Objectives: To determine the acceptability of office hysteroscopy using paracervical block with lidocaine 2 percent and to assess its efficacy in reducing pain during the procedure. Methods: Fifteen patients undergoing outpatient hysteroscopy assessed each step of the procedure using the Present Pain Intensity Scale and the Faces Pain Scale. Result: Mean pain score was highest for the administration of the paracervical block and lowest for the viewing of the endometrial cavity. Age was not a significant factor in pain scoring while nulliparity is a significant factor (PO.1). The overall accumulated pain score was 12.7, the mean peak score was highest for the insertion of the scope at 2.3. Vasovagal attack and dizziness were the only complications experienced by the patients and 86.7 percent were willing to repeat the procedure if needed. Conclusions: Hysteroscopy with paracervical block is an acceptable outpatient procedure in terms of pain experienced during the procedure, severity of complications, speed of recovery and patient satisfaction.
Human ; Female ; ANESTHESIA, OBSTETRICAL

Analgesia, Patient-Controlled* ; Anesthesia, Obstetrical*

Cardiovascular diseases during pregnancy account for significant morbidity and mortality. An abdominal aortic aneurysm posts high mortality for otherwise healthy patients, more so for conditions that alter normal physiology such as in preterm pregnancy. Abdominal aortic dissection during pregnancy is a rare and life-threatening condition for both the mother and the fetus. An understanding of physiologic maternal changes and surgical stress responses is important to attenuate perioperative hemodynamic changes and prevent progression of aortic expansion and aortic rupture. As an anesthesiologist, one is positioned to facilitate communication among the internist, obstetrician and vascular surgeon for surgical success. This case report presents the anesthetic considerations in the perioperative management of a preterm pregnancy for a major abdominal surgery.
Aortic Aneurysm, Abdominal ; Anesthesia, Obstetrical

*Anesthesia, Obstetrical ; *Episiotomy ; *Extraction, Obstetrical ; *Pregnancy Complications ; *Infant, Newborn ; *Pregnancy

This paper focuses on the process measures of quality. As shown in later sections, consensus on appropriate processes for a selected anesthesia- related maternal health service, i.e., pre -anesthetic care is obtained and corresponding input requirements for these processes are identified.
ANESTHESIA, OBSTETRICAL ; MATERNAL HEALTH SERVICES ; PATIENT SATISFACTION

Obstetric anesthesia in a parturient with severe osteogenesis imperfecta is challenging in many aspects, particularly concerning maternal pathophysiological problems and the technical difficulties of anesthesia. Here, we report a case of successful spinal anesthesia, instead of general or epidural anesthesia, during a cesarean delivery in a patient with severe osteogenesis imperfecta.
Anesthesia ; Anesthesia, Epidural ; Anesthesia, Obstetrical ; Anesthesia, Spinal ; Cesarean Section ; Female ; Humans ; Osteogenesis ; Osteogenesis Imperfecta ; Pregnancy

