International journal of obstetric anesthesia最新文献

英文中文

Artificial intelligence-created personal statements compared with applicant-written personal statements: a survey of obstetric anesthesia fellowship program directors in the United States 人工智能创建的个人陈述与申请人撰写的个人陈述比较：对美国产科麻醉研究金项目主任的调查

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-11-15 DOI: 10.1016/j.ijoa.2024.104293

A.M. Ruiz , M.B. Kraus , K.W. Arendt , D.R. Schroeder , E.E. Sharpe

Background

A personal statement is a common requirement in medical residency and fellowship applications. Generative artificial intelligence may be used to create a personal statement for these applications.

Methods

Two personal statements were created using OpenAI’s Chat Generative Pre-trained Transformer (ChatGPT) and two applicant-written statements were collected. A survey was sent to obstetric anesthesia fellowship program directors in the United States to assess the perceived readability, authenticity, and originality of the four personal statements. In addition, the survey assessed perceptions of applicants who use artificial intelligence to write a personal statement, including their integrity, work ethic, reliability, intelligence, and English proficiency.

Results

Surveyed fellowship directors could not accurately discern whether statements were applicant-written or artificial intelligence-generated. The artificial intelligence-generated personal statements were rated as more readable and original than the applicant-written statements. Most program directors were moderately or extremely concerned about the applicant’s integrity, work ethic, and reliability if they suspected the applicant utilized ChatGPT.

Conclusions

Program directors could not accurately discern if the statements were written by a person or artificial intelligence and would have concerns about an applicant suspected of using artificial intelligence. Medical training programs may benefit from outlining their expectations regarding applicants’ use of artificial intelligence.

背景个人陈述是医学住院医师和研究员申请中的一项常见要求。方法使用 OpenAI 的 Chat Generative Pre-trained Transformer (ChatGPT) 创建了两份个人陈述，并收集了两份申请人撰写的陈述。我们向美国的产科麻醉奖学金项目主任发送了一份调查问卷，以评估这四份个人陈述的可读性、真实性和原创性。此外，调查还评估了对使用人工智能撰写个人陈述的申请人的看法，包括他们的诚信度、职业道德、可靠性、智力和英语水平。与申请人撰写的个人陈述相比，人工智能生成的个人陈述被评为更具可读性和原创性。如果怀疑申请人使用了 ChatGPT，大多数项目主任会对申请人的诚信、职业道德和可靠性表示中度或高度关注。医学培训项目可能会受益于对申请人使用人工智能的期望。

{"title":"Artificial intelligence-created personal statements compared with applicant-written personal statements: a survey of obstetric anesthesia fellowship program directors in the United States","authors":"A.M. Ruiz , M.B. Kraus , K.W. Arendt , D.R. Schroeder , E.E. Sharpe","doi":"10.1016/j.ijoa.2024.104293","DOIUrl":"10.1016/j.ijoa.2024.104293","url":null,"abstract":"<div><h3>Background</h3><div>A personal statement is a common requirement in medical residency and fellowship applications. Generative artificial intelligence may be used to create a personal statement for these applications.</div></div><div><h3>Methods</h3><div>Two personal statements were created using OpenAI’s Chat Generative Pre-trained Transformer (ChatGPT) and two applicant-written statements were collected. A survey was sent to obstetric anesthesia fellowship program directors in the United States to assess the perceived readability, authenticity, and originality of the four personal statements. In addition, the survey assessed perceptions of applicants who use artificial intelligence to write a personal statement, including their integrity, work ethic, reliability, intelligence, and English proficiency.</div></div><div><h3>Results</h3><div>Surveyed fellowship directors could not accurately discern whether statements were applicant-written or artificial intelligence-generated. The artificial intelligence-generated personal statements were rated as more readable and original than the applicant-written statements. Most program directors were moderately or extremely concerned about the applicant’s integrity, work ethic, and reliability if they suspected the applicant utilized ChatGPT.</div></div><div><h3>Conclusions</h3><div>Program directors could not accurately discern if the statements were written by a person or artificial intelligence and would have concerns about an applicant suspected of using artificial intelligence. Medical training programs may benefit from outlining their expectations regarding applicants’ use of artificial intelligence.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"61 ","pages":"Article 104293"},"PeriodicalIF":2.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development and validation of a German version of Obstetric Quality of Recovery-10 (ObsQoR10-German)

