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Obstetric Anesthesia Handbook
Sanjay Datta
Verlag Springer-Verlag, 2006
ISBN 9780387315294 , 409 Seiten
4. Auflage
Format PDF
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Preface
5
Contents
6
1 Maternal Physiological Changes During Pregnancy, Labor, and the Postpartum Period
8
Changes in Blood Volume
9
Changes in the Cardiovascular System
10
Changes in the Respiratory System
11
Changes in the Renal System
13
Changes in the Gastrointestinal System
13
Changes in the Central and Peripheral Nervous Systems
16
Changes in the Musculoskeletal System
18
Changes in the Dermatological System
18
Changes in Mammary Tissue
18
Changes in the Ocular System
18
References
19
2 Local Anesthetic Pharmacology
21
Physicochemical Properties
23
Nonphysicochemical Properties
25
Other Factors Affecting Local Anesthetic Activity
26
Central Nervous System (CNS) and Cardiovascular System ( CVS) Toxicity of Local Anesthetics
28
References
31
3 Perinatal Pharmacology
34
Mother
36
Addition of Epinephrine
37
Maternal Metabolism and Elimination of the Drug
37
Maternal Protein Binding
38
Maternal pH and Drug pKa
38
Placental Transfer of Drugs
38
Fetus
40
Fetal Liver
41
Progressive Dilution of Umbilical Vein in Blood Concentration
41
Extensive Right-to-Left Shunt of the Fetal Circulation
43
References
43
4 Drug Interactions and Obstetric Anesthesia
45
Drugs Used for Maternal and Fetal Indications
46
Drugs Used for Maternal Indications
46
Drugs Used for Fetal Indications
61
References
62
5 Uteroplacental Blood Flow
66
Measurement of Uteroplacental Blood Flow
67
Factors That Can Alter Uteroplacental Blood Flow
69
References
75
6 Physiology of Labor and Delivery
79
Pain of Parturition
79
Relief of Labor Pain ( Not Related to Medication)
81
References
84
7 Relief of Labor Pain by Systemic Medication
86
Narcotics
87
Sedatives and/or Tranquilizers
90
Dissociative Medications
91
Amnestic Agents
92
Neuroleptanalgesia
92
Agonist and Antagonist Agents
92
Remifentanil
93
Inhalation Analgesia
93
References
94
8 Spinal Opiates in Obstetrics
96
Use of Spinal Opiates
98
Treatment of Side Effects
102
Monitoring
102
Newer Drugs
103
References
104
9 Effect of Maternally Administered Anesthetics and Analgesics on Neonates and Neurobehavioral Testing
107
Regional Anesthesia
108
Spinal and General Anesthesia
114
Paracervical Block
114
Pudendal Block
116
Intrathecal Narcotics
117
Systemic Medication
117
Narcotic Antagonists
119
General Anesthesia
119
References
120
10 Fetal Monitoring
124
Fetal Heart Rate Monitoring
125
Biophysical Profile
134
Assessment of Fetal Maturity
135
References
135
11 Relief of Labor Pain by Regional Analgesia/ Anesthesia
137
Epidural Analgesia
140
Possible Problems
150
Local Anesthetic Alone vs. Local Anesthetic and Narcotic Infusion
152
Contraindications
153
Monitoring Following the Administration of Epidural Analgesia
153
Effects of Epidural Anesthesia
154
Complications of Epidural Analgesia and Anesthesia
158
Treatment of Headache Following Accidental Dural Puncture
168
Spinal Anesthesia
171
Caudal Anesthesia
173
Paracervical Block
173
Lumbar Sympathetic Block
173
Pudendal Block
173
References
174
12 Anesthesia for Cesarean Delivery
179
Regional Anesthesia
180
Combined Spinal Epidural ( CSE) Technique
198
General Anesthesia
199
Postoperative Pain Relief
210
Conclusion
211
References
211
13 High- Risk Pregnancy
218
Classification
220
Techniques of Anesthesia ( Keys to Successful Management)
221
Specific Problems
223
Composition and Usefulness of Blood Components
301
Summary
301
References
302
14 Neonatal Resuscitation
309
Physiology
310
Maternal Well-Being
316
Evaluation of the Neonate
317
Treatment of Specific Conditions
323
Equipment and Medications Necessary for Neonatal Resuscitation
324
Other Specific Causes of Neonatal Respiratory Problems
324
Conclusion
330
References
331
15 Postpartum Tubal Ligation
332
Gastric Emptying in the Postpartum Period
333
Anesthetic Technique
335
References
338
16 Anesthesia for Surgery During Pregnancy
340
Maternal Safety
341
Fetal Well-Being
341
Continuation of the Pregnancy
347
References
350
17 In Vitro Fertilization
354
Preparation of the Embryo
354
Anesthetic Requirement
355
Specific Anesthetic Techniques for Ultrasound- Guided Transvaginal Oocyte Retrieval
357
Major Complications of In Vitro Fertilization
359
References
359
18 Maternal Mortality and Morbidity
360
American Society of Anesthesiologists Guidelines for Regional Anesthesia in Obstetrics
363
Practice Guidelines for Obstetrical Anesthesia
366
American Society of Anesthesiologists Optimal Goals for Anesthesia Care in Obstetrics
383
References
386
Index
388
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