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Discussion

What anesthesia complications??

I have been asked to present on anesthesia complications in obstetrics to a meeting of OB RNs. As an OB RN what kinds or types of anesthesia complications do you feel you need/want to know about???? Thanks in advance for your recommendations.

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I hope this is want you're asking for!

We have had a few epidural's gone "bad"-wrong space, requiring the anesthesiologist to remain on unit for regular bolus's. We have also had a few that went to "high"..:D

I would say hypotension with epidurals, unintentional intravascular injections, wet taps, spinal headaches and treatment with blood patches, difficult intubations, emergency tracheotomies, malignant hyperthermia

My sister's epidural stopped working during her C-section.

Her next baby, she was apprehensive about getting an epidural (who wouldn't be). So she had an epidural and then GA. Her baby was born blue. Not breathing. Was fine prior to the GA. My sister is very obese, not sure how much role that played in her complications.

Baby is now 9 and smarter than me, I'm sure :D

I'd also say untoward effects on the fetus - FHR decelerations related to maternal hypotension following the epidural.

We had a pt go into Atrial fibrilation after an epidural, NO PREVIOUS HISTORY OF ANYTHING, perfectly healthy normal pregnancy. SHe complained of "feeling funny" then went unconscious, i thought it was BP related, luckily anesthesia was still in the room and said, LOOK AT HER HEART rhythm, I WAS FREAKING OUT, basically i knew it wasn't right, tho I wasn't sure at the time what it was or what to do about it, about 10 seconds after it happened, she went back to NSR, and woke up, still no explanation, other than the epidural which was placed perfectly, needless to say, epidural was stopped and removed and she had to labor without it.

Now, get this, had she not been on an EKG, would have never known that, where I'm at now, does not require EKG monitoring for labor epidurals, NOR do they do EKG for C-section recoveries. What are your thoughts about that?

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EKG monitoring is not a "Standard of Care" for using epidurals in laboring patients but I would certainly think that the initial hour of recovery from a C-section should include EKG monitoring.

Myths and facts about positioning after anesthesia and rationales (years ago we could not sit pt. up after epidural and currently have one doc who wants pt FLAT YES FLAT immediately post epidural). Also what to do about windows. I have heard lots of different advice about what to do. Best of luck!

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