International journal of obstetric anesthesia
-
Int J Obstet Anesth · May 2023
Meta AnalysisSystematic review of the effectiveness of remifentanil in term breech pregnancies undergoing external cephalic version.
External cephalic version (ECV) is a moderately painful procedure used to turn a fetus from a non-vertex to cephalic position. This systematic review and meta-analysis compared intravenous remifentanil with other analgesia or no analgesia or placebo on the success rate and associated pain of ECV. ⋯ Remifentanil increases the procedural success of ECV and reduces pain compared with placebo. Trials were at low risk of bias and contained a sufficient number of participants to have reasonable confidence in this finding.
-
Int J Obstet Anesth · May 2023
ReviewEquity in provision and access to obstetric anaesthesia care in Nigeria.
Nigeria has a high maternal mortality rate, yet there is wide variation in the proportion of births by caesarean section between zones, states, and cities within Nigeria. This review examines the pattern of the COVID-19 pandemic and the impact of mitigation measures on women's health in Nigeria. The combined impact of COVID-19 and conflicts on maternal healthcare and access to obstetric care, as well as the availability of obstetric anaesthesia in Nigeria, are discussed. There is a vicious cycle, intensified by unwanted pregnancy, abortion, and preventable maternal death.
-
Int J Obstet Anesth · May 2023
Global issues in obstetric anaesthesia: perspectives from South Africa, Japan, China, Latin America and North America.
South Africa is classified as a low- and middle-income country, with a complex mixture of resource-rich and resource-limited settings. In the major referral hospitals, the necessary skill level exists for the management of complex challenges. However, this contrasts with the frequently-inadequate skill levels of anaesthesia practitioners in resource-limited environments. ⋯ Anaesthesia workforce challenges, exacerbated by coronavirus disease 2019, beset North American healthcare. Pre-existing struggles by governments and decision-makers to improve health care access remain, partly due to unfamiliarity with the role of the anaesthesiologist. In addition to weaknesses in work environments and dated standards of work culture, the work-life balance demanded by new generations of anaesthesiologists must be acknowledged.
-
Int J Obstet Anesth · May 2023
Persistent opioid use after cesarean delivery in the United States of America: a systematic review.
This systematic review assessed the incidence of persistent opioid use after cesarean delivery in opioid-naïve individuals in the United States of America (USA). ⋯ Findings emphasize the importance of developing a standardized definition of persistent opioid use to accurately assess the risk, rate, and trends for persistent opioid use among opioid-naïve individuals undergoing cesarean delivery.