Summary

In study session III you have learnt

• Pregnant women will receive anesthesia for various surgical indications during their pregnancy.
• The purpose of this surgery may be to prolong gestation, unrelated to the pregnancy, or to correct fetal anomalies. Hence, an appreciation of the effects of different anaesthetic drugs and techniques in such situations is essential in the care of these women.
• Ideal anesthetic consideration for these women should include maternal safety, fetal well-being, and continuation of pregnancy.
• Avoidance of the teratogenic effects of anesthetics on the neonate is paramount in caring for this population.
• Exposure to anesthetic agents may be either acute during surgery-sedatives, hypnotics, narcotics, muscle relaxants, local anesthetics, oxygen and carbon dioxide, or inhalational anesthetics-or chronic because of occupational exposure to inhalational anesthetics.
• Surgery during pregnancy is associated with a higher incidence of premature labor and spontaneous abortion. The incidenceis higher in lower abdominal, pelvic, and cervicalsurgery.
• Tocolytic drugs, both for prophylactic and therapeutic reasons, are used quite often to prevent premature delivery.
• Elective surgery should be postponed until delivery. In semi elective cases, it is best if surgery can be postponed until after the first trimester.
• In emergency cases, the anesthetic of choice should depend on the site and extent of the surgery to be performed. If possible, regional anesthesia, e.g., spinal,epidural, or nerve block, is advisable. However, general anesthesiacan be administered if necessary.
• Preoperative medications, if necessary, may include barbituratesand morphine.
• Routine, nonparticulate antacid shouldbe used, and rapid-sequence induction is recommended.