International journal of obstetric anesthesia最新文献_第5页

Retrograde intravenous cannulation: an alternative approach for blood draw for epidural blood patch 逆行静脉插管用于硬膜外血液补片

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-07-17 DOI: 10.1016/j.ijoa.2024.104231

Lim Rui Chun Sean , Jingzhi An

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Corrigendum to “Association of free maternal and fetal ropivacaine after epidural analgesia for intrapartum caesarean delivery: a prospective observational trial” [Int J Obstet Anesth. 2024;58:103975] 产后剖宫产硬膜外镇痛后母体和胎儿游离罗哌卡因的关联：一项前瞻性观察试验"[Int J Obstet Anesth.］

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-07-16 DOI: 10.1016/j.ijoa.2024.104219

J. Amian , C.F. Weber , M. Sonntagbauer , L. Messroghli , F. Louwen , H. Buxmann , A. Paulke , K. Zacharowski

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Anaesthesia for the maternal-assisted caesarean section 产妇辅助剖腹产麻醉

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-07-11 DOI: 10.1016/j.ijoa.2024.104230

P.C.F. Tan, C.J. Moran, J.D. Griffiths

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TIVA and Obstetric Anaesthesia: Hypervigilance to accidental awareness is required TIVA 和产科麻醉：需要对意外意识保持高度警惕

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-06-21 DOI: 10.1016/j.ijoa.2024.104228

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Quality of recovery and maternal satisfaction after caesarean delivery: a mixed-methods prospective cohort study 剖腹产后的恢复质量和产妇满意度：一项混合方法前瞻性队列研究

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-06-20 DOI: 10.1016/j.ijoa.2024.104227

{"title":"Quality of recovery and maternal satisfaction after caesarean delivery: a mixed-methods prospective cohort study","authors":"","doi":"10.1016/j.ijoa.2024.104227","DOIUrl":"10.1016/j.ijoa.2024.104227","url":null,"abstract":"<div><h3>Background</h3><p>Patient satisfaction and quality of recovery (QoR) are important patient-reported outcomes and quality metrics. The relationship between these two outcomes is complex, with studies showing a weak correlation between them in the non-obstetric population. We sought to evaluate the correlation between patient satisfaction and QoR scores in the obstetric population after caesarean delivery. As secondary aims, we aimed to determine the influence of urgency of procedure and mode of anaesthetic on patient satisfaction and QoR scores as well as determining drivers of satisfaction and dissatisfaction.</p></div><div><h3>Methods</h3><p>Women were invited to complete the Maternal Satisfaction Scale for Caesarean Section (MSCS) and Obstetric Quality of Recovery Score (ObsQoR-11) questionnaires at 24 h after caesarean delivery. Correlations were analysed using Spearman’s rank tests. Qualitative data were analyzed using thematic content analysis.</p></div><div><h3>Results</h3><p>Data were collected from 300 women. There was a significant but weak positive correlation between ObsQoR-11 and MSCS scores (<em>r</em> = 0.31, <em>P</em> < 0.001). Correlation was significantly influenced by mode of anaesthesia (<em>P</em> < 0.001) and urgency of procedure (<em>P</em> = 0.005), with greater satisfaction amongst patients receiving spinal anaesthesia and those undergoing scheduled caesarean deliveries for a given QoR score. Quality of communication, interactions with staff and aspects of the postpartum physical environment were significant determinants of satisfaction and dissatisfaction.</p></div><div><h3>Conclusion</h3><p>Maternal satisfaction and obstetric QoR are distinct entities with a weak correlation between the two variables. Urgency of procedure and mode of anaesthesia are significant predictors of the correlation between satisfaction and quality of recovery scores. Many of the drivers of satisfaction were modifiable including quality of communication and a comfortable physical space for postpartum recovery.</p></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141511497","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

Regarding machine translation services and patient information in minority languages 关于少数民族语言的机器翻译服务和患者信息

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-06-19 DOI: 10.1016/j.ijoa.2024.104229

引用次数: 0

Environmental sustainability in obstetric anesthesia 产科麻醉的环境可持续性

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-06-15 DOI: 10.1016/j.ijoa.2024.104216

