International journal of obstetric anesthesia最新文献

英文中文

Three initial prophylactic phenylephrine infusion rates and physician interventions in patients with preeclampsia undergoing caesarean delivery under spinal anaesthesia: a randomised double-blind trial 三种初始预防性苯肾上腺素输注率和医生干预在脊髓麻醉下剖腹产子痫前期患者：一项随机双盲试验

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2026-02-01 Epub Date: 2025-12-02 DOI: 10.1016/j.ijoa.2025.104825

M. Mohta, A. Jain, G.T. Chilkoti

Background

Patients with preeclampsia have greater sensitivity to vasopressors and require lower doses than patients without preeclampsia. The aim of the current study was to compare the number of required physician interventions using three initial prophylactic phenylephrine infusion rates titrated to maintain systolic blood pressure close to baseline values.

Methods

In this randomised, controlled, double-blind trial, 102 patients with preeclampsia undergoing caesarean delivery under spinal anaesthesia were randomised to one of three prophylactic phenylephrine infusion rates: 15 µg/min, 25 µg/min, or 35 µg/min. The rate was titrated to maintain systolic blood pressure within 10% of baseline values. The primary outcome was the number of physician interventions; secondary outcome measures included the incidence of hypertension, hypotension and bradycardia, total phenylephrine dose, neonatal outcomes, and maternal complications.

Results

The median [interquartile range] number of physician interventions was 6.5 [4–9], 6 [4–7.5] and 6.5 [4–9], respectively, for initial infusion rates of 15, 25, and 35 µg/min (P = 0.831). The total phenylephrine dose was greater with higher infusion doses (P < 0.001). No patient had bradycardia, and one patient had hypertension. Nineteen patients each in groups starting at 15 µg/min and 25 µg/min, and 22 patients starting at 35 µg/min developed hypotension (P = 0.695). Neonatal outcome and maternal complications were not different among groups.

Conclusions

All three infusion regimens required a similar number of physician interventions to maintain systolic blood pressure close to the baseline. A starting dose of 15 µg/min may be considered in this patient population.

Clinical Trial Registration number: CTRI/2023/08/055926; registered on 1st August 2023.

背景：与没有子痫前期的患者相比，子痫前期患者对血管加压药物更敏感，需要更低的剂量。当前研究的目的是比较使用三种初始预防性苯肾上腺素滴注率以维持收缩压接近基线值所需的医生干预次数。方法：在这项随机、对照、双盲试验中，102例在脊髓麻醉下剖腹产的先兆子痫患者被随机分配到三种预防性苯肾上腺素输注率中的一种：15µg/min、25µg/min或35µg/min。滴定速率以维持收缩压在基线值的10%以内。主要结局是医生干预的次数；次要结局指标包括高血压、低血压和心动过缓的发生率、苯肾上腺素总剂量、新生儿结局和产妇并发症。结果：在初始输液速率为15、25和35µg/min时，医生干预次数的中位数[四分位数范围]分别为6.5[4-9]、6[4-7.5]和6.5 [4-9]（P = 0.831）。结论：所有三种输注方案都需要相似数量的医生干预来维持收缩压接近基线。在这类患者中，可以考虑起始剂量为15µg/min。临床试验注册号：CTRI/2023/08/055926；于2023年8月1日注册。

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引用次数: 0

Opioid consumption and pain scores following perineal lacerations: a retrospective cohort study 2019–2023 会阴部撕裂伤后阿片类药物消耗和疼痛评分：2019-2023年的回顾性队列研究

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2026-02-01 Epub Date: 2025-10-08 DOI: 10.1016/j.ijoa.2025.104789

L. Squires , B. Carvalho , P. Sultan , K. Fedoruk

Background

Perineal lacerations frequently complicate vaginal deliveries and impact recovery.

Methods

We examined the relationship between laceration severity and opioid consumption with scheduled multimodal analgesia through a retrospective cohort study (2019–2023) of 14,477 vaginal deliveries. Propensity score matching was used to address baseline group imbalances, followed by logistic regression analysis.

