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Algorithm for the anesthetic management of cesarean delivery in patients with unsatisfactory labor epidural analgesia.

Vaida S, Cattano D, Hurwitz D, Mets B - F1000Res (2015)

Bottom Line: The management of a patient presenting with unsatisfactory labor epidural analgesia poses a severe challenge for the anesthetist wanting to provide safe anesthetic care for a cesarean delivery.Early recognition of unsatisfactory labor analgesia allows for replacement of the epidural catheter.The decision to convert labor epidural analgesia to anesthesia for cesarean delivery is based on the urgency of the cesarean delivery, airway examination, and the existence of a residual sensory and motor block.  We suggest an algorithm which is implemented in our department, based on the urgency of the cesarean delivery.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, Hershey, Pennysylvania, 17033, USA.

ABSTRACT
The management of a patient presenting with unsatisfactory labor epidural analgesia poses a severe challenge for the anesthetist wanting to provide safe anesthetic care for a cesarean delivery. Early recognition of unsatisfactory labor analgesia allows for replacement of the epidural catheter. The decision to convert labor epidural analgesia to anesthesia for cesarean delivery is based on the urgency of the cesarean delivery, airway examination, and the existence of a residual sensory and motor block.  We suggest an algorithm which is implemented in our department, based on the urgency of the cesarean delivery.

No MeSH data available.


Related in: MedlinePlus

Schematic of Category 3 and 4 cesarean delivery algorithm.
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f3: Schematic of Category 3 and 4 cesarean delivery algorithm.

Mentions: Alternatively general anesthesia could be used, as this is the quickest approach to reliably anesthetize the patient for cesarean delivery. Clinical situations that would favor immediate conversion to general anesthesia include the presence of an analgesic window; neuraxial dermatomal levels below T12; a unilateral block that differs by more than two or three dermatomal levels or insufficient analgesic density with uneven distribution of numbness to soft touch.


Algorithm for the anesthetic management of cesarean delivery in patients with unsatisfactory labor epidural analgesia.

Vaida S, Cattano D, Hurwitz D, Mets B - F1000Res (2015)

Schematic of Category 3 and 4 cesarean delivery algorithm.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4482209&req=5

f3: Schematic of Category 3 and 4 cesarean delivery algorithm.
Mentions: Alternatively general anesthesia could be used, as this is the quickest approach to reliably anesthetize the patient for cesarean delivery. Clinical situations that would favor immediate conversion to general anesthesia include the presence of an analgesic window; neuraxial dermatomal levels below T12; a unilateral block that differs by more than two or three dermatomal levels or insufficient analgesic density with uneven distribution of numbness to soft touch.

Bottom Line: The management of a patient presenting with unsatisfactory labor epidural analgesia poses a severe challenge for the anesthetist wanting to provide safe anesthetic care for a cesarean delivery.Early recognition of unsatisfactory labor analgesia allows for replacement of the epidural catheter.The decision to convert labor epidural analgesia to anesthesia for cesarean delivery is based on the urgency of the cesarean delivery, airway examination, and the existence of a residual sensory and motor block.  We suggest an algorithm which is implemented in our department, based on the urgency of the cesarean delivery.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, Hershey, Pennysylvania, 17033, USA.

ABSTRACT
The management of a patient presenting with unsatisfactory labor epidural analgesia poses a severe challenge for the anesthetist wanting to provide safe anesthetic care for a cesarean delivery. Early recognition of unsatisfactory labor analgesia allows for replacement of the epidural catheter. The decision to convert labor epidural analgesia to anesthesia for cesarean delivery is based on the urgency of the cesarean delivery, airway examination, and the existence of a residual sensory and motor block.  We suggest an algorithm which is implemented in our department, based on the urgency of the cesarean delivery.

No MeSH data available.


Related in: MedlinePlus