Salbutamol, obstetrics and anaesthesia: a review and case discussion

Salbutamol and related beta-2 sympathomimetic drugs have been used in Australia recently for the inhibition of premature labour and also to prevent uterine activity in acute foetal emergencies during labour. General anaesthesia in these situations presents the anaesthetist with a number of pharmacological difficulties, which can have profound effects on both mother and neonate. The use of beta-blockers to correct the cardiovascular and metabolic instability is discussed and recommendations are made for their use in association with anaesthesia for operative delivery. Ante-natal beta-blockade of mother may increase the morbidity and possibly the mortality of an already at risk pre-term neonate. The case report illustrates some of the hazards associated with salbutamol, obstetrics and anaesthesia.