Cassidy, B.Cyna, A.2010-01-202010-01-202004Anaesthesia and Intensive Care, 2004; 32(4):494-5010310-057X1448-0271http://hdl.handle.net/2440/55615A 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.enHumansPregnancy ComplicationsHeroin DependencePain, PostoperativeMethadoneAnalgesia, ObstetricalAnalgesia, Patient-ControlledAnesthesia, ObstetricalCesarean SectionPregnancyAdultFemaleJournal article002009194810.1177/0310057x04032004060002233254000072-s2.0-444433395638011Cyna, A. [0000-0002-3138-1091]