Analgesia, Anaesthesia and Pregnancy: A Practical Guide PDF
Preview Analgesia, Anaesthesia and Pregnancy: A Practical Guide
Analgesia, Anaesthesia and Pregnancy A Practical Guide Third Edition Analgesia, Anaesthesia and Pregnancy A Practical Guide Third Edition Steve Yentis ConsultantAnaesthetist,ChelseaandWestminsterHospital,London,UK Surbhi Malhotra ConsultantAnaesthetist,StMary’sHospital,London,UK CAMBRIDGE UNIVERSITY PRESS Cambridge,NewYork,Melbourne,Madrid,CapeTown, Singapore,SãoPaulo,Delhi,MexicoCity CambridgeUniversityPress TheEdinburghBuilding,CambridgeCB28RU,UK PublishedintheUnitedStatesofAmerica byCambridgeUniversityPress,NewYork www.cambridge.org Informationonthistitle:www.cambridge.org/9781107601598 Firstedition©W.B.Saunders2000 Secondedition©CambridgeUniversityPress2007 Thirdedition©SteveYentisandSurbhiMalhotra2013 Thispublicationisincopyright.Subjecttostatutoryexception andtotheprovisionsofrelevantcollectivelicensingagreements, noreproductionofanypartmaytakeplacewithout thewrittenpermissionofCambridgeUniversityPress. Firsteditionpublished2000 Secondeditionpublished2007 Reprinted2008 Thirdeditionpublished2013 PrintedandboundintheUnitedKingdombytheMPGBooksGroup AcataloguerecordforthispublicationisavailablefromtheBritishLibrary LibraryofCongressCataloguinginPublicationdata Yentis,S.M.(StevenM.) Analgesia,anaesthesia,andpregnancy:apracticalguide/SteveYentis, SurbhiMalhotra.–3rded. p.;cm. Includesbibliographicalreferencesandindex. ISBN978-1-107-60159-8(Paperback:alk.paper) I. Malhotra,Surbhi,Dr. II. Title. [DNLM: 1. Analgesia,Obstetrical. 2. Anesthesia,Obstetrical. WO450] 617.90682–dc23 2012036026 ISBN978-1-107-60159-8Paperback CambridgeUniversityPresshasnoresponsibilityforthepersistenceor accuracyofURLsforexternalorthird-partyinternetwebsitesreferredto inthispublication,anddoesnotguaranteethatanycontentonsuch websitesis,orwillremain,accurateorappropriate. Everyefforthasbeenmadeinpreparingthisbooktoprovideaccurateandup-to- dateinformationwhichisinaccordwithacceptedstandardsandpracticeatthe timeofpublication.Althoughcasehistoriesaredrawnfromactualcases,every efforthasbeenmadetodisguisetheidentitiesoftheindividualsinvolved. Nevertheless,theauthors,editorsandpublisherscanmakenowarrantiesthatthe informationcontainedhereinistotallyfreefromerror,notleastbecauseclinical standardsareconstantlychangingthroughresearchandregulation.Theauthors, editorsandpublishersthereforedisclaimallliabilityfordirectorconsequential damagesresultingfromtheuseofmaterialcontainedinthisbook.Readersare stronglyadvisedtopaycarefulattentiontoinformationprovidedbythe manufacturerofanydrugsorequipmentthattheyplantouse. Contents Preface xi – Section 1 Preconception and conception 1 Assistedconception 1 2 Ovarianhyperstimulationsyndrome 3 3 Anaesthesiabeforeconceptionorconfirmationofpregnancy 5 – Section 2 Pregnancy I – Procedures in early/mid-pregnancy 4 Ectopicpregnancy 7 5 Evacuationofretainedproductsofconception 9 6 Terminationofpregnancy 11 7 Cervicalsuture(cerclage) 12 8 Incidentalsurgeryinthepregnantpatient 14 9 Intrauterinesurgery 16 II – Normal pregnancy and delivery 10 Anatomyofthespineandperipheralnerves 19 11 Physiologyofpregnancy 27 12 Antenatalcare 31 13 Aortocavalcompression 34 14 Gastricfunctionandfeedinginlabour 35 15 Drugsandpregnancy 37 16 Placentaltransferofdrugs 40 17 Prescriptionandadministrationofdrugsbymidwives 42 18 Localanaesthetics 44 19 Normallabour 46 20 Intrapartumfetalmonitoring 51 21 Painoflabour 54 22 Epiduralanalgesiaforlabour 56 23 Epiduraltestdoses 61 24 Combinedspinal–epiduralanalgesiaandanaesthesia 64 25 Spinalanalgesia 67 26 Spinalandepiduralopioids 69 27 Inhalationalanalgesicdrugs 72 28 Systemicanalgesicdrugs 74 29 Non-pharmacologicalanalgesia 76 v vi Contents III – Operative delivery and third stage 30 Instrumentaldelivery 81 31 Caesareansection 83 32 