Hi everyone,

This week Graeme and I sit down for the first time in nearly a year and do a bit of a deep dive on the use of nitrous oxide as an analgesic in labour. We drop a few dad jokes, discuss the history of inhaled analgesics, nitrous oxide use around the world, the evidence, the environmental concerns and other interesting anecdotes.

Do you have nitrous oxide on labour ward in your part of the world? Send us a comment and let us know!

Enjoy

LINKS

ANZCA Blue Book 2021 (Australasian Anaesthesia) - go to page 183

Developments in labour analgesia and their use in Australia 2015

Safety and Utility of Nitrous Oxide for Labor Analgesia APSF Journal June 2020

Your 76 yr old patient is now two days post her laparotomy for ovarian cancer. She looks well, is starting to eat and keen to get up to the shower as well as have all the "annoying lines and tubes removed from my arms!".

Unfortunately she is still on 3ml/hr of a metaraminol infusion and everytime the nurse tries to wean it off her BP drops to 70/45..... Is there anything you can do?

Hi everyone,

This week Rheily and I discuss the pharmacology of oral midodrine a alpha adrenergic agonist useful as an oral systemic vasoconstrictor. Join us as we discuss the ins and outs of using oral midodrine - please leave us a comment if you have some experience or tips to share!

USEFUL LINKS

Australasian Anaesthesia 2019 (Blue Book) Article - go to page 101

Hi everyone,

This week Sneha leads a discussion with both Matt and myself where we take a deep dive into how to actually perform an epidural blood patch. Even though you can't really classify this as an uncommon procedure, as individuals we probably don't do very many and it is hard for most of us to become experienced and "expert" (whatever that is defined as).

We discuss the evidence, the effectiveness, the practical considerations and some of the common problems / difficulties which may be encountered.

Thanks Sneha (for organising and leading this episode) and of course you too Matt!

LINKS

Epidural blood patch: A narrative review - Anaesthesia Critical Care & Pain Medicine October 2022

Treatment of obstetric post-dural puncture headache. Part 2: epidural blood patch International Journal of Obstetric Anesthesia 2019

Welcome to this podcast, the tenth in our series of obstetric anaesthesia basics. Join us for this the second part of a conversation where we discuss all things relating to neuraxial anaesthesia for Caesarean section. Due to it’s length we have split this discussion into two parts – who would have thought we could talk for so long about this! (I thought it would only be one episode and was surprised what we teased out).

Thanks Shilpa, Matt & Roger!

BASICS OF OBSTETRIC ANAESTHESIA

The “Basics of Obstetric Anaesthesia” is a short series of podcasts, where we aim to discuss in a conversational manner the basic topics you will need to understand if you wish to practice obstetric anaesthesia. These will be especially useful to anaesthesia trainees new to obstetric anaesthesia but also may appeal to experienced practitioners wanting a refresher of the basics in this subspecialty area.

1 – Epidural analgesia in labour part 1

2 – Epidural analgesia in labour part 2, pitfalls and troubleshooting

3 – Accidental dural puncture and intrathecal catheters

4 – Post-dural puncture headaches and management

5 – Pre-eclampsia, eclampsia and hypertensive disorders

6 – General anaesthesia for Caesarean Delivery part 1

7 – General anaesthesia for Caesarean Delivery part 2

8 – Obstetric Haemorrhage

9 – Neuraxial anaesthesia for Caesarean Delivery part 1

10 - Neuraxial anaesthesia for Caesarean Delivery part 2

Welcome to this podcast, the ninth in our series of obstetric anaesthesia basics. Join us for this the first part of a conversation where we discuss all things relating to neuraxial anaesthesia for Caesarean section. Due to it’s length we have split this discussion into two parts – who would have thought we could talk for so long about this! (I thought it would only be one episode and was surprised what we teased out).

Thanks Shilpa, Matt & Roger!

BASICS OF OBSTETRIC ANAESTHESIA

The “Basics of Obstetric Anaesthesia” is a short series of podcasts, where we aim to discuss in a conversational manner the basic topics you will need to understand if you wish to practice obstetric anaesthesia. These will be especially useful to anaesthesia trainees new to obstetric anaesthesia but also may appeal to experienced practitioners wanting a refresher of the basics in this subspecialty area.

1 – Epidural analgesia in labour part 1

2 – Epidural analgesia in labour part 2, pitfalls and troubleshooting

3 – Accidental dural puncture and intrathecal catheters

4 – Post-dural puncture headaches and management

5 – Pre-eclampsia, eclampsia and hypertensive disorders

6 – General anaesthesia for Caesarean Delivery part 1

7 – General anaesthesia for Caesarean Delivery part 2

8 – Obstetric Haemorrhage

9 – Neuraxial anaesthesia for Caesarean Delivery part 1

10 - Neuraxial anaesthesia for Caesarean Delivery part 2

https://www.obsgynaecritcare.org/podcast-series-on-the-basics-of-obstetric-anaesthesia/

Hi everyone,

Join us this week as we briefly celebrate the 100th episode - almost exactly 5 years after the first episodes aired. Then we sit down to discuss some real haemorrhage cases - a follow up on our promise from the earlier episode 97 where we discuss the basics of managing obstetric haemorrhage.