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-11-14 DOI: 10.1016/j.ijoa.2024.104292

R. Fantin , C. Hütter , P. Lichtenberger , N. Guo , C. Ortner , P. Sultan

引用次数: 0

Patients’ perspectives on pain relief during childbirth and labor epidurals: A pilot qualitative study among women who chose to deliver without neuraxial labor analgesia 患者对分娩镇痛和分娩镇痛的看法：一项针对选择不使用神经镇痛分娩的产妇的试点定性研究。

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-11-14 DOI: 10.1016/j.ijoa.2024.104294

E.R. Weinstein , J. Aaronson , S.E. Abramovitz , D. McCullough , R. Gotian , R.S. White

Background

Studies have identified widespread variation in neuraxial labor analgesia use by race, ethnicity, and geographic location. However, limited research has investigated patient-level factors in the decision not to use neuraxial analgesia for labor.

Methods

We conducted semi-structured interviews at a New York City medical center from October 1, 2022, to May 30, 2023. Participants had delivered vaginally and selected not to receive neuraxial labor analgesia. Structured demographic questions were asked after interview completion. Interviews were recorded and transcribed verbatim. We analyzed data and grouped responses into themes according to grounded theory.

Results

We identified five themes encompassing the main factors participants had considered when deciding not to receive neuraxial analgesia for birth: preferences for a natural birth experience, an empowering and supportive labor environment, preparation or preparedness for birth without medication, positive outlook on labor pain, and information, misinformation, knowledge gaps and fears about the epidural. All study participants mentioned these overarching themes in their interviews.

Conclusions

Participants described various factors important in their decision to give birth without an epidural, which we mapped onto five primary themes. Our results can be used to guide effective patient-provider interactions centered on mutual understanding, evidence-based medicine, and honoring patients’ wishes. The information gathered may provide insight into how providers can incorporate shared decision-making into their practice.

背景：研究发现，不同种族、民族和地理位置的患者在使用神经镇痛分娩时存在广泛差异。然而，对决定不使用神经管镇痛分娩的患者层面因素的研究却很有限：我们于 2022 年 10 月 1 日至 2023 年 5 月 30 日在纽约市的一家医疗中心进行了半结构化访谈。参与者均经阴道分娩，并选择不接受神经镇痛分娩。在完成访谈后，还询问了结构化的人口统计学问题。我们对访谈进行了录音和逐字记录。我们对数据进行了分析，并根据基础理论将回答分为不同的主题：我们确定了五个主题，涵盖了参与者在决定不接受神经镇痛分娩时所考虑的主要因素：对自然分娩体验的偏好；有能力和支持性的分娩环境；对不使用药物分娩的准备或准备程度；对分娩疼痛的积极看法；以及关于硬膜外麻醉的信息、错误信息、知识差距和恐惧。所有研究参与者在访谈中都提到了这些重要主题：参与者描述了他们决定不使用硬膜外麻醉分娩的各种重要因素，我们将这些因素归纳为五个主要主题。我们的研究结果可用于指导患者与医护人员之间以相互理解、循证医学和尊重患者意愿为中心的有效互动。收集到的信息可为医护人员如何将共同决策纳入其实践提供启示。

