Spinal Anaesthesia Essay

Anesthesiologists give patients anesthetics in a variety of ways, such as “orally, intravenously, by gas or direct injection to render patients insensible to pain Anesthesiologists typically maintain the same daily schedule a surgeon follows, participating in both scheduled and unscheduled operations. Anesthesiologists are responsible for determining the proper anesthetic and dosage level for each patient. They monitor the patients progress prior to, during, and after surgery.”(“Anesthesiologist” 31)

In the summer of 1969 Dr. Moore, a board-certified obstetrics and gynecology doctor, administered a spinal anesthetic to a patient (Showalter, 2017). However, Dr. Moore did not follow the typical

The National Institute for Health and Clinical Excellence (NICE, 2007) Intrapartum guidelines state that during the first stage of labour women should be encouraged to adopt the position they feel most comfortable in. This is what the student was trying to encourage even though her mentor did not.There are various positions the woman can adopt in labour which are generally grouped into upright and recumbent. The positions classed as upright are; standing, walking, kneeling, squatting, on all fours and sitting, and the recumbent position could include; supine, lithotomy, semi-recumbent or side lying (Johnson and Taylor, 2011). The upright position appeared to be more beneficial in Sarah’s case and the author wants to determine if this is always the case. It is evident that sometimes there will be constraints such as continuous fetal monitoring but it is important that the midwife does

This Anaesthetic case study would describes and discussed the scenario of a patient through the anaesthetic role of their surgical procedure. It will include and discuss the anaesthetic safety procedures equipment and drug interventions used to ensure this particular patients maximum safety and comfort before and during the procedure. The case study will include pre and peri-operative assessment in order to describe the involvement contribution of various specialties in the holistic care of the critical care patient. This assignment will focus only on the anaesthetics side of the procedure but will also highlight the importance of the triad of anaesthesia and discuss the administration, maintenance and reversal of

Compared to the general adult population the maternal airway management can be more challenging as changes during pregnancy can increase the difficulty of intubation (Brien and Conlon, 2013). Its makes hard to insert laryngoscope when the patient have a large breast, the chance of bleeding and swelling increases due to oedema and vascularity of the upper respiratory tract, and the patient desaturate quicker as there is increase in oxygen requirements and there is reduced in functional residual capacity (Mushambi et al, 2015). As a result of all the changes during pregnancy, if the problems encountered during the intubation of Mrs D were to happen to an obstetric patient, it is important to provide optimal surgical condition for to progress rapidly while aiming for a good neonatal outcome (Local theatre policy, 2015b). In obstetric patients, much of the issue is about the urgency with which the foetus must be delivered and the surgical operation must be done as quickly as possible - therefore making decisions in the event of certain clinical situations occurring will require a much quicker decision making process because there is an immediate threat to the life of the woman or foetus (Mushambi et al, 2015). This is why emergency obstetric anaesthesia is such a potentially hazardous

In order to obtain an in depth knowledge of the subject of perineal massage in the intrapartum period, an extensive amount of literature needed to be investigated, this was done by accessing the University electronic database, which accessed a vast amount of sources. A search was performed using CINAHL (Cumilative Index to Nursing and Allied Health Literature). CINAHL searches a variety of health journals from around the world. By searching using key words a significant amount of literature was sourced. In order to narrow down the results the search was repeated but key words were combined, this was to access results that were more specific to the subject area. Though this database was useful and provided a vast amount of literature, few of the articles were actually research based, therefore those ones were excluded.

While we were doing our assessment I noticed that Ms. K.R. had been lying on her back for some time. During moms contractions the fetal heart monitor displayed variable decelerations and a slight deviation from the baseline heart tones. Once contractions subsided the fetal heart rate recovered to

According to the American Pregnancy organization “more than 50% of woman giving birth at hospitals use Epidural Anesthesia”. These women turn to epidural to relieve the pain of labor; however this decision poses many risks to both mother and child. An epidural is a type of regional anesthesia where pain medication is administered to the lumbar and sacral region of the back near clusters of nerves. The placement allows for nerve impulses to be blocked from the lower regions of the body resulting in decreased sensations. Although the epidural is known for taking pain away it could very well cause it too. Epidurals include the use of various narcotics and have side effects like hypotension, fever, fetal malposition, decreased fetal heart rate, respiratory depression, breastfeeding complications, an increased likelihood of operative vaginal delivery and cesarean and many more. These are the effects faced in result to a procedure that is not definite to work. In Fact “One in every 8 women” (OAA) will experience inadequate pain relief and must venture to other means of medication. Therefore, mothers should abstain from epidural anesthesia due to the risks it poses to themselves and to the fetus.