Thanks Graeme, Shilpa and Matt!

Links

097 Obstetric haemorrhage

https://youtu.be/rc9BYcIhamA

MBRRACE-UK - Maternal mortality and morbidity reports UK

https://youtu.be/nqRBbXxzX6Q

Hi everyone,

This is the second episode of two, where I sit down with my anaesthetic colleague Sneha and senior ICU trainee Jess to discuss the important and sometimes scary topic of maternal sepsis. Join us as in this second episode where we discuss amongst many things.

antibioticsfluids & vasopressorsmulti-organ dysfunctionsource controlanecdotes & tips

Thanks Sneha & Jess!

If you haven't already listen to episode one first:

https://www.obsgynaecritcare.org/098-maternal-sepsis-with-jess-and-sneha-part-1/?preview=true

LINKS

“Sepsis in Pregnancy” Burlinson et al – International Journal of Obstetric Anaesthesia 2018

“Maternal sepsis” Filetici et al – Best Pract Res Clin Anaesthesiol 2022

Hi everyone,

This is the first episode of two, where I sit down with my anaesthetic colleague Sneha and senior ICU trainee Jess to discuss the important and sometimes scary topic of maternal sepsis. Join us as in this first episode where we discuss amongst many things

the recent changes in how sepsis is defineddetection and recognition in pregnancycommon micro-organisms

Thanks Sneha & Jess!

LINKS

"Sepsis in Pregnancy" Burlinson et al - International Journal of Obstetric Anaesthesia 2018

"Maternal sepsis" Filetici et al - Best Pract Res Clin Anaesthesiol 2022

Welcome to this podcast, the eighth in our series of obstetric anaesthesia basics. Join us for this conversation where we discuss all things relating to obstetric haemorrhage, a much feared and common obstetric emergency.

Thanks Shilpa, Matt & Roger!

BASICS OF OBSTETRIC ANAESTHESIA

The “Basics of Obstetric Anaesthesia” is a short series of podcasts, where we aim to discuss in a conversational manner the basic topics you will need to understand if you wish to practice obstetric anaesthesia. These will be especially useful to anaesthesia trainees new to obstetric anaesthesia but also may appeal to experienced practitioners wanting a refresher of the basics in this subspecialty area.

1 – Epidural analgesia in labour part 1

2 – Epidural analgesia in labour part 2, pitfalls and troubleshooting

3 – Accidental dural puncture and intrathecal catheters

4 – Post-dural puncture headaches and management

5 – Pre-eclampsia, eclampsia and hypertensive disorders

6 – General anaesthesia for Caesarean Delivery part 1

7 – General anaesthesia for Caesarean Delivery part 2

8 – Obstetric Haemorrhage

9 - Neuraxial anaesthesia for Caesarean Delivery

Useful Links

https://youtu.be/rc9BYcIhamA

https://www.obsgynaecritcare.org/rotem/

Welcome to this podcast, the seventh in our series of obstetric anaesthesia basics. Join us for this the second part of a conversation where we discuss all things relating to general anaesthesia for Caesarean section. Due to it’s length we have split this discussion into two parts – who would have thought we could talk for so long about this! (I thought it would only be one episode and was surprised what we teased out). It makes easier listening if you listen to episode one first!

Thanks Laura, Matt & Roger!

BASICS OF OBSTETRIC ANAESTHESIA

The “Basics of Obstetric Anaesthesia” is a short series of podcasts, where we aim to discuss in a conversational manner the basic topics you will need to understand if you wish to practice obstetric anaesthesia. These will be especially useful to anaesthesia trainees new to obstetric anaesthesia but also may appeal to experienced practitioners wanting a refresher of the basics in this subspecialty area.

1 – Epidural analgesia in labour part 1

2 – Epidural analgesia in labour part 2, pitfalls and troubleshooting

3 – Accidental dural puncture and intrathecal catheters

4 – Post-dural puncture headaches and management

5 – Pre-eclampsia, eclampsia and hypertensive disorders

6 – General anaesthesia for Caesarean Delivery part 1

7 – General anaesthesia for Caesarean Delivery part 2

8 – Obstetric Haemorrhage

9 – Neuraxial anaesthesia for Caesarean Delivery

https://www.obsgynaecritcare.org/podcast-series-on-the-basics-of-obstetric-anaesthesia/