International journal of obstetric anesthesia最新文献_第3页

Upper back, neck, and shoulder pain during labor epidural analgesia: a quality improvement initiative 分娩硬膜外镇痛期间的上背部、颈部和肩部疼痛：质量改进倡议

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-08-22 DOI: 10.1016/j.ijoa.2024.104255

R. Achu-Lopes , L.C. Tsen , G. Ovsak , N.A. Raheel , M.K. Farber , A. Maeda

{"title":"Upper back, neck, and shoulder pain during labor epidural analgesia: a quality improvement initiative","authors":"R. Achu-Lopes , L.C. Tsen , G. Ovsak , N.A. Raheel , M.K. Farber , A. Maeda","doi":"10.1016/j.ijoa.2024.104255","DOIUrl":"10.1016/j.ijoa.2024.104255","url":null,"abstract":"<div><h3>Background</h3><p>Severe upper back/interscapular, neck and shoulder pain during labor epidural analgesia (PLEA) is not uncommon. The objective of this quality initiative was to evaluate the incidence, demographic associations and management of PLEA.</p></div><div><h3>Methods</h3><p>An eight-month, single-center quality improvement initiative was performed for the detection and management of PLEA. After survey-based consensus among obstetric anaesthetist attendings and fellows, a three-step PLEA treatment protocol with interventions and numeric rating scale (NRS, 0 – 10 scale) pain assessments was introduced. Demographic data and outcomes were compared among parturients with and without PLEA.</p></div><div><h3>Results</h3><p>Among 2888 women who received labor epidural analgesia from October 2022 through May 2023, 36 (1.2% [95% CI 0.9% to 1.7%]) reported PLEA. Women with PLEA were younger, more likely to be nulliparous, and had a higher body mass index (BMI) than women without PLEA (p < 0.05 for all). A total of 72.2% (26/36) of women with PLEA received at least one protocol treatment. Twenty-three women received first-line therapy, with pain relief in 91.3% (21/23). The median NRS score decreased from 9 [IQR 8–10] to 3 [1–4]. Women with PLEA had a higher incidence of cesarean delivery (CD) and a longer interval between epidural placement and delivery; 52.8 vs. 17.5% (p < 0.001) and 16.5 vs. 6.9 hours (p < 0.001), respectively.</p></div><div><h3>Conclusions</h3><p>The incidence of PLEA was higher than previously reported. Patients with PLEA were younger, more commonly nulliparous, had higher BMI, longer epidural infusion times and higher CD rates. A three-step treatment protocol was successful in managing PLEA.</p></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0959289X2400267X/pdfft?md5=fcf67ff95adae35953c3cfbec520e257&pid=1-s2.0-S0959289X2400267X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Obstetric anesthesia management of dilated cardiomyopathies and heart failure: a narrative review 扩张型心肌病和心力衰竭的产科麻醉管理：综述

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-08-14 DOI: 10.1016/j.ijoa.2024.104251

M.L. Meng , J. Schroder , K. Lindley

引用次数: 0

Anaesthesia considerations for assisted reproductive technology: a focused review 辅助生殖技术的麻醉注意事项：重点回顾。

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-08-08 DOI: 10.1016/j.ijoa.2024.104248

M. Egan , L. Schaler , D. Crosby , R. ffrench-O’Carroll

引用次数: 0

Extracorporeal membrane oxygenation (ECMO) in pregnancy and peripartum: a focused review 妊娠和围产期体外膜肺氧合（ECMO）：重点综述。

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-08-08 DOI: 10.1016/j.ijoa.2024.104247

Emily E. Naoum , Erika R. O’Neil , Amir A. Shamshirsaz

引用次数: 0

Neuraxial labor analgesia in a parturient with carnitine palmitoyl transferase type II deficiency: a case report 肉碱棕榈酰转移酶 II 型缺乏症产妇的神经镇痛：病例报告。

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-08-08 DOI: 10.1016/j.ijoa.2024.104246

T.K. Bowman, A. Oweidat, N. El Hage Chehade, M. Cheriyan, S. Ayad, M. Hoyt

引用次数: 0

Large language models for overcoming language barriers in obstetric anaesthesia: a structured assessment 克服产科麻醉语言障碍的大型语言模型：结构化评估。

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-08-08 DOI: 10.1016/j.ijoa.2024.104249

A. Lomas , M.A Broom

引用次数: 0

Sensorineural hearing loss and intravascular injection of local anesthetic inducing tinnitus: a case report 感音神经性听力损失与血管内注射局麻药诱发耳鸣：病例报告

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-08-08 DOI: 10.1016/j.ijoa.2024.104250

J. Schindler, B. Biney

引用次数: 0

P6 acupressure versus sham acupressure for prevention of intraoperative nausea and vomiting during cesarean delivery under neuraxial anesthesia: a randomized controlled trial P6 穴位按摩与假穴位按摩预防神经麻醉下剖宫产术中恶心和呕吐：随机对照试验

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-08-06 DOI: 10.1016/j.ijoa.2024.104242

S.K. Woodward , E.H. McCrory , K.E. Neumann , S.F. Lu , R.J. McCarthy , F.M. Peralta