{"title":"Patients’ perspectives on pain relief during childbirth and labor epidurals: A pilot qualitative study among women who chose to deliver without neuraxial labor analgesia","authors":"E.R. Weinstein , J. Aaronson , S.E. Abramovitz , D. McCullough , R. Gotian , R.S. White","doi":"10.1016/j.ijoa.2024.104294","DOIUrl":"10.1016/j.ijoa.2024.104294","url":null,"abstract":"<div><h3>Background</h3><div>Studies have identified widespread variation in neuraxial labor analgesia use by race, ethnicity, and geographic location. However, limited research has investigated patient-level factors in the decision not to use neuraxial analgesia for labor.</div></div><div><h3>Methods</h3><div>We conducted semi-structured interviews at a New York City medical center from October 1, 2022, to May 30, 2023. Participants had delivered vaginally and selected not to receive neuraxial labor analgesia. Structured demographic questions were asked after interview completion. Interviews were recorded and transcribed verbatim. We analyzed data and grouped responses into themes according to grounded theory.</div></div><div><h3>Results</h3><div>We identified five themes encompassing the main factors participants had considered when deciding not to receive neuraxial analgesia for birth: preferences for a natural birth experience, an empowering and supportive labor environment, preparation or preparedness for birth without medication, positive outlook on labor pain, and information, misinformation, knowledge gaps and fears about the epidural. All study participants mentioned these overarching themes in their interviews.</div></div><div><h3>Conclusions</h3><div>Participants described various factors important in their decision to give birth without an epidural, which we mapped onto five primary themes. Our results can be used to guide effective patient-provider interactions centered on mutual understanding, evidence-based medicine, and honoring patients’ wishes. The information gathered may provide insight into how providers can incorporate shared decision-making into their practice.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"61 ","pages":"Article 104294"},"PeriodicalIF":2.6,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Inhaled epoprostenol via high-flow nasal cannula and intravenous treprostinil for management of severe pulmonary arterial hypertension during cesarean delivery with epidural anesthesia: a case report 通过高流量鼻插管吸入缩宫素和静脉注射曲普瑞替尼治疗硬膜外麻醉下剖宫产术中的重度肺动脉高压：病例报告

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-11-12 DOI: 10.1016/j.ijoa.2024.104295

N. Perisetla , C. Miranda , J. Louis , O. Omoike , N. Farrat , E. Camporesi

Current guidelines for managing pulmonary arterial hypertension (PAH) in pregnancy recommend the use of PAH-specific medications, including phosphodiesterase type-5 inhibitors, calcium channel blockers, and prostacyclin analogs. However, there is limited consensus on the optimal agents and routes of administration during delivery. This case report describes a 24-year-old gravida 3 para 1 with Group I PAH, admitted at 29 weeks' gestation, for a planned cesarean delivery at 30 weeks gestation. She presented with worsening dyspnea, syncope, and right ventricular dysfunction. A multidisciplinary team planned her management, which included epidural anesthesia, inhaled epoprostenol (iEpo) via high-flow nasal cannula (HFNC), and intravenous (IV) treprostinil. Intraoperatively, despite continued IV treprostinil, her pulmonary artery pressure (PAP) remained elevated, prompting the initiation of iEpo. This resulted in a significant reduction in PAP, leading to successful delivery and maternal-fetal outcomes without complications. Postoperative management included continued iEpo with a hospital discharge seven days later in stable condition. This report highlights the novel use of iEpo via HFNC for managing PAH during cesarean delivery, suggesting its potential for reducing maternal morbidity and mortality in this high-risk population. Future studies should explore the simultaneous use of inhaled and intravenous prostacyclin analogs in pregnant patients with PAH.

目前治疗妊娠期肺动脉高压（PAH）的指南建议使用 PAH 专用药物，包括 5 型磷酸二酯酶抑制剂、钙通道阻滞剂和前列环素类似物。然而，关于分娩期间的最佳药物和给药途径，目前还没有达成共识。本病例报告描述了一名 24 岁的孕 3 1 型 PAH 患者，妊娠 29 周时入院，计划在妊娠 30 周时进行剖宫产。她出现呼吸困难加重、晕厥和右心室功能障碍。多学科团队为她制定了治疗方案，包括硬膜外麻醉、通过高流量鼻插管（HFNC）吸入环前列醇（iEpo）和静脉注射曲普瑞替尼。术中，尽管继续静脉注射曲普瑞司替尼，但她的肺动脉压（PAP）仍然升高，这促使她开始使用 iEpo。这使得肺动脉压明显降低，最终成功分娩，母胎均无并发症。术后管理包括继续使用 iEpo，七天后产妇病情稳定出院。该报告强调了通过 HFNC 使用 iEpo 在剖宫产过程中控制 PAH 的新方法，表明它有可能降低这一高风险人群的孕产妇发病率和死亡率。未来的研究应探索在 PAH 孕妇患者中同时使用吸入和静脉注射前列环素类似物。

