Failure of neuraxial anesthesia for postpartum tubal ligation: a single-centre retrospective cohort study.

IF 3.4 3区 医学 Q1 ANESTHESIOLOGY
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.

产后输卵管结扎的轴向麻醉失败:单中心回顾性队列研究。
目的:了解我院产后输卵管结扎手术中单次脊髓及脊髓硬膜外联合麻醉的神经轴麻醉失败率及与神经轴麻醉失败相关的变量。方法:我们对2020年1月1日至2022年12月31日在Baylor Scott & White医学中心-Temple (Temple, TX, USA)接受产后输卵管结扎手术的患者进行了一项单中心回顾性队列研究。我们将轴向麻醉失败定义为向全身麻醉的转变,包括使用气管内插管或声门上气道,静脉注射异丙酚(剂量>0 mg),静脉注射芬太尼(剂量> 100µg),或吸入一氧化二氮。结果:243例产后输卵管结扎患者采用单针脊髓麻醉或脊髓硬膜外联合麻醉,28例(11.5%)出现神经轴向麻醉失败。使用多变量逻辑回归预测神经轴麻醉失败,我们发现从脊髓麻醉放置到皮肤切开时间增加5分钟与神经轴麻醉失败相关(调整优势比[aOR], 3.10;95%置信区间[CI], 2.01 ~ 4.79;P
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.50
自引率
7.10%
发文量
161
审稿时长
6-12 weeks
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.
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