Results

Distribution included: no lacerations (26.9%), first- or second-degree (69.0%), and third- or fourth-degree (4.0%). Patients with third- or fourth-degree lacerations more frequently consumed opioids (19.4%) compared to those with no lacerations (10.4%) or first- or second-degree lacerations (7.5%) (P < 0.001). After propensity score matching and multivariable adjustment, third- or fourth-degree lacerations carried 3.98 times higher odds of opioid use compared to no lacerations (95% CI 3.26–4.87, P < 0.001), while patients with first- or second-degree lacerations were significantly less likely to use opioids (OR 0.33, 95% CI 0.26–0.44, P < 0.001). Opioid doses were significantly higher for third- or fourth-degree lacerations at 24–48 h (15 mg vs. 7.5 mg morphine equivalents, P = 0.009). These patients also reported consistently higher pain scores throughout the first 72 h.

Conclusions

Despite scheduled multimodal analgesia, third- and fourth-degree perineal lacerations are associated with significantly higher opioid consumption and pain scores, suggesting the need for enhanced management strategies and closer monitoring.

背景：会阴撕裂伤经常使阴道分娩复杂化并影响恢复。方法：通过对14477例阴道分娩的回顾性队列研究（2019-2023），研究了撕裂伤严重程度与阿片类药物使用与计划多模式镇痛之间的关系。倾向评分匹配用于解决基线组失衡，然后进行逻辑回归分析。结果：分布包括：无撕裂伤（26.9%），一度或二度（69.0%），三度或四度（4.0%）。与无撕裂伤（10.4%）或一、二度撕裂伤（7.5%）的患者相比，三度或四度撕裂伤的患者更频繁地使用阿片类药物（19.4%）。(P结论：尽管有计划的多模式镇痛，三度和四度会阴撕裂伤与阿片类药物消耗和疼痛评分显著升高相关，表明需要加强管理策略和更密切的监测。

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引用次数: 0

Pulmonary complications following postpartum tubal ligation with laryngeal mask vs. endotracheal intubation: a retrospective cohort study (2012–2024) 产后喉罩输卵管结扎与气管插管后肺部并发症的回顾性队列研究（2012-2024）

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2026-02-01 Epub Date: 2025-09-22 DOI: 10.1016/j.ijoa.2025.104776

A.F. Lindo , D. Hincapié-Ayala , S. Alzate-Ricaurte , M. Rodríguez , G.A. Cruz-Suárez , M. Vasco-Ramírez

Background

General anesthesia with endotracheal intubation is standard in obstetric patients due to the risk of aspiration. However, endotracheal intubation carries procedure-related risks, prompting interest in laryngeal masks as alternative or rescue devices. Evidence supporting their use in postpartum tubal ligation remains limited.

Methods

A retrospective cohort study was conducted at a high-risk obstetric center, including patients who underwent postpartum tubal ligation between 2012 and 2024. Patients were grouped according to the airway device used: laryngeal mask or endotracheal intubation, including those who required conversion. The primary outcome was the incidence of respiratory complications, including pneumonia, respiratory failure, anesthesia-related reactions, and other significant adverse events, within seven postoperative days. Secondary analyses included demographic and obstetric characteristics.

Results

There were 1,095 cases performed under general anesthesia, 503 (46 %) received endotracheal intubation and 592 (54 %) supra-glottic airway. No respiratory complications were observed in either group; Poisson-based confidence intervals confirmed that the upper bound of incidence remained < 1 %. Patients with supra-glottic airway were more likely to be ASA I (34 % vs. 21 %), and 2.6 % had conversion to endotracheal intubation. Patients with endotracheal intubation had a higher median body mass index (29.7 vs. 29.2 kg/m², P = 0.027).

Conclusion

In this retrospective analysis of postpartum tubal ligation under general anesthesia, there were no respiratory complications with either airway device. Supraglottic airway devices appear to be a safe alternative in carefully selected patients.

