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Obstetric AnaestheticFrom: Dr Eberhard W Lisse (el@lisse.na)Sun Jul 21 16:20:06 1996
Hi, The following was recently posted on the anesthesiology list (from Israel). I have entered my own comments as below but would like to solicit opinion by the O&Gyns because I find this two interesting topics:
At 4:05 PM 21/7/96, alexander avidan wrote:
>I would like to ask for your opinion on two cases and their management: If you put her under GA you better be able to secure her airway, right? There are hospitals in South Africa (still) that use Valium/Pethidine only, I am against this personally but one can make exeptions. Regional, but conventional wisdom says you got to have an airway anyway...
>2. Emergency C/S: Induction with thiopenthal and succinylcholine. The I have allowed Obstetricians to cut the skin incision when I could see the cords. However, I don't really think this is such an issue. How long from decision to induction? How long from induction to skin incision? How long from skin incision to uterine incision? How long from uterine incision to baby out? Penthotal has been shown in cord blood as early as 30 seconds after injection so I wonder what difference it really makes. I did hundreds of C/S in the big hospital where they put the patient to sleep before they scrub and drape and I can't say I noticed much difference. On the other hand I do become impatient when I have the knife in the hand and the guy is telling me to wait until he has the tube taped and all (in the other scenario scrub/drape then induce). In the end it's the anaesthetist's decision. Nobody can force you to allow him to cut until you have the airway secured. What do your country's guidelines say? el
-- Dr. Eberhard W. Lisse \ / Swakopmund State Hospital <el@lisse.NA> * | Resident Medical Officer Private Bag 5004 \ / +264 64 461503 (pager) 461005 (home) 461004 (fax) Swakopmund, Namibia ;____/ Zone/Domain Contact for the NA-DOM Vice-Chairman, Board of Trustees, Namibian Internet Development Foundation, an Association not for Gain. NAMIDEF is the Namibian Internet Service Provider.
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