Biomedical subjects
Publications and source records attributed to I M Browne.
A 43-year-old woman with a history of lidocaine allergy required dermatologic surgery during pregnancy. To accomplish this without the use of general anesthesia, intradermal allergy testing was performed. This information enabled appropriate anesthetic care for a tissue biopsy at 29 weeks' gestation and subsequent labor analgesia and obstetric management at term.
Illicit drugs are widely used by inner city patients and their use by pregnant women has increased in recent years. The aim of this study was to determine the prevalence of polysubstance abuse among parturients at our institution who received no prenatal care ('unbooked') and to determine the accuracy of the Ontrak TesTcup an in vitro immunodiagnostic assay. We prospectively analysed urine from 50 'unbooked' parturients and found that 26 (52%) tested positive for cocaine. Of these, six patients (23%) were also positive for morphine. All TesTcup results were confirmed by the hospital laboratory using alternate chemical methods. When comparing TesTcup to the hospital laboratory, there were no false positive or negative results. Given the high frequency of concomitant opioid abuse in cocaine-abusing parturients, anyone suspected of cocaine abuse should be tested for other illicit substances. TesTcup is a clinically accurate test that allows the rapid assessment of several drugs of abuse, which may impact on anaesthetic care.
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