Assessment of sensory block during labour epidural analgesia: a prospective cohort study to determine the influence of the direction of testing.

IF 0.7 2区历史学 0 CLASSICS

CLASSICAL PHILOLOGY Pub Date : 2022-06-01 Epub Date: 2022-03-14 DOI:10.1007/s12630-022-02228-x

Eliane Cristina de Souza Soares, Mrinalini Balki, Kristi Downey, Xiang Y Ye, Jose Carlos A Carvalho

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引用次数: 1

Abstract

Purpose: Assessment of sensory block level during labour epidural analgesia is an essential component of clinical practice and patient safety. Nevertheless, the methods and direction of testing are not standardized. In our hospital, sensory block testing to ice is routinely used, but while some anesthesiologists test the block from a nonanesthetized to an anesthetized area, some do it in the opposite direction. It is unknown how these two different practices affect identification of the sensory block level. The objective of this study was to determine the agreement between these two practices.

Methods: We enrolled 31 patients admitted to the labour and delivery unit in a prospective cohort study. At their request, labour epidural analgesia was performed as per institutional routine. Sensory block level to ice was assessed using opposite directions by two randomly assigned independent investigators, one and two hours after the loading dose was administered.

Results: Sensory block levels to ice assessed from an anesthetized area to a nonanesthetized area were lower than those when assessed with the stimulus applied in the opposite direction, typically one segment lower.

Discussion: Given the small difference detected with both methods, it may be acceptable to use either in clinical practice. Nevertheless, the lack of standardization may have a significant impact when comparing studies involving assessment of sensory block to ice.

Study registration: www.

Clinicaltrials: gov (NCT03572439); registered 28 June 2018.

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分娩硬膜外镇痛期间的感觉阻滞评估：一项前瞻性队列研究，旨在确定测试方向的影响。

目的：评估分娩硬膜外镇痛期间的感觉阻滞水平是临床实践和患者安全的重要组成部分。然而，测试的方法和方向并不统一。在我们医院，对冰区进行感觉阻滞测试是常规做法，但有些麻醉师会从非麻醉区对麻醉区进行阻滞测试，有些则反方向进行测试。目前还不清楚这两种不同的做法会如何影响感觉阻滞水平的识别。本研究的目的是确定这两种做法之间的一致性：我们在一项前瞻性队列研究中招募了 31 名入住分娩室的患者。在他们的要求下，我们按照医院的常规进行了分娩硬膜外镇痛。由两名随机分配的独立调查人员在给药一小时和两小时后，用相反的方向对冰感阻滞水平进行评估：结果：从麻醉区域到非麻醉区域的冰感阻滞水平低于反方向刺激时的冰感阻滞水平，通常低一个区段：讨论：鉴于两种方法检测出的差异较小，在临床实践中使用其中任何一种方法都是可以接受的。尽管如此，在比较涉及对冰的感觉阻滞评估的研究时，缺乏标准化可能会产生重大影响。研究注册：www.Clinicaltrials: gov (NCT03572439)；注册时间：2018年6月28日。

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

CLASSICAL PHILOLOGY CLASSICS-

CiteScore

0.70

自引率

0.00%

发文量

期刊介绍： Classical Philology has been an internationally respected journal for the study of the life, languages, and thought of the Ancient Greek and Roman world since 1906. CP covers a broad range of topics from a variety of interpretative points of view. CP welcomes both longer articles and short notes or discussions that make a significant contribution to the study of Greek and Roman antiquity. Any field of classical studies may be treated, separately or in relation to other disciplines, ancient or modern. In particular, we invite studies that illuminate aspects of the languages, literatures, history, art, philosophy, social life, and religion of ancient Greece and Rome. Innovative approaches and originality are encouraged as a necessary part of good scholarship.