{"title":"Inhaled epoprostenol via high-flow nasal cannula and intravenous treprostinil for management of severe pulmonary arterial hypertension during cesarean delivery with epidural anesthesia: a case report","authors":"N. Perisetla , C. Miranda , J. Louis , O. Omoike , N. Farrat , E. Camporesi","doi":"10.1016/j.ijoa.2024.104295","DOIUrl":"10.1016/j.ijoa.2024.104295","url":null,"abstract":"<div><div>Current guidelines for managing pulmonary arterial hypertension (PAH) in pregnancy recommend the use of PAH-specific medications, including phosphodiesterase type-5 inhibitors, calcium channel blockers, and prostacyclin analogs. However, there is limited consensus on the optimal agents and routes of administration during delivery. This case report describes a 24-year-old gravida 3 para 1 with Group I PAH, admitted at 29 weeks' gestation, for a planned cesarean delivery at 30 weeks gestation. She presented with worsening dyspnea, syncope, and right ventricular dysfunction. A multidisciplinary team planned her management, which included epidural anesthesia, inhaled epoprostenol (iEpo) via high-flow nasal cannula (HFNC), and intravenous (IV) treprostinil. Intraoperatively, despite continued IV treprostinil, her pulmonary artery pressure (PAP) remained elevated, prompting the initiation of iEpo. This resulted in a significant reduction in PAP, leading to successful delivery and maternal-fetal outcomes without complications. Postoperative management included continued iEpo with a hospital discharge seven days later in stable condition. This report highlights the novel use of iEpo via HFNC for managing PAH during cesarean delivery, suggesting its potential for reducing maternal morbidity and mortality in this high-risk population. Future studies should explore the simultaneous use of inhaled and intravenous prostacyclin analogs in pregnant patients with PAH.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"61 ","pages":"Article 104295"},"PeriodicalIF":2.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Accuracy of Spanish and English-generated ChatGPT responses to commonly asked patient questions about labor epidurals: a survey-based study among bilingual obstetric anesthesia experts 西班牙语和英语生成的 ChatGPT 回答患者有关分娩硬膜外麻醉的常见问题的准确性：一项针对双语产科麻醉专家的调查研究。

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-11-06 DOI: 10.1016/j.ijoa.2024.104290

Antonio Gonzalez Fiol , Allison A. Mootz , Zili He , Carlos Delgado , Vilma Ortiz , Sharon C. Reale

Background

Large language models (LLMs), of which ChatGPT is the most well known, are now available to patients to seek medical advice in various languages. However, the accuracy of the information utilized to train these models remains unknown.

Methods

Ten commonly asked questions regarding labor epidurals were translated from English to Spanish, and all 20 questions were entered into ChatGPT version 3.5. The answers were transcribed. A survey was then sent to 10 bilingual fellowship-trained obstetric anesthesiologists to assess the accuracy of these answers utilizing a 5-point Likert scale.

Results

Overall, the accuracy scores for the ChatGPT-generated answers in Spanish were lower than for the English answers with a median score of 34 (IQR 33–36.5) versus 40.5 (IQR 39–44.3), respectively (P value 0.02). Answers to two questions were scored significantly lower: “Do epidurals prolong labor?” (2 (IQR 2–2.5) versus 4 (IQR 4–4.5), P value 0.03) and “Do epidurals increase the risk of needing cesarean delivery?” (3(IQR 2–4) versus 4 (IQR 4–5); P value 0.03). There was a strong agreement that answers to the question “Do epidurals cause autism” were accurate in both Spanish and English.

Conclusion

ChatGPT-generated answers in Spanish to ten questions about labor epidurals scored lower for accuracy than answers generated in English, particularly regarding the effect of labor epidurals on labor course and mode of delivery. This disparity in ChatGPT-generated information may extend already-known health inequities among non-English-speaking patients and perpetuate misinformation.

