Up-to-date or out-of-date: does thiopental have a future in obstetric general anaesthesia?

Rucklidge, M. W. M.

doi:10.1016/j.ijoa.2013.03.015

Cited by 22 publications

(13 citation statements)

References 24 publications

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“…Immediately after delivery, sevoflurane was washed out to avoid the slightest risk of uterine atony which may precipitate bleeding in the setting of heparinization and CPB. [ 14 15 ] Opioids, benzodiazepines and propofol were used after delivery of the baby. High Apgar score at 1 and 5 min justifies use of thiopentone and sevoflurane.…”

Section: Discussionmentioning

confidence: 99%

Initial non-opioid based anesthesia in a parturient having severe aortic stenosis undergoing cesarean section with aortic valve replacement

et al. 2015

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Pregnancy in presence of severe aortic stenosis (AS) causes worsening of symptoms needing further intervention. In the advanced stages of pregnancy, some patients may even require aortic valve replacement (AVR) and cesarean delivery in the same sitting. Opioid based general anesthesia for combined lower segment cesarean section (LSCS) with AVR has been described. However, the use of opioid may lead to fetal morbidity and need of respiratory support for the baby. We describe successful anesthetic management for LSCS with AVR in a >33 week gravida with severe AS and congestive heart failure. We avoided opioids till delivery of the baby AVR; the delivered neonate showed a normal APGAR score.

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Section: Discussionmentioning

confidence: 99%

Initial non-opioid based anesthesia in a parturient having severe aortic stenosis undergoing cesarean section with aortic valve replacement

et al. 2015

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“…It would be unfair to blame all the adverse events described in the two reports on thiopental, which has served us so well for so long, but we believe that the tipping point predicted by Rucklidge in his elegant summary of the pros and cons of thiopental in obstetrics [17] (summarised and expanded upon in Table 1) has now been reached.…”

Section: Maternal Mortality: Moody Skiesmentioning

confidence: 92%

“…This is potentially fraught with difficulties, relating to whether and how to include a discussion of awareness in the pre-operative discussion, in what may be an urgent, time-constrained situation [16]. The chapter hints at issues with thiopental, including the unfamiliarity of it amongst trainees and the risk of mistaking it for antibiotic, but doesn't go as far as suggesting it should no longer be used in obstetrics, though that suggestion has been put forward elsewhere [17] of which more later.…”

Section: Awareness and Obstetric Anaesthesia: A Perfect Stormmentioning

confidence: 99%

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Unsettled weather and the end for thiopental? Obstetric general anaesthesia after the NAP5 and MBRRACE-UK reports

Lucas

Yentis

2015

Anaesthesia

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“…Thus, the situation now exists whereby some trainees' only exposure to the use of thiopental is in the obstetric unit (Walker, Vaughton et al 2012). This begs the question as to whether thiopental should continue as the drug of choice for obstetric anaesthesia (Rucklidge 2013).…”

Section: Doses Of Intravenous Induction Agentsmentioning

confidence: 99%

Cardiac disease in pregnancy

Steer¹

2020

Oxford Textbook of Obstetrics and Gynaecology

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Cardiac disease has become the single most important cause of maternal death in the United Kingdom and other developed countries over the last 30 years, mostly due to acquired heart disease secondary to women having their pregnancies later in life. The main causes of mortality are myocardial infarction/ischaemic heart disease (one-third) and cardiomyopathy (a further third). The remaining deaths are mostly associated with rheumatic heart disease, congenital heart disease, and pulmonary hypertension (about 5–10% each). Pregnancy represents a challenge to women with impaired cardiac function because of the cardiovascular changes associated with the increase in blood supply to the uterus and placenta. Preconception counselling is vital and should cover the risk of mortality, morbidity, and the increased rate of preterm birth and fetal growth restriction in affected women. Antenatal and intrapartum care needs to be planned by a multidisciplinary team and delivered by staff with appropriate expertise.

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Up-to-date or out-of-date: does thiopental have a future in obstetric general anaesthesia?

Cited by 22 publications

References 24 publications

Initial non-opioid based anesthesia in a parturient having severe aortic stenosis undergoing cesarean section with aortic valve replacement

Initial non-opioid based anesthesia in a parturient having severe aortic stenosis undergoing cesarean section with aortic valve replacement

Unsettled weather and the end for thiopental? Obstetric general anaesthesia after the NAP5 and MBRRACE-UK reports

Cardiac disease in pregnancy

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