Chapter

Epidural anaesthesia

Rafal Baraz and Paul Clyburn

in Obstetric Anaesthesia for Developing Countries

Published on behalf of Oxford University Press

ISBN: 9780199572144
Published online May 2011 | e-ISBN: 9780199607488 | DOI: http://dx.doi.org/10.1093/med/9780199572144.003.0008

Series: Oxford Anaesthesia Library

Epidural anaesthesia

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• Epidural anaesthesia is safe if inserted by a skilled practitioner where adequate monitoring and resuscitation can be provided • Epidural anaesthesia requires good understanding of: the anatomy of the back and spine, physiological changes of pregnancy and the pharmacological effects of local anaesthetics • Correct positioning of the mother is crucial to the success of epidural insertion • It is very important to keep control of the epidural needle at all times during insertion • Withdrawing the catheter through the epidural needle may shear the catheter. The catheter and needle should be removed as one unit • Accidental dural puncture is an important complication • Aspirating CSF through an epidural catheter is sometimes difficult and dural puncture by the catheter can be easily missed • Test doses increase the safety of epidural anaesthesia and must be employed at all times • Following accidental dural puncture, all top-ups must be given by an experienced anaesthetist.

Chapter.  2737 words.  Illustrated.

Subjects: Anaesthetics

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