International journal of obstetric anesthesia
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Int J Obstet Anesth · Aug 2019
Readability, content, quality and accuracy assessment of internet-based patient education materials relating to labor analgesia.
With over 90% of parturients searching the internet for health information, the quality of information is important. Web-based patient education materials (PEMs) related to labor analgesia are frequently of low readability. This study compares the readability, content, quality and accuracy of labor analgesia-related PEMs from relevant healthcare society websites and the top internet search results. ⋯ Google search results for labor analgesia lead to PEMs of variable quality and readability. For readers to be better informed, web-based PEMs should be improved or women directed to society PEMs. Inaccurate information may lead to incorrect expectations and conflict during labor, with potentially lower maternal satisfaction.
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Int J Obstet Anesth · Aug 2019
Meta AnalysisMetaraminol use during spinal anaesthesia for caesarean section: a meta-analysis of randomised controlled trials.
Metaraminol is likely superior to ephedrine for managing hypotension due to spinal anaesthesia for Caesarean section, and non-inferior to phenylephrine.
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Int J Obstet Anesth · Aug 2019
Design errors in vital sign charts used in consultant-led maternity units in the United Kingdom.
Paper-based charts remain the principal means of documenting the vital signs of hospitalised pregnant and postnatal women. However, poor chart design may contribute to both incorrect charting of data and clinical responses. We decided to identify design faults that might have an adverse clinical impact. ⋯ We recommend the urgent development of an evidence-based, standardised obstetric observation chart, which integrates 'human factors' and user experience. It should have a clear layout and style, appropriate colour scheme, correct language and labelling, and the ability for vital signs to be documented accurately and quickly. It should incorporate a suitable early warning score to guide clinical management.
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Int J Obstet Anesth · Aug 2019
Observational StudyRemifentanil patient-controlled intravenous analgesia during labour: a retrospective observational study of 10 years' experience.
Intravenous remifentanil patient-controlled analgesia (PCA) has been routinely available for labouring women in our unit since 2004, the regimen using a 40 µg bolus available two minutely on demand, continuous pulse oximetry and mandatory one-to-one care. We examined remifentanil use and compared, with the other analgesic options available in our unit, outcomes such as mode of delivery, Apgar scores, neonatal resuscitation and admission to the neonatal intensive care unit. ⋯ We found remifentanil PCA to be neither less safe nor associated with poorer outcomes than other analgesic options offered in our unit, when used within our guidelines for more than a 10-year period.