THE PROVISION of adequate anesthesia coverage for a small obstetrical service presents several difficult problems. In our hospital, with no more than 400-600 deliveries per year, the exclusive assignment of an anesthesiologist to the obstetrical service is impractical and uneconomical because only 1 to 2 deliveries per 24 hours can be expected. This means that only on-call service is feasible. In the past the usual result was that the anesthesiologist did not have the opportunity for the equivalent of a preoperative evaluation and interview, and was often forced to administer anesthesia under emergency conditions. While serious mishaps are rare, such conditions are potentially very dangerous. Abnormalities which would have significant influence on the choice of anesthetic management for a particular patient may easily be overlooked.
The lack of discussion between patient and anesthesiologist as to anesthetic management prior to the onset of labor puts both patient and anesthesiologist in a
Sheely LL, Urbach KF. Pre-Anesthetie Evaluation of Patients on a Small Obstetrical Service. JAMA. 1962;180(6):490–491. doi:10.1001/jama.1962.03050190000014
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