Cervical cerclage anesthesia

Cervical cerclage anesthesia

cervical cerclage anesthesia

Goals: produce adequate analgesia, prevent increase in intrauterine/intraabdominal pressure

Type of anesthesia depends on presence of bulging membranes and need for uterine relaxation

 “High saddle block” is the most commonly used approach (the block has to reach T12):

    • One to 1.2 mL hyperbaric 0.75% bupivacaine
    • One to 1.2 mL hyperbaric 5% lidocaine (rarely used because of risk of TNS)
    • Patient should remain sitting for 3–5 minutes to establish saddle block
  • General anesthesia is an option
  • Epidural anesthesia is a poor choice as sacral sparing is common
  • Adequate perioperative hydration is important to prevent increase in uterine activity
  • Treat hypotension associated with spinal anesthesia aggressively:
    • Retching may result in bearing down and rupture of the amniotic membrane; this is hypotension-induced, no indication for PONV prophylaxis
  • Use of intrathecal short-acting neuraxial opioids (e.g., fentanyl 25 μg) is controversial:
    • Improves intraoperative analgesia
    • Extends duration of block
    • May contribute to postoperative urinary retention
  • Use of long-acting neuraxial opioids is not recommended

iranian surgery

10 common questions about cervical cerclage anesthesia

1What kind of anesthesia is used for cerclage?
You'll be offered either general anesthesia (you're put asleep) or regional anesthesia. Regional anesthesia — a spinal or epidural — numbs you from the chest or waist down, but doesn't put you to sleep for the procedure. Most cerclage procedures are done transvaginally (through the vagina).
2What anesthesia is used for cervical cerclage?
During transvaginal cervical cerclage, your health care provider will insert a speculum into your vagina and grasp your cervix with ring forceps
3What to expect after a cervical cerclage?
Mild cramping is normal and should go away within 3 days after your cerclage placement. Taking a warm shower or putting a heating pad on your abdomen may bring relief. Cervical Cerclage- A cerclage is a stitch used to close the cervix during pregnancy to help prevent pregnancy loss or premature birth.
4Can I go to work after cervical cerclage?
After a cervical cerclage A cervical cerclage is a surgical procedure that requires hospitalisation for two to three days. After going home, the woman gradually resumes normal activity. She can carry on all housework. She can also go to work after two to four weeks, if she is a working woman
5Is Cerclage removal painful?
Does removing the cerclage hurt? YES! I had mine removed without numbing medication
6Can a cerclage fall out?
There are no medications to stop the dilation and effacing, so it's cerclage or nothing." Cerclage may sound like a medieval torture practice, but it has been credited with saving thousands of babies lives over the years
7Can a cervical cerclage break?
Cervical cerclage is the placement of stitches in the cervix to hold it closed. In select cases, this procedure is used to keep a weak cervix (incompetent cervix) from opening early. When a cervix opens early, it may cause preterm labor and delivery
8What is the success rate of a cervical cerclage?
Fetal survival rate (good apgar score) was 76%. Overall success rate of cervical cerclage was 80%. Conclusion: Application of cervical cerclage in pregnant women with previous preterm delivery reduces the preterm delivery rate at a reasonable cost with no additional risk to the mother and the fetus
9What are the risks of cervical cerclage?
Possible risks could include: Rupture of membranes. Cervical infection. Cervical laceration if labor happens before the cerclage is removed. Some risks associated with general anesthesia include vomiting and nausea
10How long is the procedure for a cervical cerclage?
Your doctor will perform cervical cerclage, also called cervical stitch, in a hospital. The procedure usually takes less than one hour

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