背景：大语言模型（LLMs），其中最著名的是 ChatGPT，现在病人可以用各种语言寻求医疗建议。然而，用于训练这些模型的信息的准确性仍是未知数：将有关分娩硬膜外麻醉的 10 个常见问题从英语翻译成西班牙语，并将所有 20 个问题输入 ChatGPT 3.5 版。对答案进行了转录。然后向 10 位接受过双语研究培训的产科麻醉师发送了一份调查问卷，采用 5 点李克特量表评估这些答案的准确性：总体而言，ChatGPT 生成的西班牙语答案的准确性得分低于英语答案，中位数分别为 34（IQR 33-36.5）和 40.5（IQR 39-44.3）（P 值 0.02）。有两个问题的答案得分明显较低："硬膜外麻醉会延长产程吗？"（2 (IQR 2-2.5) 对 4 (IQR 4-4.5)，P 值 0.03）和 "硬膜外麻醉会增加需要剖宫产的风险吗？3（IQR 2-4）对 4（IQR 4-5）；P 值 0.03）。对于 "硬膜外麻醉会导致自闭症吗 "这一问题，西班牙文和英文的答案都非常准确：结论：对于有关分娩镇痛剂的十个问题，用西班牙语通过 ChatGPT 生成的答案在准确性方面得分低于用英语生成的答案，尤其是在分娩镇痛剂对产程和分娩方式的影响方面。在 ChatGPT 生成的信息中存在的这种差异可能会扩大非英语患者中已知的健康不公平现象，并使错误信息长期存在。

{"title":"Accuracy of Spanish and English-generated ChatGPT responses to commonly asked patient questions about labor epidurals: a survey-based study among bilingual obstetric anesthesia experts","authors":"Antonio Gonzalez Fiol , Allison A. Mootz , Zili He , Carlos Delgado , Vilma Ortiz , Sharon C. Reale","doi":"10.1016/j.ijoa.2024.104290","DOIUrl":"10.1016/j.ijoa.2024.104290","url":null,"abstract":"<div><h3>Background</h3><div>Large language models (LLMs), of which ChatGPT is the most well known, are now available to patients to seek medical advice in various languages. However, the accuracy of the information utilized to train these models remains unknown.</div></div><div><h3>Methods</h3><div>Ten commonly asked questions regarding labor epidurals were translated from English to Spanish, and all 20 questions were entered into ChatGPT version 3.5. The answers were transcribed. A survey was then sent to 10 bilingual fellowship-trained obstetric anesthesiologists to assess the accuracy of these answers utilizing a 5-point Likert scale.</div></div><div><h3>Results</h3><div>Overall, the accuracy scores for the ChatGPT-generated answers in Spanish were lower than for the English answers with a median score of 34 (IQR 33–36.5) versus 40.5 (IQR 39–44.3), respectively (<em>P</em> value 0.02). Answers to two questions were scored significantly lower: “Do epidurals prolong labor?” (2 (IQR 2–2.5) versus 4 (IQR 4–4.5), <em>P</em> value 0.03) and “Do epidurals increase the risk of needing cesarean delivery?” (3(IQR 2–4) versus 4 (IQR 4–5); P value 0.03). There was a strong agreement that answers to the question “Do epidurals cause autism” were accurate in both Spanish and English.</div></div><div><h3>Conclusion</h3><div>ChatGPT-generated answers in Spanish to ten questions about labor epidurals scored lower for accuracythananswers generated in English, particularly regarding the effect of labor epidurals on labor course and mode of delivery. This disparity in ChatGPT-generated information may extend already-known health inequities among non-English-speaking patients and perpetuate misinformation.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"61 ","pages":"Article 104290"},"PeriodicalIF":2.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Labor epidural analgesia among Han and Uyghur parturients: a prospective observational study in China 中国汉族和维吾尔族产妇的分娩硬膜外镇痛：一项前瞻性观察研究。

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-11-05 DOI: 10.1016/j.ijoa.2024.104291

Xiaoqian Deng , Xueyu Zhang , Junyu Yan , Ruhui Liu , Yun Shi

Background

Disparities in pain sensitivity and tolerance have been described, however little is known about variability in the experience of labor pain and childbirth in China.

Methods

This prospective observational study was conducted at a tertiary hospital in Xinjiang, China with two major ethnic groups: Han and Uyghur women. Women with a vaginal delivery with labor epidural analgesia were enrolled. The primary outcome was cervical dilation at labor epidural analgesia request, and multivariable linear regression analysis was performed to determine associated variables. Secondary outcomes were pain score at epidural request and epidural analgesics use. Data presented as mean ± standard deviation.

