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If you wish to respond to a paper or other item already published in the BJA, please go to the abstract/full text version of that item and click on the link "E-Letters: Submit a response to the article".

Electronic Letters to:

Obstetrics:
M. K. Panni and M. O. Columb
Obese parturients have lower epidural local anaesthetic requirements for analgesia in labour
Br. J. Anaesth. 2006; 96: 106-110 [Abstract] [Full text] [PDF]
*E-letters: Submit a response to this article

Electronic letters published:

[Read E-letter] Local anaesthetics and Obstetric Anaesthesia
Dr Snehal Ramnath Kumbhare, Dr Ramabhadran Kadayam Sreenivasan   (16 January 2006)

Local anaesthetics and Obstetric Anaesthesia 16 January 2006
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Dr Snehal Ramnath Kumbhare,
Clinical Attachment in Anaesthetics
Huddersfield Royal Infirmary,
Dr Ramabhadran Kadayam Sreenivasan

Send letter to journal:
Re: Local anaesthetics and Obstetric Anaesthesia

I read this article with great interest. As correctly mentioned in this article use of lower dosage of local anaesthetics should be encouraged in obese parturients.

Local anaesthetic requirements are less in pregnant patients, more so in obese patients.(1)

Local anaesthetic requirements for epidural and spinal anaesthesia are reduced to 75–80% of normal in the morbidly obese, since fatty infiltration and the increased blood volume caused by increased intra- abdominal pressure reduce the volume of the epidural space. This leads to reduced requirements , unpredictable spread and variability in block height achieved.(2)

References:

1.K. Saravanakumar, S. G. Rao and G. M. Cooper

Obesity and Obstetric Anaesthesia

Anaesthesia,January 2006; 61: 36-48

2. J. P. Adams and P. G. Murphy

Obesity in anaesthesia and intensive care

Br. J. Anaesth., Jul 2000; 85: 91 – 108

Conflict of Interest:

None declared