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Reasons given for not using patient-controlled epidural analgesia include cost, clinician preference, safety concerns and the inconvenience of change. Despite the potential advantages of patient-controlled epidural analgesia over continuous epidural infusions for labor analgesia, patient-controlled epidural analgesia has not been widely adopted in California hospitals. Education regarding this technique is needed to encourage its increased use. Obstetric hemorrhage is a leading cause of maternal mortality. We describe the anesthetic management of elective cesarean delivery in patients at high risk for hemorrhage. The utility and limitations of intraarterial balloon catheter placement and epidural anesthesia are described.

Daugherty, Metropolis Symphony, Deus Ex Machina Mark Donahue, John Hill amp; Dirk Sobotka, engineers Have You Ever Been. Billboard Hot 100 ‚ The Billboard Hot 100 is the music industry standard record chart in the United States for singles, published weekly by Billboard magazine.]