Troubleshooting obstetric spinal anaesthesia at district hospital level

South African Family Practice

 
 
Field Value
 
Title Troubleshooting obstetric spinal anaesthesia at district hospital level
 
Creator Bishop, David G. le Roux, Simon P.D.P.
 
Subject Family medicine; rural health; anaesthesia; perioperative care anaesthesia; resource-limited settings; emergency surgery; obstetric spinal anaesthesia; anaesthetic complications; caesarean section
Description Obstetric spinal anaesthesia is routinely used in South African district hospitals for caesarean sections, providing better maternal and neonatal outcomes than general anaesthesia in appropriate patients. However, practitioners providing anaesthesia in this context are usually generalists who practise anaesthesia infrequently and may be unfamiliar with dealing with complications of spinal anaesthesia or with conversion from spinal to general anaesthesia. This is compounded by challenges with infrastructure, shortages of equipment and sundries and a lack of context-sensitive guidelines and support from specialised anaesthetic services for district hospitals. This continuous professional development (CPD) article aims to provide guidance with respect to several key areas related to obstetric spinal anaesthesia, and to address common concerns and queries. We stress that good clinical practice is essential to avoid predictable, common complications, and hence a thorough preoperative preparation is essential. We further discuss clinical indications for preoperative blood testing, spinal needle choice, the use of isobaric bupivacaine, spinal hypotension, failed or partial spinal block and pain during the caesarean section. Where possible, relevant local and international guidelines are referenced for further reading and guidance, and a link to a presentation of this topic is provided.
 
Publisher AOSIS
 
Contributor
Date 2022-07-28
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Review
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/safp.v64i1.5529
 
Source South African Family Practice; Vol 64, No 1 (2022): Part 4; 5 pages 2078-6204 2078-6190
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://safpj.co.za/index.php/safpj/article/view/5529/7472 https://safpj.co.za/index.php/safpj/article/view/5529/7473 https://safpj.co.za/index.php/safpj/article/view/5529/7474 https://safpj.co.za/index.php/safpj/article/view/5529/7475
 
Coverage Africa; South Africa N/A N/A
Rights Copyright (c) 2022 David G. Bishop, Simon P.D.P. le Roux https://creativecommons.org/licenses/by/4.0
ADVERTISEMENT