A study conducted from 1997 to 2006 shows an increase of Medicare patients receiving an epidural of one hundred and two percent per 100,000 people (Manchikanti). Epidurals allow the blockade of discomfort in a specific area with an injection of an anesthetic directly into the epidural space, located along the spinal column just below the spinal cord; however, the goal of this administration route is not to eliminate total lack of feeling but to provide the patient with relief from strain so they may continue their activities of daily living. Pain, the body’s number one defense mechanism, transmits signals through nerves to the final destination of the brain. By blocking irritated nerve signals with an epidural, the mind and body can relax. Narcotics, an alternative option for uneasiness, only last for a limited amount of time and require frequent administration, while epidurals possess a longer mechanism of action and only require a one-time injection. Therefore, it remains as the primary line of method of pain alleviation for labor. Epidurals provide effective pain relief for expectant mothers without causing harm to her or the newborn baby, which has, caused a dramatic increase in the popularity of epidurals over the past decade.

A commonly known procedure when it comes to hospital births are epidurals. An epidural is an injection of a drug between the “epidural space” which causes

Numerous studies have been conducted on the use of local anesthetic agents with adjuvants such as clonidine (a partial α2-adrenoreceptor agonist) and tramadol3, 4 for a brachial plexus block to improve the quality and duration of anesthesia, and these studies have shown that the adjuvants may prolong anesthesia and analgesia. Moreover, dexmedetomidine is a α2-receptor agonist that has more selectivity than clonidine and has analgesic and sedative properties.5, 6 Although several studies have described the effects of dexmedetomidine on neuroaxial and peripheral nerve blocks,7, 8, 9 to date, there is only 1 study available, performed by Esmaoglu et al,10 on the effect of adding dexmedetomidine to levobupivacaine for an axillary brachial plexus block. In view of the idea that decreasing the dose of dexmedetomidine may help to reduce side effects such as bradycardia and hypotension, we wanted to evaluate the effect of dexmedetomidine at a lower dose than that used in their study and the results. We think that more studies on this issue are needed.

It seems essential that pain management as well as treatment of nausea be improved.” (Rullander, 2013, p. 58) It is well stated that pain control and nausea/vomiting needs to be controlled. There was also reference to whether PCEA which gives the patient the feeling of control. It is also shown “that the most effective analgesic method is a double epidural catheter with continuous infusion of ropivacaine.” (Rullander, 2013, p. 51). It is also mentioned that we need to take a holistic approach to treating these patients.

There is enough footage and personal stories of childbirth for anyone to know how excruciating it can be to give birth. This could be one reason why more mothers are asking for epidural anesthesia in order to avoid labor pain. This medication is injected into a small space outside the spinal cord in the lower back. Why is this becoming more popular and is it even safe?

Learning about the potential complications of epidural reinforced my knowledge in being able to choose the right anaesthetic monitoring equipment. Knowing that Spinal and epidural anaesthesia can cause unpredictable and profound arterial hypotension necessitate the use of adequate monitoring like the; Pulse oximetry, ECG and Blood pressure cuff. This knowledge will help me to be able to select appropriate monitoring devices during epidural catheter insertion. Also it goes without saying that an epidural must be performed in a work area that is equipped for airway management and resuscitation.

Pharmacological comfort measures can provide partial or complete pain relief. The epidural is the most efficient way of reducing labor pain. Opioids can be given continuously or in intermittent doses at the patient 's request or through the patient controlled pump. There is the potential for these drugs to have some effect on the fetus, such as breathing difficulties that may require assistance through the use of Narcan. Providing pain relief during the labor process is solely the patient’s choice, and as the nurse only support and encouragement should be given for however she chooses to handle the pain. (Jansen, Gibson, Bowles, & Leach, 2013)