背景：由于存在误吸的风险，全麻气管插管是产科患者的标准选择。然而，气管内插管具有手术相关的风险，促使人们对喉罩作为替代或抢救装置的兴趣。支持其用于产后输卵管结扎的证据仍然有限。方法回顾性队列研究，选取2012 - 2024年在某高危产科中心行产后输卵管结扎术的患者。患者根据使用的气道设备进行分组：喉罩或气管插管，包括需要转换的患者。主要终点是术后7天内呼吸系统并发症的发生率，包括肺炎、呼吸衰竭、麻醉相关反应和其他重大不良事件。二次分析包括人口统计学和产科特征。结果全麻1095例，气管插管503例（46%），声门上气道592例（54%）。两组患者均未出现呼吸系统并发症；基于泊松的置信区间证实，发病率的上限仍然为1%。声门上气道的患者更有可能是ASA I(34%对21%)，2.6%的患者转换为气管插管。气管插管组的中位体重指数较高（29.7 vs 29.2 kg/m2, P = 0.027）。结论回顾性分析全麻下输卵管结扎术后两种气道装置均无呼吸系统并发症。在精心挑选的患者中，声门上气道装置似乎是一种安全的选择。

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引用次数: 0

Labor analgesia in pregnant women with reversible cerebral vasoconstriction syndrome managed with magnesium sulfate infusion to prevent exacerbation and recurrence: two case reports 硫酸镁输注预防可逆性脑血管收缩综合征孕妇分娩镇痛的加重和复发：2例报告

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2026-02-01 Epub Date: 2025-09-22 DOI: 10.1016/j.ijoa.2025.104774

T Nagase , M. Shishii , H. Kondo , T. Fujita , S. Hyuga

引用次数: 0

Intrathecal dexmedetomidine for cesarean delivery and postoperative outcomes: a single-center retrospective cohort study (2019–2020) 鞘内右美托咪定用于剖宫产和术后结局：一项单中心回顾性队列研究（2019-2020）。

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2026-02-01 Epub Date: 2025-11-14 DOI: 10.1016/j.ijoa.2025.104819

E. Takalo , M. Karpala , X. An , B. Cobb , S. Zhao , R. Bari , M. Hylton , S. Grant , J. Schoenherr

Background

Intrathecal opioids are the standard adjuvant for spinal anesthesia in cesarean delivery, but investigating alternatives is warranted. A community hospital began adding intrathecal dexmedetomidine 10 µg to spinal anesthetics for cesarean deliveries due to a local shortage in opioids. This retrospective study evaluates its impact on postoperative pain, opioid use, and hemodynamic outcomes.

Methods

After IRB approval, cesarean delivery cases conducted between 2019 and 2020 were screened. Exclusion criteria included epidural labor analgesia, general anesthesia, intrathecal catheters, or intrathecal dexmedetomidine dose other than 10 µg. Primary outcome was postoperative pain score; secondary outcomes included opioid use (in milligram morphine equivalents), incidence of intraoperative hypotension, vasopressor use, postoperative mean arterial pressure, Apgar scores, and length of stay.

Results

Of 572 cesarean deliveries, 414 met inclusion criteria; 163 received 10 µg of intrathecal dexmedetomidine, 251 did not. Demographics were similar. Patients who received intrathecal dexmedetomidine 10 µg had significantly lower postoperative pain scores (effect size −0.41, 95% CI −0.18 to −0.64; P < 0.001). Opioid use was significantly reduced 0–6 h after anesthesia (15.0 mg vs. 22.5 mg; P < 0.001) and 6–24 h after anesthesia end (26.1 mg vs. 29.4 mg; P = 0.0465). However, there was a higher incidence of intraoperative hypotension (44.2% vs. 28.3%; P < 0.001).

Conclusion

Intrathecal dexmedetomidine 10 µg was associated with reduced postoperative pain and opioid use, supporting its role as an intrathecal adjuvant. However, its association with increased hypotension highlights the need for cautious use and further investigation.

