By Robin Russell
This most modern contribution to the FAAM sequence offers a complete and recent dialogue of anaesthetic administration in being pregnant, in the course of supply, and in sufferers present process gynaecological surgical procedure. With authoritative contributions from foreign specialists it's a functional reference for all anaesthetists and expert clinicians.
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Additional resources for Anaesthesia for Obstetrics and Gynaecology: Fundamentals of Anaesthesia and Acute Medicine
During the third trimester women become particularly vulnerable to hypoxia because of the combination of increased oxygen consumption and the reduced FRC, especially in the supine position. Adequate preoxygenation and denitrogenation are crucial. A rapid-sequence induction should always be used and, as in the second trimester, pregnant women must always be tilted or wedged to the left. Although excessive doses of volatile agents should be avoided, adequate doses must be maintained to avoid awareness.
3 ~ )T. h e concentration in the UA exceeds that in the UV and the fetal/maternal ratio may exceed unity. 31 at delivery. 2). Because the healthy fetus has a p H slightly below that in the mother, a higher proportion of the opioid will be ionised in the fetus compared with in the mother. This maintains a concentration gradient down which unionised free drug may pass. In the presence of hypoxia the fetus becomes more acid, more opioid passes from mother to fetus, ion trapping occurs, and the fetal concentration of the drugs rises.
Maternal and umbilical cord plasma noradrenaline concentrations during labour with and without segmental extradural analgesia, and during caesarean section. B r J Anaesth 1984;56:25 1-255. 5 Robson SC, Dunlop W, Boys R, Hunter S. Cardiac output during labour. BM3 1987;295:1169-72. 6 Hendricks CH. The hemodynamics of a uterine contraction. A m J Obstet Gynecol 1958;76:969-82. 7 Lee W, Rokey R, Miller J, Cotton DB. Maternal hemodynamic effects of uterine contractions by M-mode and pulsed-Doppler echocardiography.
Anaesthesia for Obstetrics and Gynaecology: Fundamentals of Anaesthesia and Acute Medicine by Robin Russell