Feature
JAP Volume 7 Issue 1
presents a good example of multiple risk factors i.e. full stomach, GOR, raised abdominal pressure, gestational diabetes and difficult airway. Regional anaesthesia is of great value. Anaesthetic drugs Intravenous drugs given during GA are lipid soluble and can cross placenta and many are secreted in milk. RA can obviate this problem. Analgesia The analgesia during RA can be extended into the postpartum
Dr Sher Mohammad Dr Mohammad has carried out his training in
many cities, from Peshawer in Pakistan, to Dublin, London and Pontefract. He is currently working as a cardiac anaesthetist in Sheffield’s Royal Halamshire hospital, managing major vascular and renal transplants and major urology and regional anaesthesia. He is keen on teaching the basics and connecting them to the clinical side of medicine, which can be seen from his articles. Dr Mohammad would still like to take the occasional break from his busy occupation to spend time with his wife and son and relive his days as a fast-pitch bowler for his college team.
Dr Ashok Elayaperumal Specialty Registrar in Anaesthetics, Royal Halamshire Hospital, Sheffield.
Dr Sireesha Aluri Speciality Registrar in Anaesthetics, Royal Halamshire Hospital, Sheffield.
Dr Abdul Hamid Physician Assistant in Anaesthetics Royal Halamshire Hospital, Sheffield.
period and the epidural can be topped up for removal of retained placenta or repair of episiotomy. Accidental awareness Awareness can result from light GA in situations like caesarean section. Atonic uterus – The uterus may not contract as a result of volatile anaesthetics used during GA leading to postpartum haemorrhage
– Ante-natal epidural in pre-eclampsia improves utero-placental blood flow and will have a good effect on blood-pressure control – Additional benefits of RA are less blood loss and less DVT
Non-clinical advantages of Regional Anaesthesia/Analgesia – Accompanying partner can stay with parturient woman when under RA only
– Awake mother and partner welcome new family member at an earlier stage
– Advancing to breast feeding can happen at an early stage – Anaesthetist satisfaction is more with RA – Atmospheric pollution is avoided under RA – Anticipated costs for RA are fewer compared to those for GA
Indications for GA in Dental Surgery Most of the dental procedures are done under local anaesthesia but
there are situations in which general anaesthesia is indicated. To mention a few, simply remember the word “DENTAL”.
D Dental abcess E Extensive dental surgery N Needle-phobic patients T Trauma to teeth during laryngoscopy and intubation (patient is already anaesthetised)
A Allergy to local anaesthetics L Learning difficulties in children and adults
JAP 2013: 1: 18-21
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