chronic pain after elective caesarean delivery under spinal anaesthesia in a Chinese cohort: a prospective study.

    abstract:BACKGROUND:China has one of the highest rates of caesarean delivery in the world. The aim of this study was to investigate the incidence and risk factors for chronic pain after caesarean delivery in a Chinese cohort. METHODS:Patients undergoing elective caesarean delivery with a Pfannenstiel incision under spinal anae...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2018.01.009

    authors: Wang LZ,Wei CN,Xiao F,Chang XY,Zhang YF

    更新日期:2018-05-01 00:00:00

  • Personalized analgesic management for cesarean delivery.

    abstract::Current pain and analgesic management strategies apply a standardized one-size-fits-all approach to women undergoing cesarean delivery. These standardized protocols do not account for significant variability in women's pain and may lead to under-treatment in patients with high analgesic needs and overtreatment, associ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,评审

    doi:10.1016/j.ijoa.2019.02.124

    authors: Carvalho B,Habib AS

    更新日期:2019-11-01 00:00:00

  • Analgesic effects of intrathecal tramadol in patients undergoing caesarean section: a randomised, double-blind study.

    abstract:BACKGROUND:Intrathecal tramadol combined with local anaesthetics has been used for postoperative analgesia following lower abdominal and perineal surgery. The present study evaluated the effect of intrathecal tramadol on spinal block characteristics and neonatal outcome after elective caesarean section. METHODS:Eighty...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ijoa.2013.05.009

    authors: Subedi A,Biswas BK,Tripathi M,Bhattarai BK,Pokharel K

    更新日期:2013-11-01 00:00:00

  • Intravenous dexmedetomidine as an adjunct for labor analgesia and cesarean delivery anesthesia in a parturient with a tethered spinal cord.

    abstract::For parturients desiring labor analgesia who have contraindications to neuraxial techniques, intravenous opioid-based patient-controlled analgesia (IVPCA) offers a reasonable alternative, although incomplete analgesia and maternal and neonatal respiratory depression can occur. Dexmedetomidine, a highly selective alpha...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2008.10.002

    authors: Palanisamy A,Klickovich RJ,Ramsay M,Ouyang DW,Tsen LC

    更新日期:2009-07-01 00:00:00

  • A comparison of epidural ropivacaine 0.75% and bupivacaine 0.5% with fentanyl for elective caesarean section.

    abstract:BACKGROUND:Early studies suggested that ropivacaine had clinical advantages over bupivacaine with respect to cardiotoxicity and motor block, and that it was suitable for epidural caesarean section. This study was set up to compare epidural 0.75% ropivacaine with a popular bupivacaine/fentanyl mixture for elective caesa...

    journal_title:International journal of obstetric anesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/j.ijoa.2005.01.002

    authors: Christelis N,Harrad J,Howell PR

    更新日期:2005-07-01 00:00:00

  • The successful use of extra-corporeal membrane oxygenation in the management of a pregnant woman with severe H1N1 2009 influenza complicated by pneumonitis and adult respiratory distress syndrome.

    abstract::We report a case of H1N1 2009 influenza A, in a previously fit woman at 24 weeks of gestation, who presented atypically with abdominal pain. The infection was complicated by severe respiratory failure and acute respiratory distress syndrome, requiring ventilatory support, including extra-corporeal membrane oxygenation...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2010.04.010

    authors: Robertson LC,Allen SH,Konamme SP,Chestnut J,Wilson P

    更新日期:2010-10-01 00:00:00

  • Risk factors for post-dural puncture headache following injury of the dural membrane: a root-cause analysis and nested case-control study.

    abstract:BACKGROUND:Post-dural puncture headache following trauma to the dural membrane during neuraxial anaesthesia occurs in 0.13-6.5% of pregnant patients. Identifying factors beyond individual performance that contribute to this adverse event is crucial to developing improvement strategies. METHODS:We used a root cause ana...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2018.05.007

    authors: Haller G,Cornet J,Boldi MO,Myers C,Savoldelli G,Kern C

    更新日期:2018-11-01 00:00:00

  • Concealed paracetamol overdose treated as HELLP syndrome in the presence of postpartum liver dysfunction.

    abstract::Paracetamol is the most frequently used analgesic during pregnancy and the most common drug involved in suicidal overdose in the UK. Manifestation of toxicity classically occurs over four phases with clinical and laboratory features resembling HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome. We repo...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2014.01.006

    authors: Mills AT,Davidson ME,Young P

    更新日期:2014-05-01 00:00:00

  • Risk factors for failed conversion of labor epidural analgesia to cesarean delivery anesthesia: a systematic review and meta-analysis of observational trials.

    abstract:BACKGROUND:This systematic review and meta-analysis evaluates evidence for seven risk factors associated with failed conversion of labor epidural analgesia to cesarean delivery anesthesia. METHODS:Online scientific literature databases were searched using a strategy which identified observational trials, published bet...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,meta分析,评审

    doi:10.1016/j.ijoa.2012.05.007

    authors: Bauer ME,Kountanis JA,Tsen LC,Greenfield ML,Mhyre JM

    更新日期:2012-10-01 00:00:00

  • Effect of preoperative skin infiltration with 0.5% bupivacaine on postoperative pain following cesarean section under spinal anesthesia.

