Recent advances in obstetric anaesthesia and critical care

Abstract

Newer modalities in labour analgesia and anaesthesia for caesarean section including regional anaesthesia techniques and airway management are emerging constantly. Techniques such as point of care ultrasound, especially of the lungs and stomach and point of care tests of coagulation based on viscoelastometry are about to revolutionise perioperative obstetric care. This has improved the quality of care thereby ensuring good perioperative outcomes in the parturient with comorbidities. Critical care for obstetrics is an emerging field that requires a multidisciplinary approach with obstetricians, maternal-foetal medicine experts, intensivists, neonatologists, and anaesthesiologists working together with enhanced preparedness and uniform protocols. Newer techniques and concepts of understanding have thus been established in the traditional speciality of obstetric anaesthesia over the last decade. These have improved maternal safety and neonatal outcomes. This article touches upon some recent advances that have made a significant impact in the field of obstetric anaesthesia and critical care.

¿Han cambiado los conceptos de analgesia obstétrica en los últimos 100 años?

“…B. Fernández Torres 1,2 , E. Peralta Espinosa 1 , I. M. Fontán Atalaya 3 1 Servicio de Anestesiología y Reanimación. Hospital Virgen Macarena.…”

“…Resulta obvio que en la actualidad existe un interés especial en la analgesia y anestesia obstétrica, y específicamente en aspectos relacionados con la mortalidad maternofetal, la calidad y la seguridad, los costes de la atención a la maternidad, la atención clínica general y el futuro de la atención anestésica periparto [1][2][3][4][5][6] . Por otra parte, han pasado 100 años desde que se publicó, en agosto de 1922, el primer número de Anesthesia & Analgesia, entonces llamado Current Researches in Anesthesia & Analgesia.…”

Innovative research and technological advancements: Oars of the boat of progress

“…Early warning scores, algorithms, and indices help to detect early chances of clinical deterioration in the ICU, in the detection of sepsis, and in the management of postpartum haemorrhage (PPH), eg-The obstetric early warning scores and the shock index have been used to recognise and predict severe haemorrhage and the need for blood transfusion. [ 13 ] The role of point-of-care tests to decide perioperative blood transfusion and in the management of PPH has been very beautifully brought out in two articles being published in this issue. [ 13 , 14 ]…”

“…[ 13 ] The role of point-of-care tests to decide perioperative blood transfusion and in the management of PPH has been very beautifully brought out in two articles being published in this issue. [ 13 , 14 ]…”

“…[ 22 ] The concept of ERAS and its implementation in the fields of onco-anaesthesia, caeserean section and paediatric anaesthesia has been elegantly touched upon in the articles in this issue. [ 13 , 23 , 24 ] ERAS protocols are now being followed even in transplant surgery such as renal and liver transplants. [ 25 ] The advances in transplant anaesthesia are thus proceeding in parallel with the advances in surgical techniques, improved understanding of immunology and rapidly developing laboratory research.…”