1 / 15

Obstetric anesthesia in Estonia (Tartu)

Obstetric anesthesia in Estonia (Tartu). Juri Karjagin with the help from Raido Paasma (Pärnu) Jaanus Eelermaa (Tallinn) Neeme Somma (Tallinn). Some geo-demographic data. Area 45 227 km 2 Inhabitants 1 340 194 (01.01.2011). Births 2007 - 2010. www.stat.ee. Analgesia in labour.

chance
Télécharger la présentation

Obstetric anesthesia in Estonia (Tartu)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Obstetric anesthesia in Estonia (Tartu) Juri Karjaginwiththehelpfrom RaidoPaasma (Pärnu) Jaanus Eelermaa (Tallinn) Neeme Somma (Tallinn)

  2. Some geo-demographic data • Area 45 227 km2 • Inhabitants 1 340 194 (01.01.2011)

  3. Births 2007 - 2010 www.stat.ee

  4. Analgesia in labour • Midwifesand/orobstetrician • Systemicdrugs • Paracetamol • Opioids • N2O • Blocks • Paracervicalblocks (Tartu data) • 2008 16.6% of all labours • 2009 and 2010 7-8% • Aquablocks ???

  5. Analgesia in labour • Anesthesiologists • Epidural • Spinal • Combined spinal-epidural

  6. Epidural in labour

  7. Some hospitals…

  8. Epidural: drugs and methods • Bupivacaine 0.1 – 0.125% • Fentanyl 5 – 10 µg/ml • Placement in labour room • Standart monitoring • Blood pressure • Pulse-oximetry • First dose (5 ml) by anesthetist >>midwife as required

  9. Other regional • Mini-spinal 2ml • Bupivacaine 2.5 mg + Fentanyl 25µg + NaCl 0.9% • Numbers are 10-20 for whole Estonia, but it seems gaining popularity • Combined technique ???

  10. Cesarean section

  11. Cesarean section

  12. Cesarean section Tartu data 2010 • 537 CS (20,7% of all labours) • 204 elective and 333 emergency • Elective • 77% regional (100% spinal) • 23% general • Emergency • 44.7% regional (12% epidural and 88% spinal) • 55.35 general

  13. Spinal for CS • Bupivacaine heavy or plain (7-10 mg) with or without fentanyl (10-20 µg) • Vasopressors tactics (Tartu) • phenylephrine 0.1 mg/ml 30 ml/t simultaneously with injection • Ephedrine 0.5 mg/ml by drip or 5 mg boluses • Conversion to general ca 2.5% in Tartu (2010)

  14. Epidural top-up for CS • In operating theatre • Drugs • Marcaine 0.5% 75 mg • Lidocaine 2% 200-300 mg

  15. Problems… • Airways • PDPH

More Related