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- W3147483802 abstract "TrIE question of the use of Spinal Anaesthesia in obstetrics may be approached from two points of view, there being anaesthetists ~vho feel that one should never use spinal anaesthesia, and others who would use i t a t eyery possible opport~,nity. Let us first consider the question, Why should one e~eer use spinal anaesthesia in obstetrics? A recent writer (1) has declared that a ~ertain number of healthy young women are doomed to death because o~ the l~onti,~Lning use of spinal anaesthesia in obstetrics. Another (2) cites the horrible complications which have occurred after subarachnoid injections for anaesthesi~t. I wish to state most emphatically that one should never employ a spi~al tedhnlque unless one is prepared to observe the most exacting rules for its p~oper ~se. Such rule~ have been reiterated many times (3, 4), the most importan~ to our mi~ads being the autoclaving of all solutions and the use of dilute preparations of the dzyugs. These precautions, with meticulous surgical technique, round out a safe method. Undoubtedly when one is unable to make a lumbar tap ~tuickly and easily in any particular case (and preferably with a No. 22 gauge __n~edle or finer), the spinal technique should not be employed. Repeated jabbing Iserves only to traumatize the back, tends to cause post-spinal backache, and serves to discredit the method. Further, one should never employ spinal anaesthesia o~'er the clear-cut objection of the patient, though many may be more concerned about the needle than about the spinal anaesthetic. Of course one must not o~zerlook the usual absolute contra-indications to the use of spinal anaesthesia. In obstetxics the presence of placenta praevia requires special consideration, and spinal anaesthesia is often contra-indicated. We would recommend to those who oppose spin~l anaesthesia in obstetrics and elsewhere on the basis of complications which ha~e occurred that they look to their technique before condemning an excellent form of anaesthesia. The many good anaesthetists who continue to use this method despite the clamour attest to its safety when used properly. In the city of Hamilton we have specialist obstetricians and a gradually increasing number of general practitioners who demand Ispinal anaesthesia in every possible case. We ourselves tend to favour this method for the following reasons: 1. It is the anaesthetic of choice for the parturient woman with a full stomach. i 2. It is the anaesthetic of choice for the heavily sedated patient. 8. It is the anaesthetic of choice to control labour And delivery while awaiting the delayed obstetrician. 4. It is the anaesthetic of choice in premature deliveries because of the maximal perineal relaxation with no foetal depression. 5. It is the anaesthetic of choice in the gravid cardiac patient." @default.
- W3147483802 created "2021-04-13" @default.
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- W3147483802 date "2008-01-01" @default.
- W3147483802 modified "2023-09-23" @default.
- W3147483802 title "WHY USE SPINAL ANAESTHESIA IN OBSTETRICS" @default.
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