背景：鞘内阿片类药物是剖宫产脊髓麻醉的标准辅助剂，但研究替代方案是有必要的。由于当地阿片类药物短缺，一家社区医院开始在剖宫产脊髓麻醉药中加入鞘内右美托咪定10µg。本回顾性研究评估其对术后疼痛、阿片类药物使用和血流动力学结果的影响。方法：对经IRB批准的2019 ~ 2020年剖宫产病例进行筛查。排除标准包括硬膜外分娩镇痛、全身麻醉、鞘内插管或鞘内右美托咪定剂量超过10µg。主要结局为术后疼痛评分；次要结局包括阿片类药物使用（毫克吗啡当量）、术中低血压发生率、血管加压药物使用、术后平均动脉压、Apgar评分和住院时间。结果：572例剖宫产中，414例符合纳入标准；163例鞘内注射10µg右美托咪定，251例未注射。人口统计数据相似。鞘内注射右美托咪定10µg的患者术后疼痛评分显著降低（效应值-0.41,95% CI -0.18至-0.64；P）结论：鞘内注射右美托咪定10µg与术后疼痛和阿片类药物使用减少相关，支持其作为鞘内佐剂的作用。然而，它与低血压升高的相关性强调了谨慎使用和进一步研究的必要性。

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引用次数: 0

Anesthetic management of congenital methemoglobinemia in emergency caesarean delivery: a case report 急诊剖宫产中先天性高铁血红蛋白血症的麻醉处理：1例报告

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2026-02-01 Epub Date: 2025-10-22 DOI: 10.1016/j.ijoa.2025.104807

M. Büyükcavlak

引用次数: 0

Airway events in pregnant patients with morbid obesity undergoing caesarean delivery under general anaesthesia: a retrospective cohort study (2015–2024) 妊娠病态肥胖全麻剖宫产患者气道事件的回顾性队列研究（2015-2024）

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2026-02-01 Epub Date: 2025-11-08 DOI: 10.1016/j.ijoa.2025.104815

A. Saracoglu , S. Padhy , K.C. Yilmaz , M. Arif , S.R. Kapoor , L. Ramanathan , A. Kumar , K.T. Saracoglu

Background

Airway management in morbidly obese obstetric patients is challenging, with increased risk of difficult ventilation, failed intubation, and maternal morbidity. By focusing exclusively on pregnant patients with a BMI 40 kg/m², this study aimed to quantify the frequency and types of airway complications occurring during cesarean section under general anesthesia, stratified by obesity class. The secondary objective was to identify risk factors for difficult mask ventilation, difficult laryngoscopy, and difficult airway.

Methods

This retrospective cohort study included all 315 pregnant patients aged ≥ 18 years with a BMI ≥ 40 kg/m² who underwent caesarean delivery under general anaesthesia between January 2015 and December 2024. Data on demographics, comorbidities, airway assessments, intubation metrics, and perioperative complications were extracted from electronic medical records. Statistical analyses included correlation testing, group comparisons, and multivariable logistic regression (adjusted for age, BMI, and comorbidties).

Results

A total of 315 patients with morbid obesity were analyzed (Class III: 94.3%; Class IV/V: 5.7%). Overall, the most common airway-related complication was cardiovascular instability (7.9%), followed by laryngospasm (1.6%). When stratified by obesity class, cardiovascular instability was similar in Class III and IV, while other airway complications were generally rare and varied. A positive correlation was observed between BMI and peak airway pressure post-intubation. Thyromental distance inversely correlated with intubation attempts (r = −0.150, P = 0.008) and showed the strongest predictive value (OR 0.22, 95% CI 0.11–0.44; P < 0.001) for difficult mask ventilation. Perioperative complications were infrequent: cardiovascular instability (7.9%) and desaturation < 94% during intubation (1.0%).

Conclusion

In conclusion, cardiovascular instability was the most common airway-related complication, difficult airway incidence increased with obesity class, and thyromental distance was the most consistent predictor, highlighting the need for tailored airway management in obstetric patients with morbid obesity.

