Key result
Early establishment of epidural analgesia allowed extension to an appropriate level for surgery in 70% of 360 consecutive emergency caesarean sections.
Why the study?
Does early involvement of the anaesthetist and early establishment of epidural analgesia improve the management of emergency caesarean sections?
Observational (n=360)
Does early involvement of the anaesthetist and early establishment of epidural analgesia improve the management of emergency caesarean sections?
Early involvement of anaesthetists and early establishment of epidural analgesia can anticipate and facilitate the management of most emergency caesarean sections.
Answers are grounded in this paper and cite their sources.
May support early epidural use in labor; leaves open whether routine placement improves emergency caesarean outcomes in trials.
The Report on Confidential Enquiries into Maternal Deaths in England and Wales 1982-84 (Department of Health 1989) recommends early involvement of the anaesthetist in women having emergency caesarean sections and the use of epidural anaesthesia in preference to general anaesthesia. In an observational prospective study the need for emergency abdominal delivery could be anticipated in 87% of 360 consecutive emergency caesarean sections. Early establishment of epidural analgesia allowed extension, to an appropriate level for the surgery, in 70%. The duty anaesthetist accompanying the obstetric team on three wardrounds a day could be forewarned of anticipated problems in most women who are eventually delivered abdominally.
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Morgan et al. (1990) conducted an observational in Emergency caesarean section (n=360). Early establishment of epidural analgesia was evaluated on Extension of epidural analgesia to an appropriate level for surgery. Early establishment of epidural analgesia allowed extension to an appropriate level for surgery in 70% of 360 consecutive emergency caesarean sections.
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