OBJECTIVE: To explore the effect of epidural labor analgesia duration on the outcomes of different anesthetic approaches for conversion to cesarean section. METHODS: We retrospectively collected the clinical data of pregnant women undergoing conversion from epidural labor analgesia to cesarean section at Sichuan Maternal and Child Health Hospital and Jinjiang District Maternal and Child Health Care Hospital between July, 2019 and June, 2020. For cesarean section, the women received epidural anesthesia when the epidural catheter was maintained in correct position with effective analgesia, spinal anesthesia at the discretion of the anesthesiologists, or general anesthesia in cases requiring immediate cesarean section or following failure of epidural anesthesia or spinal anesthesia. Receiver-operating characteristic curve analysis was performed to determine the cutoff value of the analgesia duration using Youden index. The women were divided into two groups according to the cut off value for analyzing the relative risk using cross tabulations. RESULTS: A total of 820 pregnant women undergoing conversion to cesarean section were enrolled in this analysis, including 615 (75.0%) in epidural anesthesia group, 186 (22.7%) in spinal anesthesia group, and 19 (2.3%) in general anesthesia group; none of the women experienced failure of epidural or spinal anesthesia. The mean anesthesia duration was 8.2±4.7 h in epidural anesthesia, 10.6±5.1 h in spinal anesthesia group, and 6.7 ± 5.2 h in general anesthesia group. Multivariate logistic regression analysis showed that prolongation of analgesia duration by 1 h (OR=1.094, 95% CI: 1.057-1.132, P < 0.001) and an increase of cervical orifice by 1 cm (OR=1.066, 95% CI: 1.011-1.124, P=0.017) were independent risk factors for epidural analgesia failure. The cutoff value of analgesia duration was 9.5 h, and beyond that duration the relative risk of receiving spinal anesthesia was 1.204 (95% CI: 1.103-2.341, P < 0.001). CONCLUSION Prolonged epidural labor analgesia increases the risk of failure of epidural analgesia for conversion to epidural anesthesia. In cases with an analgesia duration over 9.5 h, spinal anesthesia is recommended if immediate cesarean section is not required.
Analgesia, Epidural/adverse effects* ; Analgesia, Obstetrical/adverse effects* ; Anesthesia, Obstetrical ; Cesarean Section ; Child ; Female ; Humans ; Pregnancy ; Retrospective Studies

The number of women with major congenital heart defects reaching reproductive age is likely increasing. We herein describe the anesthetic management of a 33-year-old woman at 37 gestational weeks with a history of Glenn surgery who was undergoing an urgent cesarean section due to pathological cardiotocography. Combined spinal-epidural anesthesia was the most suitable technique for urgent cesarean section in our patient with a single ventricle and phasic flow in the pulmonary artery because it provided rapid-onset anesthesia with negligible hemodynamic effects.
Adult ; Anesthesia* ; Anesthesia, Obstetrical ; Cardiotocography ; Cesarean Section* ; Female ; Heart Defects, Congenital ; Hemodynamics ; Humans ; Pregnancy ; Pulmonary Artery

BACKGROUND: Obstetrics departments are unique and medical accidents in obstetric anesthesia may show differences from non-obstetric anesthesia accidents.So we compared both groups in several aspects for the understanding their characters and decreasing their incidence. METHODS: Obstetric anesthesia accidents (n = 30) and non-obstetric anesthesia accidents (n = 106) were compared in 6 categories (patient age, anesthesia method, damaging event, anesthetic care, severity of injury, payment). RESULTS: The most common complications in obstetric anesthesia accidents were maternal death (40%), maternal brain damage (13%), and maternal nerve injury (13%).In contrast, the most common complications in non-obstetric anesthesia accidents were patient death (62%), and patient brain damage (27%). The severity of injury score of obstetric anesthesia adverse outcomes was analogous to that of non-obstetric anesthesia adverse outcomes, but the payment for obstetric accidents was significantly greater than that for non-obstetric accidents. CONCLUSIONS: Obstetric anesthesia accidents revealed distinct medical risk profiles, such as patient age, damaging event, severity of injury, and payment.Special care should be used when anesthetizing younger women and caring for a newborn in obstetric anesthesia.More studies and analyses are necessary to prevent obstetric anesthesia accidents.
Anesthesia ; Anesthesia, Obstetrical ; Brain ; Female ; Humans ; Infant, Newborn ; Maternal Death ; Obstetrics and Gynecology Department, Hospital

OBJECTIVETo analyse the preoperative conditions and intraoperative anesthetic managements of parturients who underwent Caesarean section and explore possible relationship between perianesthetic managements and prognosis of parturients and fetuses.

METHODSA group of 30 parturients who underwent Caesarean sections under general anesthesia were analysed retrospectively.

RESULTSAll the 30 Caesarean sections were smooth in terms of both procedure and anesthesia.

CONCLUSIONSGeneral anesthesia is still indicated in Caesarean section, although multiple risks may still exist. Considerate perinatal planning, careful preoperative preparations, and delicate intraoperative managements positively contribute to the good prognosis of parturient and fetus.