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|Title:||Challenges that opioid-dependent women present to the obstetric anaesthetist|
|Citation:||Anaesthesia and Intensive Care, 2004; 32(4):494-501|
|Publisher:||Australian Soc Anaesthetists|
|B Cassidy and A M Cyna|
|Abstract:||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.|
|Keywords:||Humans; Pregnancy Complications; Heroin Dependence; Pain, Postoperative; Methadone; Analgesia, Obstetrical; Analgesia, Patient-Controlled; Anesthesia, Obstetrical; Cesarean Section; Pregnancy; Adult; Female|
|Appears in Collections:||Obstetrics and Gynaecology publications|
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