Phenylephrine in obstetric regional anaesthesia

Vasopressors in obstetrics: what should we be using?

“…A reflex decrease in heart rate is common with phenylephrine and occasionally treatment with an anticholinergic drug is required [51]. Phenylephrine is commonly supplied commercially as a 10 mg/ml preparation and care is required to avoid dosage and dilution errors [53]. Phenylephrine is commonly supplied commercially as a 10 mg/ml preparation and care is required to avoid dosage and dilution errors [53].…”

Is ‘starting on time’ useful (or useless) as a surrogate measure for ‘surgical theatre efficiency’?*

“…Consequently, start times are monitored routinely within many NHS Trusts, and are used both as local 'key performance indicators' to guide planning, and, occasionally, to pressurise individuals or teams to change behaviour, attitudes or policies [11,12]. The Foundation Trust Network has promoted start times as a key target [13] and the Royal College of Anaesthetists has suggested that fewer than 10% of lists should start more than 10 min late [14].…”

“…With late starts, the scheduled time (which has been budgeted in advance) will be wasted and with late finishes, unbudgeted overtime costs are incurred, with the attendant risk of unplanned patient cancellation. Several studies, however, have found a very high prevalence of non- Anaesthesia 2012Anaesthesia , 67, 823-832 doi:10.1111Anaesthesia /j.1365Anaesthesia -2044Anaesthesia .2012 Consequently, start times are monitored routinely within many NHS Trusts, and are used both as local 'key performance indicators' to guide planning, and, occasionally, to pressurise individuals or teams to change behaviour, attitudes or policies [11,12]. The Foundation Trust Network has promoted start times as a key target [13] and the Royal College of Anaesthetists has suggested that fewer than 10% of lists should start more than 10 min late [14].…”

What’s new and novel in obstetric anesthesia? Contributions from the 2003 scientific literature

“…273 Metaraminol makes a favorable reappearance in a letter detailing its prophylactic benefit versus saline. 274 In using phenylephrine, anesthesiologists are cautioned to evaluate the different formulations 275 and to consider the refractory hypotension that can occur. 276 In an editorial, Vallejo and Ramanathan suggest that the choice of vasopressor should depend on the blood pressure and heart rate.…”