背景：病态肥胖产科患者的气道管理具有挑战性，通气困难、插管失败和孕产妇发病率的风险增加。本研究仅针对BMI为40 kg/m2的妊娠患者，旨在量化全麻剖宫产术中气道并发症发生的频率和类型，并按肥胖类别分层。次要目的是确定面罩通气困难、喉镜检查困难和气道困难的危险因素。方法回顾性队列研究纳入2015年1月至2024年12月接受全麻剖宫产的孕妇315例，年龄≥18岁，BMI≥40 kg/m2。统计数据、合并症、气道评估、插管指标和围手术期并发症从电子病历中提取。统计分析包括相关性检验、分组比较和多变量逻辑回归（调整年龄、BMI和合并症）。结果共分析了315例病态肥胖患者，其中III类占94.3%，IV/V类占5.7%。总的来说，最常见的气道相关并发症是心血管不稳定（7.9%），其次是喉痉挛（1.6%）。当按肥胖类别分层时，心血管不稳定性在III类和IV类中相似，而其他气道并发症通常罕见且多样。BMI与插管后气道压力峰值呈正相关。甲状腺距离与插管次数呈负相关（r = - 0.150, P = 0.008），对困难面罩通气的预测价值最强（OR 0.22, 95% CI 0.11-0.44; P < 0.001）。围手术期并发症很少：心血管不稳定（7.9%）和插管期间的去饱和（94%）（1.0%）。结论：心血管不稳定是最常见的气道相关并发症，气道困难发生率随肥胖程度的增加而增加，甲状腺距离是最一致的预测因素，强调了对产科病态肥胖患者进行量身定制气道管理的必要性。

{"title":"Airway events in pregnant patients with morbid obesity undergoing caesarean delivery under general anaesthesia: a retrospective cohort study (2015–2024)","authors":"A. Saracoglu , S. Padhy , K.C. Yilmaz , M. Arif , S.R. Kapoor , L. Ramanathan , A. Kumar , K.T. Saracoglu","doi":"10.1016/j.ijoa.2025.104815","DOIUrl":"10.1016/j.ijoa.2025.104815","url":null,"abstract":"<div><h3>Background</h3><div>Airway management in morbidly obese obstetric patients is challenging, with increased risk of difficult ventilation, failed intubation, and maternal morbidity. By focusing exclusively on pregnant patients with a BMI 40 kg/m<sup>2</sup>, this study aimed to quantify the frequency and types of airway complications occurring during cesarean section under general anesthesia, stratified by obesity class. The secondary objective was to identify risk factors for difficult mask ventilation, difficult laryngoscopy, and difficult airway.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included all 315 pregnant patients aged ≥ 18 years with a BMI ≥ 40 kg/m<sup>2</sup> who underwent caesarean delivery under general anaesthesia between January 2015 and December 2024. Data on demographics, comorbidities, airway assessments, intubation metrics, and perioperative complications were extracted from electronic medical records. Statistical analyses included correlation testing, group comparisons, and multivariable logistic regression (adjusted for age, BMI, and comorbidties).</div></div><div><h3>Results</h3><div>A total of 315 patients with morbid obesity were analyzed (Class III: 94.3%; Class IV/V: 5.7%). Overall, the most common airway-related complication was cardiovascular instability (7.9%), followed by laryngospasm (1.6%). When stratified by obesity class, cardiovascular instability was similar in Class III and IV, while other airway complications were generally rare and varied. A positive correlation was observed between BMI and peak airway pressure post-intubation. Thyromental distance inversely correlated with intubation attempts (r = −0.150, <em>P</em> = 0.008) and showed the strongest predictive value (OR 0.22, 95% CI 0.11–0.44; <em>P</em> < 0.001) for difficult mask ventilation. Perioperative complications were infrequent: cardiovascular instability (7.9%) and desaturation < 94% during intubation (1.0%).</div></div><div><h3>Conclusion</h3><div>In conclusion, cardiovascular instability was the most common airway-related complication, difficult airway incidence increased with obesity class, and thyromental distance was the most consistent predictor, highlighting the need for tailored airway management in obstetric patients with morbid obesity.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"65 ","pages":"Article 104815"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516373","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

