Anaesthesia for Obstetrics and Gynaecology: Fundamentals of by Robin Russell

By Robin Russell

This most recent contribution to the FAAM sequence offers a entire and recent dialogue of anaesthetic administration in being pregnant, in the course of supply, and in sufferers present process gynaecological surgical procedure. With authoritative contributions from foreign specialists it's a functional reference for all anaesthetists and professional clinicians.

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7 29 24 pethidine, the drug appears in fetal blood within two minutes and equilibrium occurs between maternal and fetal plasma levels after six minutes. In contrast, morphine is more polar than other opioids and transfer is partially limited by placental permeability. Opioids are basic drugs and most are bound predominantly to (x,-acid glycoprotein. T h e higher concentration of a,-acid glycoprotein in the mother compared with the fetus should, in theory at least, limit placental transfer. However, pethidine is only 40-70% plasma protein bound in the mother (Table 2 .

35 Nimmo WS, Wilson J, Prescott LF. Narcotic analgesics and delayed gastric emptying during labour. Lancet 1975;i:890-3. 36 Nimmo WS, Wilson J, Prescott LF. Further studies of gastric emptying in labour. Anaesthesia 1977;32:100-101. 37 La Salvia LA, Steffen EA. Delayed gastric emptying time in labor. A m J Obster Gynecol 1950;59: 1075-81. 38 Kelly MC, Carabine UA, Hill DA, Mirakhur RK. A comparison of the effect of intrathecal and extradural fentanyl on gastric emptying in laboring women. Anesth Analg 1997;85:834-8.

78 Whittaker M, Crawford J, Lewis M. Some observations of levels of plasma cholinesterase activity within an obstetric population. Anaesthesia 1988;43:42-5. 79 Leighton BL, Cheek T, Gross JB, et al. Succinylcholine pharmacodynamics in peripartum patients. Anesthesiology 1986;64:202-5. 80 Mazze RI, Kallen B. Reproductive outcome after anesthesia and operation during pregnancy: a registry study of 5405 cases. A m J Obstet Gynecol 1989;161:1178-85. 81 Brodsky J, Cohen EN, Brown BW, Wu M, Whitcher C.

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