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Re: Anaesthesia From: Joanne Bulley (jbulley@cheshire.net) Sat May 8 23:43:08 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Madhumita Roy: "Anaesthesia for emergency C-section from Suresh Deshpande" Previous message: Endometriosis ZONE Newscast: "Endometriosis ZONE May'99 Edition" > Date: Fri, 7 May 1999 13:41:48 -0500 > From: "Braun, R. Daniel" <rbraun@iupui.edu> > IV nitroglycerine or Terbutaline will give uterine relaxation. I never > rupture the membranes on the second twin until after I have hold of at least > one and preferably two feet. At that point rupture of the membranes occurs > after the baby is in a longitudinal lie. > Dan > R. Daniel Braun, MD FACOG I agree with all of the above - but have not seen excess contraction from spinal... Also - until I read the responses to Suresh's post, the fact that it was a C/Section eluded me. From Suresh's description, and the difficulties I was picturing the delivery as from below. Now, realizing it was a C/S - I can't really imagine having that difficult a time. The question asked about incision was important. If the lie is back-down transverse, then you know before the incision that there will be nothing to grasp if a low transverse incision is made... Maybe I am not so sorry I am not doing OB afterall.... -- Joanne Bulley, MD Keene, NH > > -----Original Message----- > From: Dr Suresh Deshpande [SMTP:sureshdeshpande@hotmail.com] > Sent: Friday, May 07, 1999 12:50 PM > Subject: Anaesthesia for emergency C-Section > > Dr Suresh Deshpande, > M.D., F.I.C.O.G., > Consultant Obstetrician & Gynaecologist, > Deshpande Hospital & Laparascopy Clinic > 33/15,B, Karve Road, > PUNE 411 004, INDIA > > Date: Fri, 07 May 1999 21:35:53 +0100 > From: Dr Eberhard W Lisse <el@linux.lisse.na> > > Suresh, > > What skin incision did you do, and what uterine incision? > > Did you extend your incision? > > 12 minutes after incision into the Uterus or after extraction of the > first baby? > > How was the baby rescuscitated and by whom? > > Well, I haven't operated many under spinal, but that's the first I > hear about it. > > I can't follow your timing, though. After the Spinal it takes at least > 10 minutes to get her scrubbed and draped. So you are in fact saying > that no spinals should undertaken for C/S? > > I don't think you can blame it on the anaesthetist, though I think he > should be hauled in front of the Medical Board (if such a thing exists > in your country) for not being able to give a General Anaesthetics. > > I would have tried to tocolyse her in the first place and give her > steroids. If delivery was unevitable I would have (and have done in > transverse and compound presentations) a midline skin incision and > either a low Classical or a skewed transverse ("J") incision, that you > can extend easily. After a minute of trying I would have (and have in > similar cases) extended the incision as much as required, no matter > how large and what happened to the Uterus afterwards. > > 12 Minutes post uterine incision is not justifiable in my view. > > I am really quite interested in the rescuscitation aspect. > > el > Next message: Madhumita Roy: "Anaesthesia for emergency C-section from Suresh Deshpande" Previous message: Endometriosis ZONE Newscast: "Endometriosis ZONE May'99 Edition"

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