In response to “Obstetric anesthesia in Japan: an existential crisis in need of an intervention” 回应“日本的产科麻醉：需要干预的生存危机”

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2026-02-01 Epub Date: 2025-10-21 DOI: 10.1016/j.ijoa.2025.104805

K. Ogawa, H. Azuma, F. Shimizu, K. Yamano, S. Wada

引用次数: 0

Effect of magnesium sulfate in patients with preeclampsia with severe features on gastric antrum cross-sectional area: a prospective observational study 硫酸镁对重度子痫前期患者胃窦横截面积影响的前瞻性观察研究

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2026-02-01 Epub Date: 2025-11-10 DOI: 10.1016/j.ijoa.2025.104816

M.A. Helmy , K.A. Helmy , M.R. Salem , M.A. El-Monem Morsy , M. Fikry , L.M. Milad

Background

While the systemic effects of magnesium sulfate administration are well described, its effects on gastric motility and aspiration risk remain underexplored. We evaluated the effect of magnesium sulfate administration on the gastric antrum cross-sectional area (CSA) in the setting of preeclampsia with severe features.

Methods

This prospective observational study included 31 patients with preeclampsia and severe features receiving an intravenous bolus of magnesium sulfate 5 g over 20 min, followed by an infusion (1 g/h). Gastric ultrasound was performed at baseline (pre-bolus) and 10- and 20-min post-bolus. Serum magnesium levels were measured at baseline and 20 min post-bolus. The primary outcome was the change in gastric CSA from baseline to 20 min post-bolus. The secondary outcomes included the proportion of patients with unsafe gastric volume (CSA > 608 mm²) and correlation between the increasing serum magnesium levels and change in CSA.

Results

There was an increase in gastric antrum CSA from baseline to 10- and 20-min post-bolus, with median CSA values rising from 403 mm² to 440 mm² and 507 mm², respectively (P < 0.001). Serum magnesium levels increased from 1.96 ± 0.26 mg/dL to 5.24 ± 0.86 mg/dL (mean difference: 3.27 ± 0.80 mg/dL). At baseline and 10- and 20-min post-bolus, 2, 5, and 7 of 31 participants, respectively, met criteria for unsafe gastric volume. A strong positive correlation was observed between change in serum magnesium levels and change in CSA (r = +0.896, P < 0.001)

Conclusions

In patients with preeclampsia with severe features, magnesium sulfate 5 g is associated with a significant increase in gastric antrum CSA. The strong positive correlation between serum magnesium levels and CSA supports a potential dose-dependent effect on gastric smooth muscle relaxation. However, further research is warranted to determine whether these sonographic changes correspond to clinically significant increases in gastric volume or translate into a measurable risk of pulmonary aspiration.

背景：虽然硫酸镁的全身性作用已被很好地描述，但其对胃运动和误吸风险的影响仍未被充分探讨。我们评估硫酸镁对重度子痫前期患者胃窦横截面积（CSA）的影响。方法本前瞻性观察研究纳入31例有严重子痫前期症状的患者，在20分钟内静脉滴注硫酸镁5 g，然后以1 g/h的速度输注。在基线（服药前）和服药后10分钟和20分钟进行胃超声检查。在基线和丸后20分钟测量血清镁水平。主要结果是胃CSA从基线到丸后20分钟的变化。次要结局包括胃容量不安全（CSA > 608 mm2）患者的比例以及血清镁水平升高与CSA变化的相关性。结果注射后10分钟和20分钟胃窦CSA从基线增加，中位CSA值分别从403 mm2上升到440 mm2和507 mm2 （P < 0.001）。血清镁水平从1.96±0.26 mg/dL上升至5.24±0.86 mg/dL（平均差值3.27±0.80 mg/dL）。在基线和丸后10分钟和20分钟，31名参与者中分别有2名、5名和7名符合不安全胃容量标准。血清镁水平变化与CSA变化呈极显著正相关（r = +0.896, P < 0.001）结论在重度子痫前期患者中，硫酸镁5 g与胃窦CSA显著升高相关。血清镁水平与CSA之间的强正相关支持胃平滑肌松弛的潜在剂量依赖性作用。然而，需要进一步的研究来确定这些超声变化是否与临床显著的胃容量增加相对应，或者转化为可测量的肺误吸风险。

