International journal of obstetric anesthesia
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Int J Obstet Anesth · Aug 2020
ReviewNovel coronavirus SARS-CoV-2 and COVID-19. Practice recommendations for obstetric anaesthesia: what we have learned thus far.
SARS-CoV-2 is a novel coronavirus causing a global pandemic of a severe respiratory illness known as COVID-19. To date, globally, over 30,000 people have died from this emerging disease. As clinicians and healthcare systems around the world are rapidly adapting to manage patients with COVID-19, limited data are emerging from different patient populations to support best-practice and improve outcomes. In this review, we present a summary of emerging data in the obstetric population and offer obstetric and anaesthetic clinicians around the world a set of evidence-driven, practice-based recommendations for the anaesthetic management of pregnant women with suspected or confirmed COVID-19.
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Int J Obstet Anesth · May 2020
Review Meta AnalysisQuadratus lumborum block for postoperative analgesia after cesarean delivery: a systematic review and meta-analysis.
Quadratus lumborum block (QLB) can reduce pain and opioid consumption after cesarean delivery. This systematic review investigated the effectiveness of QLB in reducing postoperative opioid use and its effect on pain scores compared with other analgesic methods after cesarean delivery. ⋯ The review findings show the superior analgesic effect of QLB when compared with systemic opioids in reducing postoperative opioid consumption, when intrathecal morphine is not administered.
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Int J Obstet Anesth · May 2020
Review Meta AnalysisQuadratus lumborum block for postoperative analgesia after cesarean delivery: a systematic review and meta-analysis.
Quadratus lumborum block (QLB) can reduce pain and opioid consumption after cesarean delivery. This systematic review investigated the effectiveness of QLB in reducing postoperative opioid use and its effect on pain scores compared with other analgesic methods after cesarean delivery. ⋯ The review findings show the superior analgesic effect of QLB when compared with systemic opioids in reducing postoperative opioid consumption, when intrathecal morphine is not administered.
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Int J Obstet Anesth · May 2020
ReviewRescue supraglottic airway devices at caesarean delivery: What are the options to consider?
Tracheal intubation is considered the gold standard means of securing the airway in obstetric general anaesthesia because of the increased risk of aspiration. Obstetric failed intubation is relatively rare. Difficult airway guidelines recommend the use of a supraglottic airway device to maintain the airway and to allow rescue ventilation. ⋯ However, after failed intubation via laryngoscopy, there is a lack of specific recommendations or indications for SAGFBI in current obstetric difficult airway guidelines in relation to achieving tracheal intubation. Our narrative review explores the issues pertaining to airway management in these cases: the use of supraglottic airway devices and the techniques of, and technical issues related to, SAGFBI. We also discuss the factors involved in the decision-making process as to whether to proceed with surgery with the airway maintained only with a supraglottic airway device, or to proceed only after SAGFBI.
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Int J Obstet Anesth · May 2020
ReviewReducing post-caesarean delivery surgical site infections: a narrative review.
Surgical site infection complicates 1-10% of caesarean deliveries. With the rate of caesarean delivery increasing, it is important to identify effective measures of preventing surgical site infection and to consider their impact on maternal and neonatal outcomes. ⋯ Advances in wound dressings are an evolving area of interest and surgical technique can influence outcomes. This narrative review explores pharmacological and non-pharmacological methods of preventing surgical site infection following caesarean delivery.