Safety guideline: neurological monitoring associated with obstetric neuraxial block 2020

Abstract

Summary Serious neurological lesions such as vertebral canal haematoma are rare after obstetric regional analgesia/anaesthesia, but early detection may be crucial to avoid permanent damage. This may be hampered by the variable and sometimes prolonged recovery following ‘normal’ neuraxial block, such that an underlying lesion may easily be missed. These guidelines make recommendations for the monitoring of recovery from obstetric neuraxial block, and escalation should recovery be delayed or new symptoms develop, with the aim of preventing serious neurological morbidity.

Bench experiments to investigate the effect of nitrous oxide cracking technology in ideal circumstances

“…eliminated in the operating theatre by employing alternative analgesic methods [3], the wide-scale use of alternatives is limited in the maternity setting due to the requirement for more intensive maternal and fetal monitoring [4,5], and maternal preferences for less-invasive methods of analgesia.…”

Adjuvant Sufentanil Decreased the EC50 of Epidural Ropivacaine for Labor Analgesia in Healthy Term Pregnancy

“…A modified Bromage scale was used to assess motor block induced by intravertebral anesthesia: 0, no motor block; 1, inability to raise an extended leg but able to move knees and feet; 2, inability to raise an extended leg and move knee but able to move feet; and 3, complete block of the motor limb. 12 The onset of epidural analgesia, the duration of the first and second labor stages, umbilical artery pH, PaO 2 and PaCO 2 immediately after delivery, and neonatal Apgar scores at 1, 5, and 10 min after birth were all recorded. An Apgar score less than 8 was defined as asphyxia.…”

Celebrating 75 years of Anaesthesia: our past, present and future. The science of neuromuscular blockade, 75 years on

“…anaesthetists and their employers [14]. Guidelines on the management of patients following neuraxial anaesthesia, and in those who suffer complications, continue to shape current and future practice [15].…”

“…Although spinal anaesthesia is now not associated with the same degree of fear as it might have been in 1946, complications when they do occur can be devastating, with high associated financial awards against anaesthetists and their employers [14]. Guidelines on the management of patients following neuraxial anaesthesia, and in those who suffer complications, continue to shape current and future practice [15].…”