Results

Cervical dilatation at labor epidural analgesia request was significantly lower (1.2 ± 0.7 vs. 0.8 ± 0.6 cm; p = 0.0095), and pain score (numerical pain scale 0–10) was significantly higher (0.8 ± 1.0 vs. 4.2 ± 1.2; P = 0.0002) among Uyghur compared to Han women. In the multivariate model, Uyghur women had a lower cervical dilation (p = 0.0392) and a higher pain score (P <0.0001) at epidural request. During the labor process, a larger proportion of Uyghur women used the patient-controlled epidural analgesia (PCEA) pump (77.8% vs. 53.6%, P = 0.0011). They pressed the pump in a significantly shorter time (61.3 ± 41.2 vs. 104.0 ± 105.2 min, P = 0.0015) and for more times (1.9 ± 1.7 vs. 1.2 ± 1.4, P = 0.0022), contributing to significantly more epidural analgesic use (sufentanil: 0.06 ± 0.02 vs. 0.07 ± 0.03 μg/kg/h, P = 0.0150, ropivacaine: 0.11 ± 0.04 vs. 0.14 ± 0.06 mg/kg/h, P = 0.0003, respectively).

Conclusions

Our findings suggest that Uyghur women experience labor pain with higher levels of pain and with higher use of epidural analgesics than Han women. Further studies are needed to evaluate whether these differences are clinically relevant.

背景：疼痛敏感性和耐受性的差异已被描述过，但在中国，人们对分娩疼痛和分娩体验的差异知之甚少：这项前瞻性观察研究在中国新疆的一家三甲医院进行，研究对象包括两个主要民族：汉族和维吾尔族妇女。研究对象为经阴道分娩并使用硬膜外镇痛的产妇。主要结果是要求进行分娩硬膜外镇痛时的宫颈扩张，并进行了多变量线性回归分析以确定相关变量。次要结果是申请硬膜外镇痛时的疼痛评分和硬膜外镇痛药的使用情况。数据以均数±标准差表示：结果：与汉族妇女相比，维吾尔族妇女在申请分娩硬膜外镇痛时的宫颈扩张度明显较低（1.2 ± 0.7 vs. 0.8 ± 0.6 cm; P = 0.0095），疼痛评分（数字疼痛量表 0-10）明显较高（0.8 ± 1.0 vs. 4.2 ± 1.2; P = 0.0002）。在多变量模型中，维吾尔族妇女的宫颈扩张率较低（P = 0.0392），疼痛评分较高（P 结论：维吾尔族妇女的宫颈扩张率和疼痛评分均高于汉族妇女：我们的研究结果表明，与汉族妇女相比，维吾尔族妇女分娩时的疼痛程度更高，使用硬膜外镇痛药的次数也更多。还需要进一步的研究来评估这些差异是否与临床相关。

{"title":"Labor epidural analgesia among Han and Uyghur parturients: a prospective observational study in China","authors":"Xiaoqian Deng , Xueyu Zhang , Junyu Yan , Ruhui Liu , Yun Shi","doi":"10.1016/j.ijoa.2024.104291","DOIUrl":"10.1016/j.ijoa.2024.104291","url":null,"abstract":"<div><h3>Background</h3><div>Disparities in pain sensitivity and tolerance have been described, however little is known about variability in the experience of labor pain and childbirth in China.</div></div><div><h3>Methods</h3><div>This prospective observational study was conducted at a tertiary hospital in Xinjiang, China with two major ethnic groups: Han and Uyghur women. Women with a vaginal delivery with labor epidural analgesia were enrolled. The primary outcome was cervical dilation at labor epidural analgesia request, and multivariable linear regression analysis was performed to determine associated variables. Secondary outcomes were pain score at epidural request and epidural analgesics use. Data presented as mean ± standard deviation.</div></div><div><h3>Results</h3><div>Cervical dilatation at labor epidural analgesia request was significantly lower (1.2 ± 0.7 vs. 0.8 ± 0.6 cm; p = 0.0095), and pain score (numerical pain scale 0–10) was significantly higher (0.8 ± 1.0 vs. 4.2 ± 1.2; <em>P</em> = 0.0002) among Uyghur compared to Han women. In the multivariate model, Uyghur women had a lower cervical dilation (p = 0.0392) and a higher pain score (<em>P</em> <0.0001) at epidural request. During the labor process, a larger proportion of Uyghur women used the patient-controlled epidural analgesia (PCEA) pump (77.8% vs. 53.6%, <em>P</em> = 0.0011). They pressed the pump in a significantly shorter time (61.3 ± 41.2 vs. 104.0 ± 105.2 min, <em>P</em> = 0.0015) and for more times (1.9 ± 1.7 vs. 1.2 ± 1.4, <em>P</em> = 0.0022), contributing to significantly more epidural analgesic use (sufentanil: 0.06 ± 0.02 vs. 0.07 ± 0.03 μg/kg/h, <em>P</em> = 0.0150, ropivacaine: 0.11 ± 0.04 vs. 0.14 ± 0.06 mg/kg/h, <em>P</em> = 0.0003, respectively).</div></div><div><h3>Conclusions</h3><div>Our findings suggest that Uyghur women experience labor pain with higher levels of pain and with higher use of epidural analgesics than Han women. Further studies are needed to evaluate whether these differences are clinically relevant.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"61 ","pages":"Article 104291"},"PeriodicalIF":2.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Moderate factor XI deficiency and neuraxial procedures in an obstetric cohort: a retrospective study (2014–2021) 产科队列中的中度 XI 因子缺乏症与神经外科手术：一项回顾性研究（2014-2021 年）。

