Anaemia is common during pregnancy, especially in low- and middle-income countries, and iron deficiency is the most common cause of anaemia worldwide. Symptoms relating to iron deficiency can be diverse, which relate to the depletion of cellular Fe function in different tissue organs and may exist long before Fe deficiency restricts erythropoiesis and anaemia develops. It is important to understand the pathophysiological and adaptation changes occurring during anaemia as long-standing changes affect the various organ systems and may impact both maternal and neonatal outcomes. There is growing evidence linking maternal IDA with subsequent neonatal cognitive and neurobehavioral outcomes, which makes it imperative that IDA should be treated early in pregnancy. Preoperative optimization with iron therapy (oral or parenteral) and erythropoiesis-stimulating agents vs replenishing O2-carrying capacity by transfusion must always be balanced against transfusion-associated risks. The anaesthetic management in parturients with severe anaemia depends on a multitude of factors, such as severity of iron deficiency anaemia, co-morbid diseases, extent of physiological compensation, and type and nature of anticipated haemorrhagic loss. This review summarizes the pathophysiological changes and adaptations consequent to oxygen delivery and iron homeostasis, therapeutic management, and anaesthetic challenges in pregnancy with IDA. It is based on electronic search strategies from Ovid Medline, Ovid Embase and PubMed (up to June 2021) along with relevant college and society web-based resources, including Royal College of Obstetricians and Anaesthesiologists, National Institute for Health and Clinical Excellence College and Society (NICE), Patient Blood Management Guidelines and American College of Obstetricians and Gynaecologists (ACOG) practice bulletins.
{"title":"Pathophysiologic and anaesthetic considerations in iron deficiency anaemia and pregnancy; An update","authors":"Sunanda Gupta, Karuna Sharma, Charu Sharma, A. Chhabra, Lalita Jeengar, Nitasha Sharma","doi":"10.4103/joacc.joacc_46_21","DOIUrl":"https://doi.org/10.4103/joacc.joacc_46_21","url":null,"abstract":"Anaemia is common during pregnancy, especially in low- and middle-income countries, and iron deficiency is the most common cause of anaemia worldwide. Symptoms relating to iron deficiency can be diverse, which relate to the depletion of cellular Fe function in different tissue organs and may exist long before Fe deficiency restricts erythropoiesis and anaemia develops. It is important to understand the pathophysiological and adaptation changes occurring during anaemia as long-standing changes affect the various organ systems and may impact both maternal and neonatal outcomes. There is growing evidence linking maternal IDA with subsequent neonatal cognitive and neurobehavioral outcomes, which makes it imperative that IDA should be treated early in pregnancy. Preoperative optimization with iron therapy (oral or parenteral) and erythropoiesis-stimulating agents vs replenishing O2-carrying capacity by transfusion must always be balanced against transfusion-associated risks. The anaesthetic management in parturients with severe anaemia depends on a multitude of factors, such as severity of iron deficiency anaemia, co-morbid diseases, extent of physiological compensation, and type and nature of anticipated haemorrhagic loss. This review summarizes the pathophysiological changes and adaptations consequent to oxygen delivery and iron homeostasis, therapeutic management, and anaesthetic challenges in pregnancy with IDA. It is based on electronic search strategies from Ovid Medline, Ovid Embase and PubMed (up to June 2021) along with relevant college and society web-based resources, including Royal College of Obstetricians and Anaesthesiologists, National Institute for Health and Clinical Excellence College and Society (NICE), Patient Blood Management Guidelines and American College of Obstetricians and Gynaecologists (ACOG) practice bulletins.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44166353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/joacc.joacc_36_21
Thomas E Potter, N. Desai
{"title":"Extension of labor epidural analgesia for emergency cesarean section: A survey of practice in the United Kingdom","authors":"Thomas E Potter, N. Desai","doi":"10.4103/joacc.joacc_36_21","DOIUrl":"https://doi.org/10.4103/joacc.joacc_36_21","url":null,"abstract":"","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46968053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/joacc.joacc_76_21
