International journal of obstetric anesthesia
-
Int J Obstet Anesth · Nov 2024
Pain during caesarean delivery in a tertiary maternity hospital: a retrospective cohort study (2022-2023).
Intra-operative pain during Caesarean delivery (PDCD) is the leading cause of successful litigation against obstetric anaesthesiologists. PDCD may require conversion to general anaesthesia (GA). The aim of this analysis is to assess our incidence of PDCD and associated GA conversion. ⋯ PDCD occurred in 2.1% of CD, one-third required conversion to GA. Most patients experiencing PDCD met current motor and sensory blockade criteria.
-
Int J Obstet Anesth · Nov 2024
Peripartum anesthesia management and outcomes of patients with congenital heart disease: a single-center retrospective analysis (2009-2023).
Advances in medicine have enabled more patients with congenital heart disease (CHD) to become pregnant. However, these patients face significant challenges during the peripartum period. Current peripartum anesthesia guidelines for CHD patients mainly rely on case reports and small series. ⋯ In this retrospective study on the peripartum anesthetic management and outcomes of CHD patients stratified by mWHO class, cases with greater mWHO class were more likely to deliver preterm, by cesarean delivery, with a combined spinal-epidural anesthetic and an arterial line placement for that cesarean delivery. They overall had a longer hospital stay and were more likely to be admitted to the ICU. However, the overall risk of PPH did not increase with mWHO class severity.
-
Int J Obstet Anesth · Nov 2024
Upper back, neck, and shoulder pain during labor epidural analgesia: a quality improvement initiative.
Severe upper back/interscapular, neck and shoulder pain during labor epidural analgesia (PLEA) is not uncommon. The objective of this quality initiative was to evaluate the incidence, demographic associations and management of PLEA. ⋯ The incidence of PLEA was higher than previously reported. Patients with PLEA were younger, more commonly nulliparous, had higher BMI, longer epidural infusion times and higher CD rates. A three-step treatment protocol was successful in managing PLEA.