International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2018
Incidence and risk factors for chronic pain after elective caesarean delivery under spinal anaesthesia in a Chinese cohort: a prospective study.
China has one of the highest rates of caesarean delivery in the world. The aim of this study was to investigate the incidence and risk factors for chronic pain after caesarean delivery in a Chinese cohort. ⋯ Chronic pain after elective caesarean delivery under spinal anaesthesia occurs infrequently, especially in the long-term, in a Chinese population. Patients with a previous caesarean delivery and higher analgesic use were at increased risk.
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Int J Obstet Anesth · May 2018
Comparative StudyComparison of rocuronium-induced neuromuscular blockade in second trimester pregnant women and non-pregnant women.
This study set out to compare the onset and duration of rocuronium-induced neuromuscular blockade in second trimester pregnant women and non-pregnant women receiving general anesthesia. ⋯ Our data showed that the rocuronium-induced neuromuscular blockade did not significantly differ in onset but lasted significantly longer in second trimester pregnant women compared with non-pregnant women.
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Int J Obstet Anesth · May 2018
Observational StudyUltrasonographic evaluation of gastric contents in term pregnant women fasted for six hours.
Current fasting guidelines suggest six hours are adequate to minimise the aspiration risk after a light meal consumed by pregnant women undergoing elective caesarean section. We assessed gastric contents in non-labouring pregnant women, using ultrasonographic analysis. ⋯ Our cohort of pregnant women fasted for six hours had no solid food visible in the antrum, but many had both qualitative and quantitative ultrasonographic evidence of gastric volumes potentially associated with aspiration risk. This suggests that pregnancy-specific fasting guidelines may be required.
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Int J Obstet Anesth · May 2018
Case ReportsDexmedetomidine, high-flow nasal oxygen and sugammadex-reversal of rocuronium: overcoming anaesthetic challenges in a parturient with congenital muscular dystrophy presenting for caesarean section.
Congenital muscular dystrophies are characterised by progressive skeletal muscle weakness from birth or early infancy. Maternal respiratory compromise, joint contractures and presence of spinal instrumentation or fusion are some of the anaesthetic challenges that may be encountered in the obstetric setting. ⋯ Multidisciplinary involvement is paramount to optimise peripartum care and outcomes. In this case report, we present the use of dexmedetomidine, humidified high-flow nasal oxygen, rocuronium and sugammadex in the anaesthetic management of a wheelchair-bound, non-invasive bilevel positive airway pressure ventilation-dependent parturient with congenital muscular dystrophy, who was presenting for caesarean section.
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Int J Obstet Anesth · May 2018
A retrospective analysis of factors associated with anesthetic case duration for cesarean deliveries.
Accurately predicting cesarean delivery case duration is an integral component of designing appropriate workflow protocols and ensuring adequate provider availability. Our primary objective was to describe the variability of case duration, based on factors that we hypothesized would be influential, such as hospital facility type, United States region, time of day, case volume, and patient and provider characteristics. ⋯ This study analyzed national cesarean delivery data and determined factors associated with cesarean delivery duration. We showed that case durations varied in meaningful ways according to facility type, United States region, presence of a Certified Registered Nurse Anesthetist, and anesthesia type. Our work contributes to a small but growing body of research on optimal staffing models for anesthesia practices.