Yudhyavir Singh, Alka Chabra, V. Venkateswaran, A. Trikha
Sickle cell disorder (SCD) is a genetic disorder of haemoglobin with a wide spectrum of severity and manifestations. It is a significant global public health problem and is mainly widespread among many tribal populations. Sickle cell disease (SCD) in pregnancy poses a unique challenge due to the physiological changes in pregnancy, the multitude of various organs involved, and its complications. The databases of PubMed, MedLine ResearchGate, EMbase, Scopus and Google Scholar were searched for literature about SCDs published up to 2021. Search terms and phrases used were 'sickle cell disease', 'sickle cell disease and pregnancy', 'anaesthesia and analgesia in sickle cell disease' and 'transfusion in sickle cell disease'. Original articles, guidelines, review articles, case reports, letters to editor and abstracts were reviewed with particular focus on pathophysiology and anaesthetic implications of sickle cell anaemia with pregnancy. While ample literature is available on SCDs, there is a paucity of literature on SCDs with pregnancy. In this review, we have attempted to present the relevant literature in a comprehensible manner.
{"title":"Sickle cell disease in pregnancy and anaesthetic implications: A narrative review","authors":"Yudhyavir Singh, Alka Chabra, V. Venkateswaran, A. Trikha","doi":"10.4103/joacc.joacc_76_21","DOIUrl":"https://doi.org/10.4103/joacc.joacc_76_21","url":null,"abstract":"Sickle cell disorder (SCD) is a genetic disorder of haemoglobin with a wide spectrum of severity and manifestations. It is a significant global public health problem and is mainly widespread among many tribal populations. Sickle cell disease (SCD) in pregnancy poses a unique challenge due to the physiological changes in pregnancy, the multitude of various organs involved, and its complications. The databases of PubMed, MedLine ResearchGate, EMbase, Scopus and Google Scholar were searched for literature about SCDs published up to 2021. Search terms and phrases used were 'sickle cell disease', 'sickle cell disease and pregnancy', 'anaesthesia and analgesia in sickle cell disease' and 'transfusion in sickle cell disease'. Original articles, guidelines, review articles, case reports, letters to editor and abstracts were reviewed with particular focus on pathophysiology and anaesthetic implications of sickle cell anaemia with pregnancy. While ample literature is available on SCDs, there is a paucity of literature on SCDs with pregnancy. In this review, we have attempted to present the relevant literature in a comprehensible manner.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43984888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/joacc.joacc_35_21
M. Kaur, R. Jain, Aayush Gulati, Ashima Taneja, Sahil Sardana, A. Grewal
Cardiac arrest in pregnancy is a rare, catastrophic condition that can lead to major morbidity and mortality for both mother and baby. Prompt high-quality resuscitative measures need to be employed keeping in mind the altered maternal anatomy and physiology, presence of a compromised fetus, and an urgent need to deliver the baby for optimizing maternal and fetal outcomes. Therefore, it is important that health care facilities make appropriate systems in consonance with the latest recommendations of cardiopulmonary resuscitation (CPR) for this special group of parturients. Despite protocols and training, the clinical scenario often is emotionally overwhelming and brings forth an enormous cognitive load of resuscitating two lives along with the performance of perimortem cesarean delivery (PMCD) or resuscitative hysterotomy. We report five cases of maternal cardiac arrest referred to our tertiary care hospital, wherein PMCD was performed as part of ongoing high-quality CPR with manual left uterine displacement. Two mothers had a return of spontaneous circulation (ROSC), whereas ROSC could not be achieved in three. One neonate had an Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score of 8. Four neonates needed CPR, and ROSC was achieved in two of these. Underlying causes were mainly severe hemorrhagic shock, eclampsia, severe pre-eclampsia, and anaphylactic reactions. Poor survival rates in our initial experience of setting up a maternal code blue mechanism as per the guidelines reflect the need for reinforcement of early PMCD, use of cognitive aids, and retraining using mock drills and simulation for better outcomes in the future. In addition, awareness of modified obstetric warning signs in peripheral hospitals is essential so that timely referral to tertiary care centers can help salvage precious lives.
