Document Detail


Challenges that opioid-dependent women present to the obstetric anaesthetist.
MedLine Citation:
PMID:  15675209     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A retrospective casenote review was performed to identify anaesthetic challenges relevant to the opioid-dependent obstetric population. Medical records showed that of the 7,449 deliveries during a 24 month period, 85 women (1.1%) were taking regular opioids such as methadone and/or heroin. Of these 67 (79%) received anaesthetic services, ten of whom (11.7%) were referred antenatally. Forty opioid-dependent women (47%) received epidural analgesia in labour compared with the overall hospital rate of 38%. Twenty-three women (27%) delivered by caesarean section: five received general anaesthesia, five combined spinal anaesthesia, five spinal anaesthesia and eight epidural anaesthesia. Twenty opioid-dependent women (23.5%) had documented problems related to labour analgesia and 17 (74%) had problems with analgesia after caesarean section. A variety of postoperative analgesia methods were administered in addition to maintenance methadone. Fourteen patients (16.5%) had difficult intravenous access and seven "arrest" calls were documented. One anaesthetist was exposed to hepatitis C. This review demonstrates the demands placed on obstetric anaesthetic services by opioid-dependent women. Early antenatal referral for anaesthetic review is recommended.
Authors:
B Cassidy; A M Cyna
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anaesthesia and intensive care     Volume:  32     ISSN:  0310-057X     ISO Abbreviation:  Anaesth Intensive Care     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2005-01-28     Completed Date:  2005-04-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0342017     Medline TA:  Anaesth Intensive Care     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  494-501     Citation Subset:  IM    
Affiliation:
Women's and Children's Hospital, Adelaide, South Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Analgesia, Obstetrical* / adverse effects,  methods
Analgesia, Patient-Controlled
Anesthesia, Obstetrical* / adverse effects,  methods
Cesarean Section
Female
Heroin Dependence* / diagnosis,  rehabilitation
Humans
Methadone / therapeutic use
Pain, Postoperative / drug therapy
Pregnancy
Pregnancy Complications* / diagnosis
Chemical
Reg. No./Substance:
76-99-3/Methadone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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