Challenges that opioid-dependent women present to the obstetric anaesthetist

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dc.contributor.authorCassidy, B.
dc.contributor.authorCyna, A.
dc.date.issued2004
dc.description.abstractA retrospective casenote review was performed to identify anaesthetic challenges relevant to the opioid-dependent obstetric population. Medical records showed that of the 7,449 deliveries during a 24 month period, 85 women (1.1%) were taking regular opioids such as methadone and/or heroin. Of these 67 (79%) received anaesthetic services, ten of whom (11.7%) were referred antenatally. Forty opioid-dependent women (47%) received epidural analgesia in labour compared with the overall hospital rate of 38%. Twenty-three women (27%) delivered by caesarean section: five received general anaesthesia, five combined spinal anaesthesia, five spinal anaesthesia and eight epidural anaesthesia. Twenty opioid-dependent women (23.5%) had documented problems related to labour analgesia and 17 (74%) had problems with analgesia after caesarean section. A variety of postoperative analgesia methods were administered in addition to maintenance methadone. Fourteen patients (16.5%) had difficult intravenous access and seven arrest calls were documented. One anaesthetist was exposed to hepatitis C. This review demonstrates the demands placed on obstetric anaesthetic services by opioid-dependent women. Early antenatal referral for anaesthetic review is recommended.
dc.description.statementofresponsibilityB Cassidy and A M Cyna
dc.identifier.citationAnaesthesia and Intensive Care, 2004; 32(4):494-501
dc.identifier.doi10.1177/0310057x0403200406
dc.identifier.issn0310-057X
dc.identifier.issn1448-0271
dc.identifier.orcidCyna, A. [0000-0002-3138-1091]
dc.identifier.urihttp://hdl.handle.net/2440/55615
dc.language.isoen
dc.publisherAustralian Soc Anaesthetists
dc.source.urihttps://doi.org/10.1177/0310057x0403200406
dc.subjectHumans
dc.subjectPregnancy Complications
dc.subjectHeroin Dependence
dc.subjectPain, Postoperative
dc.subjectMethadone
dc.subjectAnalgesia, Obstetrical
dc.subjectAnalgesia, Patient-Controlled
dc.subjectAnesthesia, Obstetrical
dc.subjectCesarean Section
dc.subjectPregnancy
dc.subjectAdult
dc.subjectFemale
dc.titleChallenges that opioid-dependent women present to the obstetric anaesthetist
dc.typeJournal article
pubs.publication-statusPublished

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