International journal of obstetric anesthesia
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Cold sensation is often used to check neuraxial anaesthesia and analgesia. One opportunity to reduce the carbon footprint of anaesthesia is to replace vapo-coolant sprays such as ethyl chloride with a reusable device called the CoolStick, which is cooled in a refrigerator between uses. We designed a study to investigate how long the CoolStick remains at its working temperature, which we defined as <15 °C. ⋯ Our study indicates that it is feasible to use the CoolStick for providing cold sensation in clinical practice. Further study would be required to directly compare the effectiveness of the device to existing methods such as coolant sprays or ice in the clinical setting.
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Int J Obstet Anesth · Aug 2023
Comment ReviewAccidental dural puncture during epidural blood patch: a narrative review.
Whilst performing an epidural blood patch (EBP) to treat post dural-puncture headache following accidental or intentional dural puncture, the risk of a subsequent accidental dural puncture (ADP) is commonly quoted as 1%. However, a recent review reported only three documented cases. It seems likely that this complication is more common than is acknowledged, yet there is a paucity of literature and an absence of any guidance as to how to proceed in practice. ⋯ However, the limited evidence means that the risks are poorly characterised, and more data may lead to alternative conclusions. There is uncertainty amongst obstetric anaesthetists about how to manage ADP during EBP. More data and pragmatic guidance, which evolves with further evidence, will ensure optimal care for patients suffering this compound iatrogenic complication.
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Int J Obstet Anesth · Aug 2023
Obstetric anaesthesia over the next 10 years: Africa and Middle East.
Maternal and neonatal health outcomes vary within Africa and the Middle East. Despite substantial improvements over the past 20 years, there are persisting inequities in access to, and the quality of, obstetric anaesthetic care. ⋯ Improvements are being made by: improving access; increasing numbers of trained staff; delivering accessible training; gathering data; conducting research and quality improvement activities; using innovative technologies; and forming productive collaborations. Further improvements will be needed to cope with increasing demand, the impacts of climate change and potential future pandemics.
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Int J Obstet Anesth · Aug 2023
Impact of conflict and pandemic on women's health in Latin America: implementation to improve equity in the provision and access to safe obstetric anesthesia.
Latin America is one of the regions with the most significant inequalities in women's health as a result of factors such as social disparity, lack of work opportunities, unemployment, violence, and corruption. Adding a health crisis like the COVID-19 pandemic to these elements created a perfect storm that perpetuated extreme inequalities. ⋯ Several initiatives to allow better access and to provide safe anesthesia to pregnant patients have been taken in the region to improve obstetric patient care during the pandemic and beyond. Education has been pivotal and one of the most essential tools in bridging the gap in inequalities between men and women.