{"title":"Case series of perimortem caesarean delivery during maternal cardiac arrest: Our initial experience and audit","authors":"M. Kaur, R. Jain, Aayush Gulati, Ashima Taneja, Sahil Sardana, A. Grewal","doi":"10.4103/joacc.joacc_35_21","DOIUrl":"https://doi.org/10.4103/joacc.joacc_35_21","url":null,"abstract":"Cardiac arrest in pregnancy is a rare, catastrophic condition that can lead to major morbidity and mortality for both mother and baby. Prompt high-quality resuscitative measures need to be employed keeping in mind the altered maternal anatomy and physiology, presence of a compromised fetus, and an urgent need to deliver the baby for optimizing maternal and fetal outcomes. Therefore, it is important that health care facilities make appropriate systems in consonance with the latest recommendations of cardiopulmonary resuscitation (CPR) for this special group of parturients. Despite protocols and training, the clinical scenario often is emotionally overwhelming and brings forth an enormous cognitive load of resuscitating two lives along with the performance of perimortem cesarean delivery (PMCD) or resuscitative hysterotomy. We report five cases of maternal cardiac arrest referred to our tertiary care hospital, wherein PMCD was performed as part of ongoing high-quality CPR with manual left uterine displacement. Two mothers had a return of spontaneous circulation (ROSC), whereas ROSC could not be achieved in three. One neonate had an Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score of 8. Four neonates needed CPR, and ROSC was achieved in two of these. Underlying causes were mainly severe hemorrhagic shock, eclampsia, severe pre-eclampsia, and anaphylactic reactions. Poor survival rates in our initial experience of setting up a maternal code blue mechanism as per the guidelines reflect the need for reinforcement of early PMCD, use of cognitive aids, and retraining using mock drills and simulation for better outcomes in the future. In addition, awareness of modified obstetric warning signs in peripheral hospitals is essential so that timely referral to tertiary care centers can help salvage precious lives.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41954668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/joacc.joacc_24_21
Chin-ho. Chan, Anqi Lu, M. Mok
Relapsing polychondritis is a rare multisystem autoimmune disorder characterized by recurrent, progressive inflammation and destruction of cartilaginous tissue. Respiratory involvement is the major cause of morbidity and mortality. Airway management during anaesthesia in these patients can be challenging and may result in failed oxygenation and death. Increased physiological demand during pregnancy further complicates anaesthesia planning. Collaborative management under a multidisciplinary team of obstetricians, obstetric anaesthetists, rheumatologist, and pulmonologist is essential. We report a case of a parturient with relapsing polychondritis and severe respiratory involvement for caesarean section under combined epidural-spinal anaesthesia and discuss the anaesthetic management based on current literature.
{"title":"Relapsing polychondritis in a primiparous women for elective lower segment caesarean section","authors":"Chin-ho. Chan, Anqi Lu, M. Mok","doi":"10.4103/joacc.joacc_24_21","DOIUrl":"https://doi.org/10.4103/joacc.joacc_24_21","url":null,"abstract":"Relapsing polychondritis is a rare multisystem autoimmune disorder characterized by recurrent, progressive inflammation and destruction of cartilaginous tissue. Respiratory involvement is the major cause of morbidity and mortality. Airway management during anaesthesia in these patients can be challenging and may result in failed oxygenation and death. Increased physiological demand during pregnancy further complicates anaesthesia planning. Collaborative management under a multidisciplinary team of obstetricians, obstetric anaesthetists, rheumatologist, and pulmonologist is essential. We report a case of a parturient with relapsing polychondritis and severe respiratory involvement for caesarean section under combined epidural-spinal anaesthesia and discuss the anaesthetic management based on current literature.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48303224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/joacc.joacc_59_21
Omar Rajab, S. Kanawati, M. Barada, Z. Naja, L. Sinno
A 23-year-old parturient with a body mass index of 20.8 kg/m2 at term was admitted for elective caesarean section. Spinal anaesthesia was done using a 27-G pencil-point needle without an introducer guide, with the usage of a separate 18-G introducer needle. After the introduction of the introducer at the level of L4–L5, accidental free flow of cerebrospinal fluid (CSF) was seen. The introducer was withdrawn and inserted at the level of L3–L4, followed by the spinal needle. CSF backflow was seen; an anaesthetic mixture was given. Block was successful and caesarean section was done with no intraoperative complications.
