Managing Complications in Pregnancy and Childbirth: - IAWG

C-44 Anaesthesia and analgesiaCARDIAC ARREST• Hyperventilate with oxygen.• Perform cardiac massage.• If the woman has not yet delivered, immediately deliver the baby bycaesarean section (page P-43) using general anaesthesia.• Give adrenaline 1:10 000, 0.5 mL IV.ADRENALINE TOXICITY• Systemic adrenaline toxicity results from excessive amounts orinadvertent IV administration and results in:- restlessness;- sweating;- hypertension;- cerebral haemorrhage;- rapid heart rate;- ventricular fibrillation.• Local adrenaline toxicity occurs when the concentration isexcessive and results in ischaemia at the infiltration site with poorhealing.GENERAL PRINCIPLES FOR ANAESTHESIA AND ANALGESIAThe keys to pain management and comfort of the woman are:- supportive attention from staff before, during and after aprocedure (helps reduce anxiety and lessen pain);- a provider who is comfortable working with women who areawake and who is trained to use instruments gently;- the selection of an appropriate type and level of painmedication.• Tips for performing procedures on women who are awake include:- Explain each step of the procedure before performing it;- Use adequate premedication in cases expected to last longerthan 30 minutes;