{"title":"P6 acupressure versus sham acupressure for prevention of intraoperative nausea and vomiting during cesarean delivery under neuraxial anesthesia: a randomized controlled trial","authors":"S.K. Woodward , E.H. McCrory , K.E. Neumann , S.F. Lu , R.J. McCarthy , F.M. Peralta","doi":"10.1016/j.ijoa.2024.104242","DOIUrl":"10.1016/j.ijoa.2024.104242","url":null,"abstract":"<div><h3>Introduction</h3><div>Intraoperative and postoperative nausea and vomiting (IONV and PONV) are common during cesarean delivery (CD) with neuraxial anesthesia. Limited information exists on the antiemetic benefit of combined P6 acupoint stimulation with acupressure (P6 acupressure) and pharmacologic antiemetics on preventing IONV and PONV after CD. This study assessed the antiemetic efficacy of P6 acupressure compared to a non-P6 acupoint stimulation with acupressure (sham acupressure) in preventing IONV during CD.</div></div><div><h3>Methods</h3><div>We performed a randomized double-blinded trial comparing the efficacy of intraprocedural P6 acupressure versus sham acupressure in preventing IONV during CD after following the Society for Obstetric Anesthesia and Perinatology enhanced recovery recommendations. Subjects were instructed to apply additional pressure at the acupressure sites when they perceived nausea. The primary outcome was the incidence of IONV, and the secondary outcome was the need for rescue antiemetic treatment.</div></div><div><h3>Results</h3><div>Ninety-nine P6 acupressure and 100 sham acupressure subjects were studied. There was no difference in the incidence of intraoperative nausea (67%), vomiting (17%), emesis episodes, or the need for rescue antiemetics intraoperatively. There were also no differences in the incidence of PONV and antiemetic treatment from PACU to discharge. At discharge, 70% of respondents reported experiencing nausea, but only 10% reported it affected self-care. Approximately 50% of the patients in both groups were satisfied with acupressure therapy.</div></div><div><h3>Conclusion</h3><div>P6 acupressure did not reduce the incidence of IONV or PONV when combined with antiemetic therapy per enhanced recovery recommendations. There does not appear to be sufficient evidence to support using P6 acupressure for IONV prevention.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141940825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development of the obstetric unanticipated difficult video-laryngoscopy algorithm through a quality improvement randomized open-label in situ simulation study 通过质量改进随机开放标签原位模拟研究开发产科意外困难视频喉镜检查算法

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-08-02 DOI: 10.1016/j.ijoa.2024.104245

S. Maxwell, B. Rajala, S.A. Schechtman, J.A. Kountanis, S. Singh, T.T. Klumpner, R. Cassidy, L. Zisblatt, D.W. Healy, M. Engoren, J.M. Cooke, C. Pancaro

{"title":"Development of the obstetric unanticipated difficult video-laryngoscopy algorithm through a quality improvement randomized open-label in situ simulation study","authors":"S. Maxwell, B. Rajala, S.A. Schechtman, J.A. Kountanis, S. Singh, T.T. Klumpner, R. Cassidy, L. Zisblatt, D.W. Healy, M. Engoren, J.M. Cooke, C. Pancaro","doi":"10.1016/j.ijoa.2024.104245","DOIUrl":"10.1016/j.ijoa.2024.104245","url":null,"abstract":"<div><h3>Background</h3><p>Video-laryngoscopy is increasingly used during general anesthesia for emergency cesarean deliveries. Given the heightened risk of difficult tracheal intubation in obstetrics, addressing challenges in airway management is crucial. In this simulation study, we hypothesized that using a flexible bronchoscope would lead to securing the airway faster than the Eschmann introducer when either device is used in addition to video-laryngoscopy.</p></div><div><h3>Methods</h3><p>Twenty-eight anesthesia trainees (n=14/group) were randomized to use either one of the rescue devices and video-recorded in a simulated scenario of emergency cesarean delivery. The primary outcome was the time difference in establishing intubation; secondary outcomes were the differences in incidence of hypoxemia, need for bag and mask ventilation, and failed intubation between the two rescue devices.</p></div><div><h3>Results</h3><p>Mean (±SD) time to intubation using flexible bronchoscopy was shorter compared to using an Eschmann introducer (24 ± 10 <em>vs</em> 86 ± 35 s; <em>P</em><0.0001; difference in mean 62 seconds, 95% CI 42 to 82 seconds). In the fiberoptic bronchoscopy group, there were no episodes of hypoxemia or need for bag and mask ventilation; in contrast both such events occurred frequently in the Eschmann introducer group (71%, 10/14); <em>P</em>=0.0002). All flexible bronchoscopy-aided intubations were established on the first attempt. The incidence of failed intubation was similar in both groups.</p></div><div><h3>Conclusions</h3><p>Our data from simulated emergency tracheal intubation suggest that flexible bronchoscopy combined with video-laryngoscopy results in faster intubation time than using an Eschmann introducer combined with video-laryngoscopy.</p></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141969180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Peripartum management of cardiac arrhythmias: a narrative review 心律失常的围产期管理

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-08-02 DOI: 10.1016/j.ijoa.2024.104243

Andrew K. Hallmark , Kathryn J. Lindley , Jennifer M. Banayan

引用次数: 0