Spinalanaesthesiaforcaesareansection 88 33 Epiduralanaesthesiaforcaesareansection 91 34 Generalanaesthesiaforcaesareansection 95 35 Cricoidpressure 99 36 Failedanddifficultintubation 101 37 Awakeintubation 105 38 Removalofretainedplacentaandperinealsuturing 106 39 Postoperativeanalgesia 108 IV – Anaesthetic problems 40 Bloodytap 113 41 Duralpuncture 114 42 Postduralpunctureheadache 116 43 Epiduralbloodpatch 119 44 Extensiveregionalblocks 121 45 Inadequateregionalanalgesiainlabour 124 46 Backache 127 47 Horner’ssyndromeandcranialnervepalsy 128 48 Peripheralnervelesionsfollowingregionalanaesthesia 130 49 Spinalcordlesionsfollowingregionalanaesthesia 133 50 Arachnoiditis 135 51 Caudaequinasyndrome 137 52 Opioid-inducedpruritus 138 53 Shivering 139 54 Aspirationofgastriccontents 140 55 Awareness 144 56 Airembolism 147 V – Problems confined to obstetrics 57 Inductionandaugmentationoflabour 149 58 Oxytocicandtocolyticdrugs 151 59 Prematurelabour,deliveryandruptureofmembranes 154 60 Malpresentationsandmalpositions 156 61 Externalcephalicversion 158 62 Multiplepregnancy 160 63 Trialofscar 161 64 Under-agepregnancyandadvancedmaternalage 163 65 Placentapraevia 165 66 Placentalabruption 168 67 Prolapsedcord 170 68 Fetaldistress 172 Contents vii 69 Shoulderdystocia 174 70 Intrauterinedeath 176 71 Uterineinversion 178 72 Majorobstetrichaemorrhage 179 73 Postpartumhaemorrhage 182 74 Collapseonlabourward 185 75 Maternalcardiopulmonaryresuscitation 186 76 Amnioticfluidembolism 189 77 Cholestasisofpregnancy(obstetriccholestasis) 190 78 Acutefattyliverofpregnancy 192 79 HELLPsyndrome 194 80 Hypertension,pre-eclampsiaandeclampsia 196 81 Magnesiumsulphate 202 82 Hyperemesisgravidarum 205 83 Maternalmortality 207 VI – Problems not confined to obstetrics 84 Allergicreactions 211 85 Cardiovasculardisease 213 86 Arrhythmias 216 87 Pulmonaryoedema 218 88 Cardiomyopathy 220 89 Coarctationoftheaorta 223 90 Prostheticheartvalves 225 91 Congenitalheartdisease 227 92 PulmonaryhypertensionandEisenmenger’ssyndrome 230 93 Ischaemicheartdisease 233 94 Endocrinedisease 235 95 Diabetesmellitus 236 96 Anaemiaandpolycythaemia 240 97 Deep-veinthrombosisandpulmonaryembolism 241 98 Thrombophilia 244 99 Coagulopathy 246 100 VonWillebrand’sdiseaseandhaemophilia 248 101 Disseminatedintravascularcoagulation 251 102 Thrombocytopenia 253 103 Lymphomaandleukaemia 256 104 Haemoglobinopathies 258 105 Connectivetissuedisorders 261 106 Rheumatoidarthritis 264 107 Cervicalspinedisorders 266 108 Kyphoscoliosis 267 109 Lowbackpain 269 110 Neurologicaldisease 272 111 Meningitis 274 112 Acutepost-infectiveperipheralneuropathy(Guillain–Barrésyndrome) 276 viii Contents 113 Pasthistoryofneurologicaltrauma 277 114 Benignintracranialhypertension 279 115 Intracranialtumour 280 116 Cerebrovascularaccident 282 117 Epilepsy 285 118 Convulsions 286 119 Migraine 288 120 Multiplesclerosis 289 121 Myastheniagravis 291 122 Spinabifida 293 123 Respiratorydisease 295 124 Asthma 296 125 Cysticfibrosis 298 126 Pulmonaryfibrosis 299 127 Sarcoidosis 300 128 Acutelunginjury(acuterespiratorydistresssyndrome) 302 129 Pneumonia 303 130 Sepsis 307 131 Hepatitis 310 132 Herpessimplexinfection 312 133 HIVinfection 314 134 Malariainpregnancy 316 135 Pyrexiaduringlabour 318 136 Migrants/disadvantagedwomen 320 137 Psychiatricdisease 322 138 Substanceabuse 325 139 Obesity 328 140 Renalfailure 331 141 Steroidtherapy 333 142 Traumainpregnancy 335 143 Malignantdisease 336 144 Transplantation 338 145 Criticalcareinpregnancy 341 146 Invasivemonitoring 343 VII – The neonate 147 Neonatalassessment 347 148 Neonatalphysiologyandpharmacology 350 149 Neonatalresuscitation 352 150 Perinatalmortality 355 – Section 3 Puerperium and after 151 Drugsandbreastfeeding 359 152 Follow-up 361 153 Maternalsatisfaction 363
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