{"title":"Effect of magnesium sulfate in patients with preeclampsia with severe features on gastric antrum cross-sectional area: a prospective observational study","authors":"M.A. Helmy , K.A. Helmy , M.R. Salem , M.A. El-Monem Morsy , M. Fikry , L.M. Milad","doi":"10.1016/j.ijoa.2025.104816","DOIUrl":"10.1016/j.ijoa.2025.104816","url":null,"abstract":"<div><h3>Background</h3><div>While the systemic effects of magnesium sulfate administration are well described, its effects on gastric motility and aspiration risk remain underexplored. We evaluated the effect of magnesium sulfate administration on the gastric antrum cross-sectional area (CSA) in the setting of preeclampsia with severe features.</div></div><div><h3>Methods</h3><div>This prospective observational study included 31 patients with preeclampsia and severe features receiving an intravenous bolus of magnesium sulfate 5 g over 20 min, followed by an infusion (1 g/h). Gastric ultrasound was performed at baseline (pre-bolus) and 10- and 20-min post-bolus. Serum magnesium levels were measured at baseline and 20 min post-bolus. The primary outcome was the change in gastric CSA from baseline to 20 min post-bolus. The secondary outcomes included the proportion of patients with unsafe gastric volume (CSA > 608 mm<sup>2</sup>) and correlation between the increasing serum magnesium levels and change in CSA.</div></div><div><h3>Results</h3><div>There was an increase in gastric antrum CSA from baseline to 10- and 20-min post-bolus, with median CSA values rising from 403 mm<sup>2</sup> to 440 mm<sup>2</sup> and 507 mm<sup>2</sup>, respectively (<em>P</em> < 0.001). Serum magnesium levels increased from 1.96 ± 0.26 mg/dL to 5.24 ± 0.86 mg/dL (mean difference: 3.27 ± 0.80 mg/dL). At baseline and 10- and 20-min post-bolus, 2, 5, and 7 of 31 participants, respectively, met criteria for unsafe gastric volume. A strong positive correlation was observed between change in serum magnesium levels and change in CSA (r = +0.896, <em>P</em> < 0.001)</div></div><div><h3>Conclusions</h3><div>In patients with preeclampsia with severe features, magnesium sulfate 5 g is associated with a significant increase in gastric antrum CSA. The strong positive correlation between serum magnesium levels and CSA supports a potential dose-dependent effect on gastric smooth muscle relaxation. However, further research is warranted to determine whether these sonographic changes correspond to clinically significant increases in gastric volume or translate into a measurable risk of pulmonary aspiration.</div></div>","PeriodicalId":14250,"journal":{"name":"International journal of obstetric anesthesia","volume":"65 ","pages":"Article 104816"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145516374","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

Response to correspondence from McCarthy et al. regarding maternal sepsis screening and the role of the neutrophil-to-lymphocyte ratio 对McCarthy等人关于母体败血症筛查和中性粒细胞与淋巴细胞比例作用的回复。

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia

Pub Date : 2026-02-01 Epub Date: 2025-10-30 DOI: 10.1016/j.ijoa.2025.104804

T. Culling , D. Camilleri , C. Bertorelli , A. Strang , S. Oram , F. Faggian , S. Sharma , A. Ridgway , S. Zaher , M. Labeta , S.A. Jones , L.C. Davies , J. Watkins , K. Siddall , V. Keeping , K. Simpson , M. Bray , P. Ghazal , S.F. Bell , R.E. Collis

引用次数: 0

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