Subject(s)
Methoxyflurane/administration & dosage , Volatilization , Adolescent , Adult , Drug Evaluation , Humans , Middle AgedABSTRACT
There were sixteen maternal deaths following 1,450 Caesarian sections at the Lagos University Teaching Hospital in an eight year period 1966 to 1974, a maternal mortality rate of 1.1%. The chief causes of maternal deaths in this environment are pre-eclamptic toxaemia, eclampsia and haemorrhage. Most of the obstetric deaths following Caesarian sections are preventable through the application of current knowledge and availability of modern facilities. Reduction of maternal deaths will follow recognition and attention to the most frequent causes.
Subject(s)
Cesarean Section/mortality , Maternal Mortality , Cesarean Section, Repeat/mortality , Eclampsia/mortality , Female , Hospitals, Teaching , Humans , Nigeria/epidemiology , PregnancyABSTRACT
The obstetric anaesthetist should not only be skilled in the administration of anaesthesia, but should also have a thorough knowledge of the pharmacology and physiology of pregnancy, labour and delivery and the full implications of the complications that may arise in late pregnancy and during labour. The diagnosis and treatment of these complications are as much his concern as the choice and administration of anaesthetic agents. Such complications which may arise before, during and after Ceasarian Section include prolonged and obstructed labour, inhalation of gastric contents, pre-eclamptic toxaemia and eclampsia, haemorrhage and coagulation disorders, supine hypotensive syndrome and amniotic fluid embolism. Close co-operation between obstetrician and anaesthetist, careful overall management and the judicious choice of drugs in pre-medication, anaesthetic agents and techniques, on the lines outlined and discussed should aid the reduction of meternal mortality in elective and emergency caesarian section to the barest minimum.
Subject(s)
Anesthesia, Obstetrical , Cesarean Section/adverse effects , Cesarean Section/mortality , Anesthesia, Conduction , Female , Humans , PregnancyABSTRACT
Blind nasotracheal intubation has been attempted in 72 patients under light general anaesthesia with propanidid in a one-dose or two-dose technique which provides conditions for up to six attempts. Nasotracheal intubation was achieved in 49 patients with a one-dose technique, and in a further 15 patients with the supplementary dose. It is suggested that this technique with propanidid is safer than other techniques using non-anasthetic respiratory stimulants with their attendant dangers, and that the success rate with propanidid is similar to that using these other techniques.