引用次数: 0

Sacral sensory blockade from 27-gauge pencil-point dural puncture epidural analgesia or epidural analgesia in laboring nulliparous parturients: a randomized controlled trial 27 号铅笔尖硬膜外穿刺硬膜外镇痛或硬膜外镇痛对非顺产产妇的骶骨感觉阻滞：随机对照试验

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-06-14 DOI: 10.1016/j.ijoa.2024.104217

{"title":"Sacral sensory blockade from 27-gauge pencil-point dural puncture epidural analgesia or epidural analgesia in laboring nulliparous parturients: a randomized controlled trial","authors":"","doi":"10.1016/j.ijoa.2024.104217","DOIUrl":"10.1016/j.ijoa.2024.104217","url":null,"abstract":"<div><h3>Background</h3><p>The dural puncture epidural (DPE) technique has been associated with better sacral analgesia compared with a traditional epidural (EPL) technique in laboring parturients. The aim of this study was to investigate whether DPE with a 27-gauge pencil-point needle compared with a traditional EPL technique produces more rapid bilateral sacral blockade in nulliparous parturients.</p></div><div><h3>Methods</h3><p>Patients were randomized to a DPE or EPL technique. Epidural analgesia in both groups was initiated with ropivacaine 0.1% and sufentanil 0.5 μg/mL (15 mL) and maintained via programmed intermittent epidural boluses. Analgesic blockade was tested bilaterally beginning 10 min after initiation, and then at predefined intervals until delivery. The presence of an S2 blockade at 20 min was the primary outcome.</p></div><div><h3>Results</h3><p>Among 108 (54 per group) patients enrolled, bilateral sacral (S2) blockade at 20 min was significantly more common in the DPE than in the EPL group [47 (87%) vs. 23 (43%), absolute risk reduction (ARR) 44%, 95% CI 28 to 60; <em>P</em> < 0.001]. Time to a numeric pain rating scale score (0–10 scale) ≤ 3 (20 [20,30] min in both groups, HR 1.15, 95% CI 0.77 to 1.15; <em>P</em> = 0.50), number of rescue doses [0 (0, 1) vs 0 (0, 1); <em>P</em> 0.08], and presence of bilateral S2 blockade at delivery were not significantly different between groups.</p></div><div><h3>Conclusions</h3><p>The DPE technique with a 27-gauge pencil-point spinal needle more often provides bilateral sacral blockade at 20 min following block initiation compared with the EPL technique. The time to adequate analgesia and need for supplemental analgesia did not appear to differ between techniques.</p></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0959289X24002292/pdfft?md5=74e841df10f1aa9bb07b78dca509d603&pid=1-s2.0-S0959289X24002292-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141393589","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

Effect of pneumatic leg compression on phenylephrine dose for hypotension prophylaxis via variable rate infusion at cesarean delivery: an unblinded randomized controlled trial 气动腿部加压对剖宫产时通过变速输注预防低血压的苯肾上腺素剂量的影响：非盲随机对照试验

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-06-11 DOI: 10.1016/j.ijoa.2024.104218

