International journal of obstetric anesthesia
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Int J Obstet Anesth · May 2019
Observational StudyDetermination of ChloraPrep® drying time before neuraxial anesthesia in elective cesarean delivery. A prospective observational study.
ChloraPrep® is a skin antiseptic commonly used before neuraxial anesthesia. It is believed that skin must be allowed to dry to prevent nerve damage by seeding ChloraPrep® solution into the neuraxis. We aimed to determine ChloraPrep® drying time in pregnant women before initiation of neuraxial anesthesia. ⋯ Our results suggest that ChloraPrep® drying time may be longer than the current manufacturer-recommended guideline of three minutes. The amount of ChloraPrep® used, application methods, patient characteristics, and environmental factors could influence the drying time.
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Int J Obstet Anesth · May 2019
Observational StudyObservational study evaluating obstetric anesthesiologist residents' wellbeing, anxiety and stress in a North American academic program.
The obstetric work environment has a unique set of stressors that may be associated with burnout. We investigated how well-being during the obstetric anesthesia (ObA) rotation compared to other rotations; which workplace environment characteristics precipitated the greatest stress; and whether anxiety and stress levels changed in trainees before and after an ObA rotation. ⋯ We provide the first example of tools for assessing work environment stressors in ObA. Our study illustrates that beyond excessive workload, lack of fairness and community values are areas that impact physician well-being. Use of these tools can guide initiatives to address work environment concerns, and presents a need for a validated well-being instrument to gauge physician well-being, in order to create a cultural shift from burnout to one of well-being.
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Int J Obstet Anesth · May 2019
ReviewTreatment of obstetric post-dural puncture headache. Part 2: epidural blood patch.
The 2009-12 MBRRACE-UK report highlighted the deaths of two women in whom dural puncture had occurred during insertion of a labour epidural catheter. Despite suffering long-term headaches, neither woman was adequately followed-up after discharge from hospital. ⋯ These guidelines have been condensed into two review articles. In this second review, the role of an epidural blood patch is discussed using a question and answer format.
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Int J Obstet Anesth · May 2019
Letter Randomized Controlled TrialIn vitro intravenous fluid co-load rates with and without an intravenous fluid warming device.
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The Gerard W. Ostheimer lecture is delivered every year at the annual meeting of the Society for Obstetric Anesthesia and Perinatology. The lecture aims to provide the anesthesiologist who provides obstetric anesthesia care with a review of the most relevant articles that were published in the preceding calendar year. This article highlights the literature published in 2017 related to maternal mortality, maternal cardiac arrest, cesarean delivery and labor analgesia.