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https://hdl.handle.net/2440/55615
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Type: | Journal article |
Title: | Challenges that opioid-dependent women present to the obstetric anaesthetist |
Author: | Cassidy, B. Cyna, A. |
Citation: | Anaesthesia and Intensive Care, 2004; 32(4):494-501 |
Publisher: | Australian Soc Anaesthetists |
Issue Date: | 2004 |
ISSN: | 0310-057X 1448-0271 |
Statement of Responsibility: | 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 |
DOI: | 10.1177/0310057x0403200406 |
Published version: | http://dx.doi.org/10.1177/0310057x0403200406 |
Appears in Collections: | Aurora harvest 5 Obstetrics and Gynaecology publications |
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