{"title":"Accidental Dural Puncture With An Introducer Needle (18 G) For Elective Caesarean Section: A case report","authors":"Omar Rajab, S. Kanawati, M. Barada, Z. Naja, L. Sinno","doi":"10.4103/joacc.joacc_59_21","DOIUrl":"https://doi.org/10.4103/joacc.joacc_59_21","url":null,"abstract":"A 23-year-old parturient with a body mass index of 20.8 kg/m2 at term was admitted for elective caesarean section. Spinal anaesthesia was done using a 27-G pencil-point needle without an introducer guide, with the usage of a separate 18-G introducer needle. After the introduction of the introducer at the level of L4–L5, accidental free flow of cerebrospinal fluid (CSF) was seen. The introducer was withdrawn and inserted at the level of L3–L4, followed by the spinal needle. CSF backflow was seen; an anaesthetic mixture was given. Block was successful and caesarean section was done with no intraoperative complications.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43598089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/joacc.joacc_45_21
K. Ramaswamy, N. Hooker, Z. Kotyra, Saravanan Solai Dhanashekaran, S. Soltanifar, N. Aldamluji
Background: Perineal tear (PT) occurs in more than 85% of the women undergoing vaginal birth and up to 11% of these can be third- and fourth-degree tears and the majority suffer from pain. Poorly managed pain can impact the mother and her capacity to look after the baby. The institution introduced a PT pain management programme (PPP) as part of a quality improvement programme. This paper is a retrospective analysis to determine the effect of this implementation on the pain scores and patient satisfaction. Objective: Does the PT pain management programme improve pain scores at rest 12 and 24 h post-repair? Does the programme improve maternal satisfaction? Methods: A pain management protocol had been implemented for women with PT from January 1, 2020. To assess the effectiveness of the protocol, data were retrieved from electronic medical records (Cerner Millennium) of 100 women who had a PT from January 1, 2019, to March 31, 2019 (pre-PPP), and 96 women who had a PT from April 1, 2020, to July 31, 2020 (post-PPP). We included consecutive women who had second-, third- and fourth-degree tears. Results: A significant difference in the pain scores at 12 h (mean ± SD [difference of means], 95% CI) (2.17 ± 1.11 vs. 4.5 ± 1.65 [2.33], 1.93–2.73, t (194) = 11.54, P
{"title":"Effect of implementation of perineal tear pain management programme on pain scores","authors":"K. Ramaswamy, N. Hooker, Z. Kotyra, Saravanan Solai Dhanashekaran, S. Soltanifar, N. Aldamluji","doi":"10.4103/joacc.joacc_45_21","DOIUrl":"https://doi.org/10.4103/joacc.joacc_45_21","url":null,"abstract":"Background: Perineal tear (PT) occurs in more than 85% of the women undergoing vaginal birth and up to 11% of these can be third- and fourth-degree tears and the majority suffer from pain. Poorly managed pain can impact the mother and her capacity to look after the baby. The institution introduced a PT pain management programme (PPP) as part of a quality improvement programme. This paper is a retrospective analysis to determine the effect of this implementation on the pain scores and patient satisfaction. Objective: Does the PT pain management programme improve pain scores at rest 12 and 24 h post-repair? Does the programme improve maternal satisfaction? Methods: A pain management protocol had been implemented for women with PT from January 1, 2020. To assess the effectiveness of the protocol, data were retrieved from electronic medical records (Cerner Millennium) of 100 women who had a PT from January 1, 2019, to March 31, 2019 (pre-PPP), and 96 women who had a PT from April 1, 2020, to July 31, 2020 (post-PPP). We included consecutive women who had second-, third- and fourth-degree tears. Results: A significant difference in the pain scores at 12 h (mean ± SD [difference of means], 95% CI) (2.17 ± 1.11 vs. 4.5 ± 1.65 [2.33], 1.93–2.73, t (194) = 11.54, P","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43932000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/joacc.joacc_92_20
