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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : -16 مورد

Indications for antenatal anesthesia consultation

Indications for antenatal anesthesia consultation
Patients should ideally be referred for anesthesiology consultation by 32 weeks gestation, or earlier if premature birth is anticipated.
  1. Cardiac issues
    1. Valvular disease (excluding asymptomatic mitral valve prolapse)
    2. History of chest pain without cardiac workup
    3. History of arrhythmias (specifically SVT, atrial fibrillation, VT)
    4. Complex congenital cardiac defects
    5. Pacemakers/ICDs
    6. History of cardiomyopathy or IHSS
  1. Pulmonary disease
    1. Asthma - poorly controlled or worsening during pregnancy
    2. History of pulmonary hypertension
    3. Other pulmonary disease (eg, previous chest surgery, cystic fibrosis, sarcoid) that compromises ability to perform usual ADLs
  1. Neurologic/neurosurgical disease
    1. Current or prior history of intracranial vascular malformation, hemorrhage, tumor or any mass lesion
    2. Chiari malformation
    3. Spinal anatomy concerns: Hardware (eg, lumbar drains, nerve stimulators for chronic pain), prior surgery (including Harrington Rod placement), major or minor paralysis, diagnosed spina bifida, neurofibromatosis, low back pain if it significantly compromises ability to perform ADLs
    4. Neuromuscular disease (eg, multiple sclerosis or myasthenia gravis) that compromises ability to perform ADLs
  1. Hematologic
    1. History of thrombocytopenia without a formal diagnosis or with platelet count <75,000/microL
    2. History of bleeding disorder
    3. Anticoagulation therapy
  1. Chronic pain syndrome involving visits to pain clinics or neurologists
  1. Severe obesity
  1. Allergy (anaphylaxis) to local anesthetics (eg, lidocaine, novocaine)
    or opioids (eg, morphine, fentanyl, hydromorphone, meperidine, codeine)
  1. History of anesthetic complications or problems in the patient or in a family member
    1. Malignant hyperthermia
    2. Airway concerns (history of difficult intubation, history of oral or facial surgery)
  1. Specific questions, special requests, or significant anxiety regarding anesthesia care (eg, complicated birth plans or requests for general anesthesia)
  1. Declines blood and derived products (eg, packed red blood cells [PBRCs], albumin), including Jehovah's Witness
  1. Opioid use disorder, not on stable methadone or buprenorphine regimen
ADL: activity of daily living; ICD: implantable cardioverter-defibrillator; IHSS: idiopathic hypertrophic subaortic stenosis; SVT: supraventricular tachycardia; VT: ventricular tachycardia.
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