International journal of obstetric anesthesia
-
Int J Obstet Anesth · Jan 2025
Investigating disparity in labor epidural analgesia management in black vs. white women: a retrospective case-control study (2018-2022).
Disparities in labor epidural analgesia (LEA) management could reduce maternal satisfaction and increase risk. We compared times from the first administration of breakthrough pain medication (top-up) to LEA replacement to evaluate disparities across race. ⋯ We didn't detect disparity in treatment at our institution with standardized LEA management protocols. However, Black women and those with LEA replacements were less satisfied. Future studies should evaluate the generalizability and explore interventions that improve patient satisfaction.
-
Int J Obstet Anesth · Dec 2024
Case ReportsSpinal anesthesia for cesarean delivery in a laboring patient with known cranial arachnoid cyst: a case report.
Arachnoid cysts are fluid-filled cavities that are usually asymptomatic and do not require surgical intervention. However, there are concerns and limited literature on the safety of neuraxial procedure in obstetric patients with cranial arachnoid cysts. ⋯ After a multidisciplinary discussion, it was concluded that neuraxial labor anesthesia and labor would be appropriate. Ultimately, the patient received spinal anesthesia for cesarean delivery for fetal intolerance to labor.
-
Int J Obstet Anesth · Dec 2024
Novel bimanual haptic simulator for epidural loss-of-resistance detection: a pilot study assessing movement strategies and performance across anesthesiologist experience levels.
Correct identification of the epidural space requires extensive training for technical proficiency. This study explores a novel bimanual haptic simulator designed for the precise insertion of an epidural needle based on loss-of-resistance (LOR) detection, providing realistic dual-hand force feedback. ⋯ The innovative bimanual haptic simulator shows significant potential as a tool for assessing epidural skills and differentiating expertise levels. Its ability to provide realistic, concurrent feedback for both hands, adapt to patient anatomical variations, and generate precise metrics for performance evaluation distinguishes it from existing simulators. However, further research is necessary to establish its value as a training tool. Planned studies will focus on developing an effective training protocol and evaluating the long-term educational impact of the simulator, determining whether its integration into residency programs can improve patient outcomes.