Shashikiran, R. Bala
Pregnancy with kyphoscoliosis is relatively a rare condition. Cardiopulmonary compromise due to mechanical restriction associated with spine deformity is exacerbated by pregnancy-related respiratory changes. We successfully managed a pregnant patient with kyphoscoliosis who reported to us in her third trimester with impending respiratory failure.
{"title":"Management of kyphoscoliotic pregnant patient presenting with impending respiratory failure – A case report","authors":"Shashikiran, R. Bala","doi":"10.4103/joacc.joacc_92_20","DOIUrl":"https://doi.org/10.4103/joacc.joacc_92_20","url":null,"abstract":"Pregnancy with kyphoscoliosis is relatively a rare condition. Cardiopulmonary compromise due to mechanical restriction associated with spine deformity is exacerbated by pregnancy-related respiratory changes. We successfully managed a pregnant patient with kyphoscoliosis who reported to us in her third trimester with impending respiratory failure.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49206921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/joacc.joacc_94_20
N. Mehta, K. Shah, Y. Bhatt
Acute coronary syndrome (ACS) during pregnancy is a rare event and can be a significant contributor to maternal and foetal mortality. We present here one such case of a 40-year-old primigravida posted for elective caesarean section at 36 weeks of pregnancy with a history of acute myocardial infarction (AMI) and left ventricular failure which was treated conservatively.
{"title":"Caesarean section in a case of acute coronary syndrome - A case report","authors":"N. Mehta, K. Shah, Y. Bhatt","doi":"10.4103/joacc.joacc_94_20","DOIUrl":"https://doi.org/10.4103/joacc.joacc_94_20","url":null,"abstract":"Acute coronary syndrome (ACS) during pregnancy is a rare event and can be a significant contributor to maternal and foetal mortality. We present here one such case of a 40-year-old primigravida posted for elective caesarean section at 36 weeks of pregnancy with a history of acute myocardial infarction (AMI) and left ventricular failure which was treated conservatively.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41527491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/joacc.joacc_40_20
N. D’souza, Tasnim Karachiwala, Pratiksha Kulkarni
Lipomas are benign tumours which are frequently seen, however there is no specific mention regarding the incidence of lumbar lipomas. Literature does not describe challenges of anaesthesia technique in patients with lumbar lipomas without neuro deficit. An ultrasound examination of the spine using a low frequency probe contributes to screening for the path for passage of the needle.
{"title":"Ultrasonography in aid of spinal anaesthesia in lumbar lipomas not infallible","authors":"N. D’souza, Tasnim Karachiwala, Pratiksha Kulkarni","doi":"10.4103/joacc.joacc_40_20","DOIUrl":"https://doi.org/10.4103/joacc.joacc_40_20","url":null,"abstract":"Lipomas are benign tumours which are frequently seen, however there is no specific mention regarding the incidence of lumbar lipomas. Literature does not describe challenges of anaesthesia technique in patients with lumbar lipomas without neuro deficit. An ultrasound examination of the spine using a low frequency probe contributes to screening for the path for passage of the needle.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43229887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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