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International journal of obstetric anesthesia最新文献

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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 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。
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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 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
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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 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。
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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 Pub Date : 2024-10-19 DOI: 10.1016/j.ijoa.2024.104287
A. Brenders , T. Bleeser , J. Deprest , S. Rex , S. Devroe
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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 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
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引用次数: 0
Pregnancy revealing hereditary angioedema type III with factor XII mutation managed in a resource-limited setting with no C1-inhibitor concentrate availability: a case report.
IF 2.6 3区 医学 Q2 ANESTHESIOLOGY Pub Date : 2024-10-09 DOI: 10.1016/j.ijoa.2024.104283
H Saddouk, M Tajir, H Saadi, B Housni, N Zerrouki, N Zizi, S Dikhaye
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引用次数: 0
High flow nasal cannula: A new tool for obstetric pre-oxygenation 高流量鼻插管:产科预吸氧的新工具。
IF 2.6 3区 医学 Q2 ANESTHESIOLOGY Pub Date : 2024-10-09 DOI: 10.1016/j.ijoa.2024.104282
Sharon C. Reale, Michaela K. Farber
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引用次数: 0
Comparison of mephentermine and norepinephrine infusions for prevention of post-spinal hypotension during elective caesarean delivery: a randomised, double-blind trial 比较输注甲芬特明和去甲肾上腺素预防择期剖腹产术后椎管内低血压:随机双盲试验
IF 2.6 3区 医学 Q2 ANESTHESIOLOGY Pub Date : 2024-10-09 DOI: 10.1016/j.ijoa.2024.104285
M. Mohta , N. Kumari , G.T. Chilkoti , D. Agarwal , R.K. Malhotra , R. Agarwal
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引用次数: 0
Anesthetic management for fetal surgery: Lessons from a single-center experience (2019–2023) 胎儿手术的麻醉管理:从单个中心的经验中汲取教训(2019-2023)。
IF 2.6 3区 医学 Q2 ANESTHESIOLOGY Pub Date : 2024-10-09 DOI: 10.1016/j.ijoa.2024.104284
A. Faruja , A. Idelson , K. Azem , L. Yosef , K. Tenenbaum-Gavish , N.R. Duvdevani , S. Fein , S. Orbach-Zinger , Y. Gielchinsky
Fetal surgery presents distinctive anesthetic challenges due to the need to balance maternal and fetal safety. This retrospective study evaluates the anesthetic management strategies used at a single center for various fetal interventions, including fetoscopic laser photocoagulation, fetal endoluminal tracheal occlusion, bipolar cord coagulation, and fetoscopic spina bifida repair.
We reviewed 195 fetal procedures performed between 2019 and 2023 at Rabin Medical Center. Data collected included maternal and fetal characteristics, anesthetic techniques (spinal, combined spinal-epidural, general), intraoperative hypotension, and perioperative complications. We examined the evolution of anesthetic practice, particularly focusing on hemodynamic management and postoperative pain control.
Spinal anesthesia was increasingly preferred for shorter procedures such as fetoscopic laser photocoagulation and bipolar cord coagulation, while general anesthesia was used exclusively for spina bifida repair. Intraoperative hypotension was a significant issue, leading to the implementation of prophylactic phenylephrine infusions, which improved blood pressure control. A shift from volatile anesthesia to total intravenous anesthesia in spina bifida repair resulted in fewer complications, including reduced bleeding. Postoperative pain management was optimized with a multimodal approach, improving pain scores.
This study underscores the importance of tailoring anesthetic techniques to the specific fetal surgery. Key improvements in hypotension management, adopting total intravenous anesthesia for complex surgeries, and optimized postoperative pain control have contributed to better maternal and fetal outcomes. Ongoing reassessment and adaptation of anesthetic protocols remain critical as fetal surgery evolves.
由于需要平衡母体和胎儿的安全,胎儿手术带来了独特的麻醉挑战。这项回顾性研究评估了单个中心在各种胎儿干预中使用的麻醉管理策略,包括胎儿镜下激光光凝、胎儿腔内气管闭塞、双极脐带凝固和胎儿镜下脊柱裂修复。我们回顾了拉宾医疗中心在 2019 年至 2023 年期间实施的 195 例胎儿手术。收集的数据包括母体和胎儿特征、麻醉技术(脊柱麻醉、脊柱硬膜外联合麻醉、全身麻醉)、术中低血压和围手术期并发症。我们研究了麻醉实践的演变,尤其关注血液动力学管理和术后疼痛控制。脊髓麻醉越来越多地用于较短的手术,如胎儿镜激光光凝术和双极脊髓凝固术,而全身麻醉只用于脊柱裂修复术。术中低血压是一个重要问题,因此实施了预防性苯肾上腺素输注,从而改善了血压控制。脊柱裂修复术从挥发性麻醉转向全静脉麻醉,减少了并发症,包括出血量。采用多模式方法优化了术后疼痛管理,提高了疼痛评分。这项研究强调了针对特定胎儿手术调整麻醉技术的重要性。在低血压管理、复杂手术中采用全静脉麻醉以及优化术后疼痛控制方面的主要改进有助于改善孕产妇和胎儿的预后。随着胎儿手术的发展,不断重新评估和调整麻醉方案仍然至关重要。
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引用次数: 0
Pain during caesarean delivery: what gets measured, gets managed 剖腹产过程中的疼痛:有测量就有管理
IF 2.6 3区 医学 Q2 ANESTHESIOLOGY Pub Date : 2024-09-26 DOI: 10.1016/j.ijoa.2024.104281
Ciara Luke, Lorcan O’ Carroll, Robert Ffrench O’ Carroll, Roger McMorrow
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期刊
International journal of obstetric anesthesia
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