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Re: C/S Under Local Anesthesia From: Braun, R. Daniel (rbraun@iupui.edu) Sat Feb 5 15:50:27 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: J. Hellriegel: "Re: Uterine fibroid" Previous message: art fougner, md: "Re: fhr acelerations or reactividad ??" Maybe in reply to: Gerald P. Rodriguez: "C/S Under Local Anesthesia" Next in thread: Joe Cutchin: "Re: C/S Under Local Anesthesia" I haven't seen a protocol either, but I have done it twice. That is 2 times too many. It is better than nothing, but boy it sure ain't good. I would only use it for a midline incision in the abdomen. Infiltrate the skin like for a biopsy, then infiltrate the fascia once you get there, then infiltrate the peritoneum when you get there. At this point do not mess with a bladder flap, just stay above the bladder and make your uterine incision after infiltating the peritoneal surface. Use no more than 50 cc of 1% lidocaine without epinephrine. Deliver the baby, then , if possible, leave the placenta in place and wait for anesthesia to arrive before you deliver the placenta and suture the uterus. Once you have good general anesthesia, proceed with finishing up. The problem is not with the incision site so much as it is with the peritoneum which is very sensitive to stretch and you can't anesthetise the whole peritoneum, so whenever you move anything you will be pulling on it and the patient will let you know. Dan -----Original Message----- From: Gerald P. Rodriguez To: Multiple recipients of list OB-GYN-L Sent: 2/5/00 11:39 AM Subject: C/S Under Local Anesthesia Has anyone seen a recent protocol for doing a C/S under local anesthesia? Given the recent VBAC issues recently, I failed to see local anesthesia discussed but I could have missed this, since I am now traveling more after semi-retiring in September. -- Gerald P. Rodriguez, M.D., FACOG +++++++++++++++++++++++++++++++++++++++++++++++ "Idealism is fine, but as it approaches reality the cost becomes prohibitive."--Wm. F. Buckley "¿Qúe es un pedo pa' tanta naríz?"--quien sabe quien lo dijo +++++++++++++++++++++++++++++++++++++++++++++++ Next message: J. Hellriegel: "Re: Uterine fibroid" Previous message: art fougner, md: "Re: fhr acelerations or reactividad ??" Maybe in reply to: Gerald P. Rodriguez: "C/S Under Local Anesthesia" Next in thread: Joe Cutchin: "Re: C/S Under Local Anesthesia"

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