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Re: Subject: Section on demandFrom: ainsron (ainsron@sbcglobal.net)Fri Apr 28 12:38:21 2006
-----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Efrain Ramirez Sent: Friday, April 28, 2006 10:11 AM To: Multiple recipients of list OB-GYN-L Subject: Re: Subject: Section on demand I was raised in the neighborhood of bed rest for at least 12 hours, NPO, then clear liquids, etc. - it has become clear to me through reading and experience that such guidelines are of no benefit -nowadays is early ambulation and regular diet - no regrets - I think post spinal headaches has to do more with technique, needle size and experience of the anesthesiologist- and of course good luck.. years ago during my residency a guy was doing a spinal - he was very nervous and he punctured the lady oh. I don't know how many times - he finally succeeded, looked at me and proudly asked - "Did you like my acupuncture technique"? - we all laughed - including the patient.. Ef That sounds like the resident who did my wife's spinal for our second son's C/S when I was a senior medical student. He tried 10+ times to place the spinal and my wife is small and not a difficult placement. Finally our OB, who was later my partner for a year, tried one time and got right in. My wife had the world's worst spinal for 10 days. A blood patch was tried without effect. Of course her dura must have looked like a sieve and nothing but time could heal it. In spite of that terrible headache, she still opted for spinals with our next three children and never had a problem. Skill, training, appropriate equipment and experience are invaluable in placing spinals safely and atraumatically. Early ambulation makes no difference in the incidence of headaches. Ron
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