Evidence-based Obstetric Anesthesia Edited by Stephen H. Halpern Director of Obstetrical Anaesthesia Sunnybrook and Women’s College Health Sciences Centre University of Toronto Toronto Ontario Canada M. Joanne Douglas Clinical Professor Department of Anaesthesia University of British Columbia and British Columbia’s Women’s Hospital Vancouver British Columbia Canada Evidence-based Obstetric Anesthesia To my wife Janice and our sons Zvi, Moshe and Yoni – SHH To Bill, Matthew and Mark – MJD Evidence-based Obstetric Anesthesia Edited by Stephen H. Halpern Director of Obstetrical Anaesthesia Sunnybrook and Women’s College Health Sciences Centre University of Toronto Toronto Ontario Canada M. Joanne Douglas Clinical Professor Department of Anaesthesia University of British Columbia and British Columbia’s Women’s Hospital Vancouver British Columbia Canada © 2005 by Blackwell Publishing Ltd BMJ Books is an imprint of the BMJ Publishing Group Limited, used under licence Blackwell Publishing, Inc., 350 Main Street, Malden, Massachusetts 02148-5020, USA Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UK Blackwell Publishing Asia Pty Ltd, 550 Swanston Street, Carlton, Victoria 3053, Australia The right of the Authors to be identified as the Authors of this Work has been asserted in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. First published 2005 Library of Congress Cataloging-in-Publication Data Evidence-based obstetric anesthesia / edited by Stephen H. Halpern, M. Joanne Douglas. p. ; cm. Includes bibliographical references and index. ISBN-13: 978-0-7279-1734-8 ISBN-10: 0-7279-1734-X 1. Anesthesia in obstetrics. 2. Evidence-based medicine. [DNLM: 1. Anesthesia, Obstetrical. 2. Evidence-Based Medicine. I. Halpern, Stephen H. II. Douglas, M. Joanne. RG732.E975 2005 617.9′682—dc22 2004028825 ISBN-13: 978-0-7279-1734-8 ISBN-10: 0-7279-1734-X A catalogue record for this title is available from the British Library Set in 9.5/12pt by Graphicraft Limited, Hong Kong Printed and bound in India by Gopsons Papers Ltd, Noida Commissioning Editor: Mary Banks Project Manager: Alice Nelson Development Editor: Nick Morgan Production Controller: Kate Charman For further information on Blackwell Publishing, visit our website: http://www.blackwellpublishing.com The publisher’s policy is to use permanent paper from mills that operate a sustainable forestry policy, and which has been manufactured from pulp processed using acid-free and elementary chlorine-free practices. Furthermore, the publisher ensures that the text paper and cover board used have met acceptable environmental accreditation standards. Contents Contributors, vii Part 2: Anesthesia for cesarean section, 87 Preface, ix 9 The effect of increasing central blood volume to Acknowledgments, xi decrease the incidence of hypotension following spinal anesthesia for cesarean section, 89 Part 1: Analgesia for normal labor, 1 Pamela J. Morgan 1 Consent for obstetric analgesia and 10 The use of vasopressors for the prevention and anesthesia, 3 treatment of hypotension secondary to M. Joanne Douglas regional anesthesia for cesarean section, 101 2 Epidural analgesia and the progress Stephen H. Halpern & Michelle Chochinov of labor, 10 11 Is regional anesthesia safer than general anesthesia Barbara L. Leighton & Stephen H. Halpern for cesarean section?, 108 3 Maintenance of epidural analgesia for labor – Yehuda Ginosar, Ian F. Russell & Stephen H. continuous infusion or patient controlled, 23 Halpern Stephen H. Halpern 12 Prevention and treatment of side-effects of 4 The use of transcutaneous electrical nerve neuraxial opioids, 132 stimulation for labor pain, 30 Niall L. Purdie & Martin van der Vyver Carolyn F. Weiniger 13 Multimodal analgesia following cesarean section: 5 Is nitrous oxide an effective analgesic for labor? Use of non-steroidal anti-inflammatory drugs A qualitative systematic review, 38 combined with neuraxial opioids, 152 Jean E. Kronberg & Dorothy E.A. Thompson Pamela Angle & Kamal Hussain 6 Choice of local anesthetic for labor and delivery– bupivacaine, ropivacaine and Part 3: Complications of obstetric levobupivacaine, 56 anesthesia, 163 Stephen H. Halpern 14 The use of neuraxial anesthesia in parturients with 7 Intrathecal opioids in labor– do they increase the thrombocytopenia: What is an adequate platelet risk of fetal bradycardia?, 68 count?, 165 Chahé Mardirosoff & Martin R. Tramèr M. Joanne Douglas 8 Epidural catheter design and the incidence of 15 A rational approach to aspiration prophylaxis, 178 complications, 77 Geraldine O’Sullivan, Darren Hart & Andrew Margaret Srebrnjak & Stephen H. Halpern Shennan v Contents 16 