International journal of obstetric anesthesia
-
The past two decades has seen a growing understanding that health care leads to harm in a large number of patients. With this insight has come an understanding that clinicians who care for patients who are harmed experience an understandable and predictable emotional response. After an adverse event, medical care givers may experience a wide range of symptoms including anger, guilt, shame, fear, loneliness, frustration and decreased job satisfaction. ⋯ Care might be as simple as asking, "Are you OK?" and acknowledging the normal human emotional response to adverse events. Some centers have developed formal peer support programs in which clinicians are trained to act as peer supporter for emotional recovery after adverse events. Finally, more formal emotional support systems might be needed by some clinicians, including employee assistance programs, hospital clergy or psychological and psychiatric services.
-
Int J Obstet Anesth · Feb 2015
Letter Randomized Controlled TrialRoutine cell salvage during elective caesarean section: a pilot randomised trial.
-
Int J Obstet Anesth · Feb 2015
Observational StudyAssessing the incidence of peripartum subclinical myocardial ischemia using the troponin T assay: an observational pilot study.
Cardiac disease is the leading cause of maternal death. Non-fatal ischemic events may go unnoted during the time of delivery. The aim of this study was to assess the incidence of subclinical myocardial ischemia amongst parturients, as evidenced by a raised troponin assay in the postpartum period. ⋯ This study found that 4% of women had elevated postpartum troponin assays, within levels in the range suggestive of myocardial damage. However, we were unable to ascertain how to identify this group of women prospectively. At this time, we recommend a low threshold for investigation should be maintained.
-
Int J Obstet Anesth · Feb 2015
Observational StudyThe effect of intra-abdominal pressure on sensory block level of single-shot spinal anesthesia for cesarean section: an observational study.
Increased intra-abdominal pressure in pregnancy is thought to affect intrathecal drug spread. However this assumption remains largely untested. The aim of this prospective study was to evaluate the association between intra-abdominal pressure and maximum sensory block level in parturients receiving spinal anesthesia for cesarean section. ⋯ In parturients, intra-abdominal pressure was not associated with spinal block spread, block onset time, recovery or side effects.