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Continuous Spinal Anesthesia and Analgesia in Obstetrics

The development of the technique of continuous spinal anesthesia as it relates to the obstetric population is recounted. The advantages and disadvantages of continuous spinal anesthesia are examined, currently available catheters and kits are reviewed, and strategies for the management of continuous spinal techniques for labor analgesia and surgical anesthesia are discussed. Continuous spinal anesthesia may have particular value over other regional techniques in several specific clinical circumstances.
Continuous spinal anesthesia is one of the most useful, versatile, and reliable techniques available for providing analgesia and anesthesia, in both obstetric and nonobstetric populations. Despite its inherent advantages, it is also one of the most underutilized of regional anesthetic techniques. Though the use of continuous spinal anesthesia in the obstetric population dates back almost 7 decades, wider use and acceptance have been hampered primarily by limitations of the available equipment. 

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Management of difficult airway patients and the use of a difficult airway registry at a tertiary care pediatric hospital. Sheeran PW ,  Walsh BK ,  Finley AM ,  Martin AK ,  Brenski AC . Author information Abstract BACKGROUND: Appropriate recognition and management of the pediatric difficult airway is essential. Two patient deaths in a 2-year period involving children with a known difficult airway led to the formation of the institution's multidisciplinary Difficult Airway Committee. METHODS: Patients with a suspected difficult airway or a known difficult airway are entered into a registry of difficult airway patients. A note describing the airway and any experiences at airway manipulation is entered as part of a difficult airway note in the patient's electronic medical record as soon as the patient is recognized as having a difficult airway. A call system has been developed to mobilize expert emergency airway assistance for these patients. Multi...