Simon Ash Profile picture
Passionate about #OBAnes and #patientsafety (#OBcritcare special interest). Father of 2 future Jedi. Views my own. he/his #heforshe 🇿🇦🇮🇪🇨🇦

Jun 12, 2023, 9 tweets

Next up at #CASAM2023 - fittingly keeping the most important academic session to last: #OBAnes
@ValZaph moderating the Maternal Experience and Outcomes: Improving the care we provide. @DrWesleyEdwards

Bookends the 1st #OBAnes session, on intrapartum pain at cesarean section… twitter.com/i/web/status/1…

Dr Christina Lamontagne kicks off the session with: Use of Dexmedetomidine in improving maternal experience and outcomes. Nothing to disclose. Then an important disclosure: All indications discussed are OFF LABEL in Canada. Objectives.
#OBAnes #CASAM2023

Why does Dr Lamontagne use a lot of dexmedetomidine (not only in #OBAnes mind)? Clinical pharmacology of dexmedetomidine (1): highly selective alpha-2 agonist; sedation WITHOUT amnesia at locus coeruleus. #CASAM2023

Clinical pharmacology of dexmedetomidine (2): high lipophylicity (crosses BBB readily, entrapped at placenta); inactive metabolites, termination half -life 2h; multiple routes of administration available. #OBAnes #CASAM2023

Safety of dexmedetomidine in #OBAnes (1)… first a review of the Health Canada monograph. Remember that this is OFF LABEL use in Canada. Not a lot of data regarding use during pregnancy and breast feeding. #CASAM2023

Safety of dexmedetomidine in #OBAnes (2). As noted by Dr Eva Roofthooft @OAAinfo at #OAA3dc2022, most data from China. Meta-analysis of 6 RCT. No significant differences in neonatal Apgars and ABG; lower N&V and shivering in mothers; no difference pruritis, hypotension or… twitter.com/i/web/status/1…

Link to Dr Eva Roofthooft’s talk on new drugs in #OBAnes (including dexmedetomidine) from @OAAinfo’s #OAA3dc2022. #CASAM2023

Use of dexmedetomidine in improving maternal experience and outcomes (1): epidural use during labour - better analgesia vs placebo, similar vs opioids; less N&V; no adverse maternal or fetal effects found. Dr Lamontagne’s personal recipe for EPIDURAL dexmedetomidine use. #OBAnestwitter.com/i/web/status/1…

Use of dexmedetomidine in improving maternal experience and outcomes (2): intrathecal use during cesarean section - fast onset; prolonged duration; decreased shivering; no significant difference neonatal Apgar or hypotension/ bradycardia/ N&V (what was the trend, I wonder?) Dr… twitter.com/i/web/status/1…

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