Document Detail


The cocaine abusing parturient: a review of anesthetic considerations.
MedLine Citation:
PMID:  14766691     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The prevalence of recreational drug abuse among young women, including in pregnancy, has increased markedly over the past two decades. Cocaine remains the drug commonly used for recreational purposes in pregnancy. However, there appears to be an absence of uniform guidelines for obstetric and anesthetic management of pregnant patients with a history of cocaine abuse. SOURCE: A Medline search for articles highlighting drug abuse in pregnancy, with particular emphasis on cocaine abuse in pregnancy, the drug's impact on the fetus and implications for administration of obstetrical anesthesia was performed. MAIN FINDINGS: Because the pharmacological actions of cocaine are complex, the clinical picture can be very unpredictable, the diagnosis often difficult, and management at times controversial. The diverse clinical symptomatology of cocaine intake combined with physiologic changes of pregnancy, and pathophysiology of co-existing pregnancy specific disease may lead to life-threatening complications and significantly impact the management of obstetrical anesthesia. CONCLUSIONS: In the absence of uniform anesthetic guidelines for pregnant patients with a history of cocaine abuse the decision regarding the administration of peripartum analgesia or anesthesia should be individualized and conducted on a case-by-case basis. This article will attempt to heighten the awareness of cocaine use and abuse in pregnancy and review the perioperative anesthetic management of these high-risk parturients.
Authors:
Krzysztof M Kuczkowski
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  51     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-02-09     Completed Date:  2004-08-10     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  145-54     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, University of California San Diego, San Diego, California 92103-8770, USA. kkuczkowski@ucsd.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, Obstetrical / methods*
Cocaine / adverse effects,  pharmacology*
Cocaine-Related Disorders* / diagnosis,  epidemiology,  physiopathology
Female
Humans
Pregnancy
Pregnancy Complications* / diagnosis,  epidemiology,  physiopathology
Risk
Vasoconstrictor Agents / adverse effects,  pharmacology*
Chemical
Reg. No./Substance:
0/Vasoconstrictor Agents; 50-36-2/Cocaine

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


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