OB Anesthesia
A-OK Protocol¶
Used in amniotic fluid embolism
- Atropine 1mg for vagolysis
- Ondansetron 8mg for serotonin receptro blockade and vagolysis
- Ketorolac 30mg for thomboxane production blockade
Breast Feeding and Anesthesia¶
C-Section Plan¶
- EKG leads on before the spinal goes in, to monitor for bradycardia
- Pitocin 30un in 500cc LR
- Give 250cc bolus then trickle
- ABX
- Ancef for scheduled C/S
- If laboring Ancef and Azithromycin
- Chorio: Amp and Gent
- Clinda if PCN allergy
- Epidural
- 2% Lido 10-20cc
- or 10-15cc chloroprocaine
- Must redose every 30min 5cc
Info
If epidural bolus fails then take out and place spinal 1.6-1.8
- GETA
- 0.5MAC Des with 50% nitrous
- 7.0 ETT
- Emergency
- iStat before transfusing
D/C¶
- Mac if less than 12 weeks
Full Stomach Guidelines¶
- 12 weeks until 2 weeks postpartum
Retained Products of Conception¶
- Low dose spinal 1.2-1.4 or tube
Labor Epidural Plan¶
Danger
Do not do if platelets are less than 100k
- 0.2% Ropi plain
- 5-10cc bolus with 50-100mcg fentanyl
- Infusion 10cc/hr, 5cc bolus, 30min lockout
- Vitals q5 for 15min, q15min for 1 hr, q30 after that
- Top Off
- 0.25% Bupivacaine 5-10cc
- 2% lidocaine 5-10cc