Megan Foster, Kelsey Hudson, Jessica C Ehrig, Emily E Sharpe, Michael P Hofkamp
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引用次数: 0
Abstract
Purpose: We aimed to identify the neuraxial anesthesia failure rate of de novo single-injection spinal and combined spinal-epidural anesthesia for postpartum tubal ligation at our hospital along with variables associated with neuraxial anesthesia failure.
Methods: We conducted a single-centre retrospective cohort study of patients who underwent a postpartum tubal ligation with de novo single-injection spinal or combined spinal-epidural anesthesia from 1 January 2020 to 31 December 2022 at Baylor Scott & White Medical Center-Temple (Temple, TX, USA). We defined neuraxial anesthesia failure as conversion to general anesthesia involving the use of an endotracheal tube or supraglottic airway, administration of intravenous propofol at doses > 10 mg, intravenous fentanyl > 100 µg, or the use of inhaled nitrous oxide.
Results: During the study period, 243 patients underwent postpartum tubal ligation with single-injection spinal or combined spinal-epidural anesthesia, and 28 (11.5%) had neuraxial anesthesia failure. Using a multivariate logistic regression designed to predict neuraxial anesthesia failure using variables of interest, we found that a 5-min increase in time from spinal anesthesia placement to skin incision was associated with neuraxial anesthetic failure (adjusted odds ratio [aOR], 3.10; 95% confidence interval [CI], 2.01 to 4.79; P < 0.001) along with a 5-min increase in time from skin incision to wound closure (aOR 1.35; 95% CI, 1.10 to 1.66; P = 0.004) CONCLUSION: Patients who underwent postpartum tubal ligation under single-injection spinal or combined spinal epidural anesthesia had a neuraxial failure rate of 11.5%. Time from spinal placement to skin incision and time from skin incision to wound closure were independently associated with neuraxial anesthesia failure.
期刊介绍:
The Canadian Journal of Anesthesia (the Journal) is owned by the Canadian Anesthesiologists’
Society and is published by Springer Science + Business Media, LLM (New York). From the
first year of publication in 1954, the international exposure of the Journal has broadened
considerably, with articles now received from over 50 countries. The Journal is published
monthly, and has an impact Factor (mean journal citation frequency) of 2.127 (in 2012). Article
types consist of invited editorials, reports of original investigations (clinical and basic sciences
articles), case reports/case series, review articles, systematic reviews, accredited continuing
professional development (CPD) modules, and Letters to the Editor. The editorial content,
according to the mission statement, spans the fields of anesthesia, acute and chronic pain,
perioperative medicine and critical care. In addition, the Journal publishes practice guidelines
and standards articles relevant to clinicians. Articles are published either in English or in French,
according to the language of submission.