Postdural puncture headache, 192 19 Is there a difference between the obstetric and Peter T-L. Choi & Stefan Lucas non-obstetric airway?, 225 Eric Goldszmidt 17 Epidural analgesia and back pain, 208 Terrance W. Breen Appendix: Jadad scale for reporting randomized controlled trials, 237 18 Analgesia for external cephalic version, 217 William Wight Index, 239 vi Contributors Pamela Angle MD, FRCP(C) Stephen H. Halpern MD, MSc, FRCP(C) Assistant Professor, Dept of Anaesthesia, Sunnybrook and Director of Obstetrical Anaesthesia, Sunnybrook and Women’s College Health Sciences Centre, University of Women’s College Health Sciences Centre, University of Toronto, 76 Grenville St, Toronto, Ontario M5S 1B2, Toronto, 76 Grenville St, Toronto, Ontario M5S 1B2, Canada Canada Terrance W. Breen MD Darren Hart RM Dept of Anesthesiology, Duke University Medical Center Research Midwife, Dept of Obstetrics and Gynaecology, 3094, Durham, NC 27710, USA Guy’s and St Thomas’ Hospital, London SE1 7EH, UK Michelle Chochinov MD, FRCP(C) Kamal Hussain MB BS, FFARSCI Dept of Anaesthesia, Sunnybrook and Women’s Obstetric Anaesthesia Fellow, Dept of Anaesthesia, College Health Sciences Centre, University of Toronto, Sunnybrook and Women’s College Health Sciences Centre, 2075 Bayview Ave, Toronto, Ontario M4N 3M5, Canada University of Toronto, 76 Grenville St, Toronto, Ontario M5S 1B2, Canada Peter T-L. Choi MD, MSc, FRCP(C) Assistant Professor, Dept of Anaesthesia, University of Jean E. Kronberg PhD, MD, FRCP(C) British Columbia, 910 West Tenth Ave, Vancouver, British Columbia V5Z 4E3, Canada Associate Professor, Dept of Anaesthesia, University of Toronto and Active Staff, Sunnybrook and Women’s M. Joanne Douglas MD, FRCP(C) College Health Sciences Centre, University of Toronto, 76 Grenville St, Toronto, Ontario M5S 1B2, Canada Clinical Professor, Dept of Anaesthesia, Faculty of Medicine, University of British Columbia and British Columbia’s Women’s Hospital, 4500 Oak St, Vancouver, British Barbara L. Leighton MD Columbia V6H 3N1, Canada Dept of Anesthesiology, Washington University, Campus Box 8054, 660 S. Euclid Ave, St Louis, MO 63110-1093, Yehuda Ginosar BSc, MB BS USA Lecturer in Anesthesiology, Hebrew University Medical School, Jerusalem, Israel, and Senior Anesthesiologist, Dept Stefan Lucas MD of Anesthesiology and Critical Care Medicine, Hadassah University of Rochester, School of Medicine and Dentistry, Hebrew University Medical Center, POB 12000, Jerusalem Dept of Anesthesiology, 601 Elmwood Avenue, Rochester, 91120, Israel NY 14642, USA Eric Goldszmidt MD, FRCP(C) Dept of Anaesthesia, Mount Sinai Hospital and University of Chahé Mardirosoff MD Toronto, 600 University Ave, Toronto, Ontario M5G 1X5, Service d’Anesthésie et Réanimation, Polyclinique de Savoie, Canada 8, rue F. David, 74100 Annemasse, France vii Contributors Pamela J. Morgan MD, CCFP, FRCP(C) Margaret Srebrnjak BSc, MD, FRCP(C) Associate Professor, Staff Anaesthesiologist, Sunnybrook Dept of Anaesthesia, Sunnybrook and Women’s College and Women’s College Health Sciences Centre, University Health Sciences Centre, University of Toronto, 76 Grenville ofToronto, 76 Grenville St, Toronto, Ontario M5S 1B2, St, Toronto, Ontario M5S 1B2, Canada Canada Dorothy E.A. ThompsonMB ChB, FRCP(C) Geraldine O’Sullivan MD, FRCA Honorary Staff, Dept of Anaesthesia, Sunnybrook and Dept of Anaesthetics, Guy’s and St Thomas’ Hospital, Women’s College Health Sciences Centre, University of London SE1 7EH, UK Toronto, 76 Grenville St, Toronto, Ontario M5S 1B2, Canada Niall L. Purdie MB ChB, FFARCSI Dept of Anaesthesia, Sunnybrook and Women’s Martin R. Tramèr MD, DPhil College Health Sciences Centre, University of Toronto, Consultant Anesthetist, Division of Anesthesiology, Geneva 76 Grenville St, Toronto, Ontario M5S 1B2, Canada University Hospitals, CH-1211 Geneva, Switzerland Ian F. Russell MB ChB, FRCA Martin van der VyverMB ChB, MMed(Anes), Honorary Senior Lecturer, Academic Dept of Obstetrics and FCA(SA) Gynaecology, Hull University, and Consultant Anaesthetist, Sunnybrook and Women’s College Health Sciences Centre, Dept of Anaesthesia, Hull Royal Infirmary, Anlaby Road, University of Toronto, 76 Grenville St, Toronto, Ontario Hull HU3 2JZ, UK M5S 1B2, Canada Andrew Shennan MD, MRCOG Carolyn F. Weiniger MB ChB Senior Lecturer in Obstetrics and Gynaecology, Dept of Dept of Anesthesia, Hadassah University Hospital, POB Obstetrics and Gynaecology, Guy’s and St Thomas’ 12000, Jerusalem 91120, Israel Hospital, London SE1 7EH, UK William Wight MB BS, FRCA Consultant Anaesthetist, Dept of Anaesthesia, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK viii