    abstract::Recent work suggests that preoperative skin infiltration with local anesthetic may lead to reduced postoperative pain. We have studied this in a randomised, prospective, double-blind trial of 40 women having cesarean section under spinal anesthesia. After establishment of the spinal block, the incision line was infilt...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/0959-289x(94)90068-x

    authors: Pavy T,Gambling D,Kliffer P,Munro A,Merrick PM,Douglas J

    更新日期:1994-10-01 00:00:00

  • Pulseless electrical activity during caesarean delivery under spinal anaesthesia: a case report of severe anaphylactic reaction to Syntocinon.

    abstract::Anaphylactoid reaction to Syntocinon is rare, but has been described in the literature. The reactions described include patchy erythema, hypotension, bronchospasm and oxygen desaturation, but pulseless electrical activity following Syntocinon has not been reported. We present the case of a 34-year-old primigravida wit...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2008.09.004

    authors: Pant D,Vohra VK,Pandey SS,Sood J

    更新日期:2009-01-01 00:00:00

  • Management of a parturient with high-grade osteosarcoma of the proximal femur: a multidisciplinary approach.

    abstract::Osteosarcoma is the most common primary malignant bone tumor, yet it is exceedingly rare in pregnancy. We present a case of a 33-year-old multiparous woman diagnosed with high-grade osteosarcoma during the third trimester of pregnancy. A plan was formulated to perform cesarean delivery at 33 weeks of gestation under s...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2010.03.013

    authors: Quaye AA,Raskin KA,Ecker JL,Leffert LR

    更新日期:2010-07-01 00:00:00

  • Chagas' disease in an obstetrical patient.

    abstract::We report a case of a parturient with documented chronic Chagas' disease with cardiac manifestations presenting for labor management and complicated by the need for emergent hysterectomy after delivery. Chagas' disease is a common human hematogenous trypanosomiasis in Central and South America which is now, because of...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/s0959-289x(96)80005-7

    authors: Martin HB,Wills J

    更新日期:1996-04-01 00:00:00

  • Fluid management in pre-eclampsia.

    abstract::We review the evidence base for fluid management in pre-eclampsia. Current understanding of the relevant pathophysiology and the possible impact of styles of fluid management on maternal and fetal outcome are presented. There is little evidence upon which to base the management of fluid balance in pre-eclampsia. Repor...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/s0959-289x(99)80106-x

    authors: Engelhardt T,MacLennan FM

    更新日期:1999-10-01 00:00:00

  • Obstetric anaesthesia in Hungary.

    abstract::A nation-wide survey of pain relief in childbirth in Hungary was carried out in 1993. Information was provided on 104 137 deliveries in 98 units. The frequencies of different methods of pain relief for vaginal delivery were as follows: systemic opiates in 7387 cases (8.3%), epidural analgesia in 4611 cases (5.2%) and ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/s0959-289x(97)80029-5

    authors: Beke A,Takács G,Sziller I,Fedák L,Papp Z

    更新日期:1997-10-01 00:00:00

  • MBRRACE-UK: saving lives, improving mothers' care - implications for anaesthetists.

    abstract::In December 2014, the latest UK Confidential Enquiry into Maternal Deaths report was published, covering the surveillance period from 2009 to 2012. This is the first report since a significant change in the organisational structure of the body responsible for surveillance and dissemination of reports. The Confidential...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,评审

    doi:10.1016/j.ijoa.2015.03.004

    authors: Freedman RL,Lucas DN

    更新日期:2015-05-01 00:00:00

  • Untoward incident reporting in obstetric anaesthesia: a 6-month prospective study in Northern Ireland.

    abstract::The marked reduction in the number of cases related to the provision of anaesthesia, included in the triennial Reports on Confidential Enquiries into Maternal Deaths in the UK, may limit the educational value of such reports for anaesthetists in the future. The collection, analysis and reporting of untoward events rel...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/s0959-289x(96)80041-0

    authors: McBrien ME,Bali IM

    更新日期:1996-10-01 00:00:00

  • Management of labor and delivery in a woman with Morquio syndrome.

    abstract::Morquio syndrome, a congenital mucopolysaccharidosis, presents several challenges for the provision of effective labor analgesia. We report the case of a woman admitted for induction of labor who received an early epidural and subsequently required cesarean delivery. Optimal bilateral labor analgesia was not achieved ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2015.08.015

    authors: Delgado C,Kent C,Sedensky M,Ciliberto C,Landau R

    更新日期:2015-11-01 00:00:00

  • Blood conservation techniques in obstetrics: a UK perspective.

    abstract::In the UK, maternal mortality due to haemorrhage appears to be rising, with obstetric haemorrhage accounting for 3-4% of the red cells transfused. Allogeneic blood transfusion carries risks such as administration errors, transmitted infections and immunological reactions. The supply of blood is decreasing, partly due ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,评审

    doi:10.1016/j.ijoa.2007.01.014

    authors: Catling S

    更新日期:2007-07-01 00:00:00

  • Interventions at caesarean section for reducing the risk of aspiration pneumonitis.

    abstract:BACKGROUND:Various interventions are used as prophylaxis for aspiration pneumonitis in obstetric anaesthesia. This review, based on a Cochrane systematic review currently being updated, examines whether interventions given before caesarean section reduce the risk of aspiration pneumonitis. METHODS:Twenty-two studies, ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,评审

    doi:10.1016/j.ijoa.2010.12.006

    authors: Paranjothy S,Griffiths JD,Broughton HK,Gyte GM,Brown HC,Thomas J

    更新日期:2011-04-01 00:00:00