Acid aspiration prophylaxis in 202 obstetric anaesthetic units in the UK

Acid aspiration prophylaxis in labour: a survey of UK obstetric units

“…[8][9][10] This survey confirms that 97% of UK units are using ranitidine as the drug of choice (Table 2), although dosage intervals vary widely from 4-hourly to 24-hourly ( Table 3). The most common dosage route and interval is orally 6-hourly as seen in 62% of the units using ranitidine.…”

Difficult and failed intubation in obstetric anaesthesia: an observational study of airway management and complications associated with general anaesthesia for caesarean section

“…30 This approach is consistent with reports from the UK between 1984 and 1993. 26,27,29 We found high use of ranitidine and sodium citrate in the elective situation, but only 64% of the category 1 caesarean section patients (arguably at highest risk of aspiration) received some form of prophylaxis. Possible explanations include the considerable time pressure of these cases, inadequate training and familiarity with general anaesthesia for caesarean section and the recognition that aspiration is a rare event.…”

“…[26][27][28][29][30][31][32] Aspiration prophylaxis for caesarean section is commonly recommended and the combination of sodium citrate, ranitidine and metoclopramide has been suggested. 24 Results from a New Zealand postal survey in 1998 showed that 95% of departments would recommend sodium citrate before emergency obstetric surgery, with 72% also including a histamine type-2 receptor antagonist.…”

Analgesia and anaesthesia in childbirth: obscurantism and obfuscation

“…It has been established above, however, that this intervention increases her risk of an instrumental birth and may be linked to operative birth. Greiff et al . (1994 ) suggest that an epidural is more likely to be sited if a woman is already identified as being at increased risk of needing an instrumental or operative birth.…”