{"title":"Effect of pneumatic leg compression on phenylephrine dose for hypotension prophylaxis via variable rate infusion at cesarean delivery: an unblinded randomized controlled trial","authors":"","doi":"10.1016/j.ijoa.2024.104218","DOIUrl":"10.1016/j.ijoa.2024.104218","url":null,"abstract":"<div><h3>Background</h3><div>Phenylephrine infusion is recommended to prevent spinal hypotension during cesarean delivery (CD) but may be associated with dose-dependent side effects. We hypothesized that adding intermittent pneumatic compression (IPC) of the lower legs to a variable-rate phenylephrine infusion will reduce the dose of phenylephrine required during CD.</div></div><div><h3>Methods</h3><div>Seventy-six healthy women undergoing elective CD under combined spinal-epidural anesthesia were randomly assigned to IPC or control groups (<em>n</em><span> = 38 per group). After spinal anesthesia, IPC of the lower legs was initiated in the IPC group, and all women received a phenylephrine infusion starting at 25 μg·min</span><sup>−1</sup> and increasing by 16.7 μg·min<sup>−1</sup> for systolic blood pressure (SAP) < 90% baseline. If hypotension (SAP < 80% baseline) occurred, 100 μg phenylephrine bolus was administered. The primary outcome was the dose of phenylephrine per minute.</div></div><div><h3>Results</h3><div>The dose of phenylephrine per minute (34.4 ± 7.3 μg·min<sup>−1</sup> vs. 40.9 ± 9.5 μg·min<sup>−1</sup>, <em>P</em> = 0.001; mean difference −6.6 μg·min<sup>−1</sup>, 95% CI −10.5 to −2.7 μg·min<sup>−1</sup>) and the incidence of hypotension (24% vs. 55%, <em>P</em> = 0.005) were lower in the IPC group than in the control group. There were no significant differences between the two groups in the total dose of phenylephrine (603.2 ± 217.1 μg vs. 706.2 ± 247.5 μg, <em>P</em> = 0.058; mean difference −102.9 μg, 95% CI −209.4 to 3.5 μg), maternal side effects, or neonatal outcomes.</div></div><div><h3>Conclusions</h3><div>Intermittent pneumatic compression combined with a variable-rate phenylephrine infusion reduced the phenylephrine dose per minute and the incidence of hypotension during CD under spinal anesthesia.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141407250","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

Programmed intermittent epidural bolus regimen vs continuous epidural infusion: a retrospective study of motor block and obstetric outcomes using the Robson’s Ten Group Classification System 程序化间歇硬膜外栓剂疗法与持续硬膜外输注：使用罗布森十组分类系统对运动阻滞和产科结果进行的回顾性研究

IF 2.6 3区医学

International journal of obstetric anesthesia Pub Date : 2024-06-06 DOI: 10.1016/j.ijoa.2024.104215

C. Joyce , R. Free , P. Calpin , I. Browne , M. Robson , R. ffrench-O’Carroll

{"title":"Programmed intermittent epidural bolus regimen vs continuous epidural infusion: a retrospective study of motor block and obstetric outcomes using the Robson’s Ten Group Classification System","authors":"C. Joyce , R. Free , P. Calpin , I. Browne , M. Robson , R. ffrench-O’Carroll","doi":"10.1016/j.ijoa.2024.104215","DOIUrl":"10.1016/j.ijoa.2024.104215","url":null,"abstract":"<div><h3>Background</h3><p>Use of a programmed intermittent epidural bolus (PIEB) regimen during labour is associated with several benefits over a continuous epidural infusion (CEI), including reduced local anaesthetic consumption and reduced risk of motor block. We hypothesise that the benefits of a PIEB regimen may vary according to the Robson Ten Group Classification System (TGCS). The aim of this study was to determine if introduction of a PIEB regimen was associated with reduced incidence of motor block. We also wished to examine changes in obstetric outcomes following PIEB introduction across the Robson TGCS.</p></div><div><h3>Methods</h3><p>This was a single-centre retrospective cohort study. Data were collected over two three-month periods before and after PIEB introduction. The primary outcome was the incidence of motor block. Maternal and obstetric outcomes across Robson Groups 1–4 were analysed.</p></div><div><h3>Results</h3><p>Introduction of PIEB was associated with reduced incidence of motor block (28.4% (95% CI 25.7% to 31.3%) vs 22.4%, (95% CI 19.9% to 25.2%), difference 5.9% (95% CI 1.0% to 21.1%), <em>P</em>=0.003), with no association with changes in rates of caesarean section, operative vaginal delivery or other obstetric outcomes. Use of a PIEB regimen was associated with reduced incidence of motor block in Robson Group 4a (20.3% (16.0%, 28.0%) vs 12.0%, (7.6%, 16.4%), difference 9.9% (95% CI −17.4% to −2.4%) <em>P</em>=0.009). There were no significant changes in other outcomes assessed across Robson TGCS.</p></div><div><h3>Conclusion</h3><p>Introduction of PIEB for maintenance of labour analgesia was associated with reduced incidence of motor block in our institution compared with CEI. Presenting results according to Robson’s TGCS in future studies may allow better elucidation of the impact of neuraxial analgesia on maternal and obstetric outcomes.</p></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141416416","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