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-10-28 DOI: 10.1016/j.ijoa.2024.104289

M. Billeret , A. Blandinières , D. Touati , C. Desconclois , R. Garreau , A. Le Gouez , C. Lavenu-Bombled , M. Bruyère

引用次数: 0

Artificial intelligence in obstetric anaesthesiology – the future of patient care? 产科麻醉学中的人工智能--病人护理的未来？

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-10-24 DOI: 10.1016/j.ijoa.2024.104288

A.Y.H. Kong , N. Liu , H.S. Tan , A.T.H. Sia , B.L. Sng

The use of artificial intelligence (AI) in obstetric anaesthesiology shows great potential in enhancing our practice and delivery of care. In this narrative review, we summarise the current applications of AI in four key areas of obstetric anaesthesiology (perioperative care, neuraxial procedures, labour analgesia and obstetric critical care), where AI has been employed to varying degrees for decision support, event prediction, risk stratification and procedural assistance. We also identify gaps in current practice and propose areas for further research. While promising, AI cannot replace the expertise and clinical judgement of a trained obstetric anaesthesiologist. It should, instead, be viewed as a valuable tool to facilitate and support our practice.

人工智能（AI）在产科麻醉学中的应用在提高我们的实践和护理服务方面显示出巨大的潜力。在这篇叙述性综述中，我们总结了目前人工智能在产科麻醉学四个关键领域（围手术期护理、神经手术、分娩镇痛和产科重症监护）的应用情况，在这些领域中，人工智能已在不同程度上用于决策支持、事件预测、风险分层和程序辅助。我们还发现了当前实践中的不足，并提出了进一步研究的领域。虽然人工智能大有可为，但它无法取代训练有素的产科麻醉师的专业知识和临床判断。相反，它应被视为促进和支持我们实践的宝贵工具。

引用次数: 0

Effect of vasoactive drugs used for management of hypotension during pregnancy on uterine hemodynamic parameters: a systematic review and meta-analysis of preclinical and clinical studies 用于治疗孕期低血压的血管活性药物对子宫血流动力学参数的影响：临床前和临床研究的系统回顾和荟萃分析

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-10-19 DOI: 10.1016/j.ijoa.2024.104287

A. Brenders , T. Bleeser , J. Deprest , S. Rex , S. Devroe

引用次数: 0

Dexamethasone for prevention of spinal hypotension during caesarean delivery: a randomised controlled trial 地塞米松用于预防剖腹产时脊柱低血压：随机对照试验。

IF 2.6 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2024-10-15 DOI: 10.1016/j.ijoa.2024.104286

SV. Duttala , K. Kumari , V. Kumari , TM. Meshram , A. Sharma , P. Sethi , D. Rathod , PK. Bhatia , S. Goyal

引用次数: 0

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

International journal of obstetric anesthesia

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