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April 29, 2011

Obstetric Anesthesia is launched!



Welcome to the Obstetric Anesthesia website. This website will contain a broad range of content covering the basic principles of obstetric anesthesia, current research in obstetric anesthesia and how it guides practice at Mount Sinai Hospital, focused presentations on special issues in obstetric anesthesia, and the use of ultrasound in obstetric anesthesia. It will also contain Virtual Patient cases allowing users to exercise their clinical reasoning skills in diagnosing and treating problems in obstetric anesthesia.

The website is being launched with five topics related to the use of ultrasound in obstetric anesthesia. As additional content is developed for other sections of this site, these five chapters will be organized in a section labeled "Ultrasound".


In recent years, the use of ultrasound has gained popularity for patient management in many areas of medicine, particularly in emergency rooms and intensive care units. It has, in fact, become an essential tool in these settings.

In addition, it has gradually been introduced in anesthesia for central vascular access and peripheral nerve blocks. It is no exaggeration to say that ultrasound has redefined the way we practice regional anesthesia today.

As anesthesiologists have become more and more familiar with this new technology, new horizons have opened up very quickly. Ultrasound has been used for peripheral vascular access, assessment of bladder and stomach contents, fascial blocks, and even airway assessment.

Some of the mysteries of the spine have been unveiled as we have learned to see more and more, even through unfavourable acoustic windows. We are at the point now where epidural and spinal techniques no longer have to be performed blindly.

The untapped potential of ultrasound in the hands of the obstetric anaesthesiologist is phenomenal, and we are just starting to explore it. Ultrasound is a fantastic resource for patient management, as well as an outstanding teaching tool, and it introduces a new method for the investigation of technique, pharmacology and physiology. An ultrasound machine should be standard equipment in all labour and delivery units, to be shared by obstetricians, nurses and anesthesiologists. Hopefully this will happen in the near future.

The ultrasound 'tool kit' is here to stay, and clinicians need to adopt this technology in order to make the best use of it. The learning curves for different applications vary considerably, and require patience and persistence from the learners, as well as dedication and clear strategies from the teachers and mentors.

We encourage you to embrace the technique, train your eyes and fine tune your hand-eye coordination. We hope that by the time you finish exploring the material on this website, you will have gained the necessary information to continue on your own. Ultrasound requires patience, dedication and daily practice.

We are looking forward to sharing our experiences with you!


Jose CA Carvalho, MD, PhD