Should epidural diamorphine be withheld after caesarean section from women who suffer severe pruritus following intrathecal fentanyl?

Hogg, Nicholas J.V.; Kathirgamanathan, T.; Yentis, S. M.

doi:10.1054/ijoa.1999.0325

Cited by 2 publications

(1 citation statement)

References 16 publications

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“…Epidural blood patching may not influence outcome. Itch induced by neuraxial opiates is common (43-88 per cent) and although short-lived can be distressing (Hogg et al, 2000). The use of rectal drugs without consent has been the subject of a serious professional misconduct ruling by the General Medical Council (Mitchell, 1995).…”

Section: Discussionmentioning

confidence: 99%

Auditing the medico‐legal aspects of notekeeping for Caesarean section

2003

Clinical Governance: An International Journal

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In the UK, obstetric surgery is commonly performed with the patient awake and her partner present. Patient expectations are high. Even under high quality regional anaesthesia, non‐painful sensation may occur. This and other contentious issues must be discussed before surgery. Legal proceedings against obstetric anaesthetists are rare, but may arise many months later. Accurate contemporaneous notes are essential. The quality of notekeeping was audited for 50 Caesarean sections. A redesigned anaesthetic chart with prompts for key information was introduced and the audit repeated. There were significant improvements in documenting the pre‐operative discussion of: intra‐operative sensation; conversion to general anaesthesia; post‐dural puncture headache; suppositories; neuraxial opiate‐induced itch. Records of pain free operations; the presence or absence of nerve root pain; and the timing of events leading to delivery were significantly increased. This audit suggests that an anaesthetic chart with specific prompts improves the documentation of medico‐legally relevant information.

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Section: Discussionmentioning

confidence: 99%