{"title":"Interpectoral and serratus anterior plane blocks in mastectomy: unravelling the disconnect between acute and chronic pain.","authors":"Jing Gong, Lin Luo","doi":"10.1111/anae.70147","DOIUrl":"https://doi.org/10.1111/anae.70147","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Della Solichan, Alice Rowley, Cliff Shelton, Catherine El-Zerbi, Charlotte Hadley
{"title":"Efficiency of nitrous oxide mix utilisation in NHS Trusts in England: a pilot study.","authors":"Della Solichan, Alice Rowley, Cliff Shelton, Catherine El-Zerbi, Charlotte Hadley","doi":"10.1111/anae.70143","DOIUrl":"https://doi.org/10.1111/anae.70143","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Too thin for safety, too heavy for discharge: body mass index and postoperative independence.","authors":"Jiwang Liang","doi":"10.1111/anae.70150","DOIUrl":"https://doi.org/10.1111/anae.70150","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
James R G Womersley, Rishi Patel, Gaurika Bhardwaj, Nicholas Tetlow, Ravishankar Rao Baikady
{"title":"Cardiopulmonary fitness in patients undergoing major hepato-pancreatobiliary surgery who are non-anaemic and iron replete vs. non-anaemic and iron deficient: an observational study.","authors":"James R G Womersley, Rishi Patel, Gaurika Bhardwaj, Nicholas Tetlow, Ravishankar Rao Baikady","doi":"10.1111/anae.70140","DOIUrl":"https://doi.org/10.1111/anae.70140","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Access to videolaryngoscopy: who holds the risk?","authors":"Ben Evans, James Brooks, Chloe Fairbairns","doi":"10.1111/anae.70145","DOIUrl":"https://doi.org/10.1111/anae.70145","url":null,"abstract":"","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nils Vlaeminck, Peter Van de Putte, Melanie Dekeyser, Nele Baert, An Wallyn, Lynn Vernieuwe, Carine Smitz, Kristien Wouters, Jolijn Van Cauwenberghe, Vera Saldien
Introduction: Delayed gastric emptying is a known effect of glucagon-like peptide-1 receptor agonists, such as semaglutide. While tachyphylaxis has been reported, recent clinical data indicate an increased risk of residual gastric content on pre-operative gastric ultrasound in patients who are fasted. However, the limited available data do not control for several important potential confounders.
Methods: We conducted a prospective, multicentre, matched case-control study, enrolling patients receiving semaglutide treatment for diabetes mellitus or weight loss and having elective surgery. For each patient receiving semaglutide treatment, we included a matched control based on age, BMI and diabetes mellitus status in a 1:1 ratio. In both cohorts, gastric ultrasound was performed in the supine position, followed by the right lateral decubitus position. A patient was considered to have a 'full stomach' if solid gastric content was visible in any position or if the calculated gastric volume in the right lateral decubitus position exceeded 1.5 ml.kg-1 of total body weight.
Results: We enrolled 44 patients receiving semaglutide treatment and 44 matched controls. A full stomach was observed in 21/43 (49%) of patients receiving semaglutide treatment compared with 8/44 (18%) of controls (odds ratio 4.29, 95%CI 1.63-11.29, p = 0.003). Solid gastric contents were significantly more frequent in patients receiving semaglutide treatment (18/43 (42%)) compared with controls (3/44 (7%), odds ratio 9.85, 95%CI 2.57-37.76, p < 0.001). Calculated gastric volume did not differ significantly.
Discussion: This study compared gastric ultrasound findings in patients receiving semaglutide treatment with matched controls, thereby accounting directly for baseline delayed gastric emptying. Our findings highlight a persistently elevated pulmonary aspiration risk, even after withholding one administration of semaglutide and accounting for age, diabetes mellitus status and obesity. Where available, gastric ultrasound should be used to guide individualised anaesthetic management and optimise peri-operative safety.
胃排空延迟是已知的胰高血糖素样肽-1受体激动剂（如semaglutide）的作用。虽然有快速反应的报道，但最近的临床数据表明，禁食患者术前胃超声检查发现残留胃内容物的风险增加。然而，有限的可用数据不能控制几个重要的潜在混杂因素。方法：我们进行了一项前瞻性、多中心、匹配的病例对照研究，纳入了接受西马鲁肽治疗糖尿病或减肥并择期手术的患者。对于每个接受西马鲁肽治疗的患者，我们根据年龄、BMI和糖尿病状况按1:1的比例纳入了匹配的对照组。在两个队列中，均在仰卧位进行胃超声检查，然后是右侧侧卧位。如果在任何体位可见固体胃内容物，或者在右侧侧卧位计算胃容量超过1.5 ml，则认为患者有“饱胃”。体重的Kg-1。结果：我们招募了44名接受西马鲁肽治疗的患者和44名匹配的对照组。接受西马鲁肽治疗的患者中有21/43（49%）出现胃饱，对照组为8/44(18%)（优势比4.29,95%CI 1.63-11.29, p = 0.003）。与对照组（3/44(7%)）相比，接受西马鲁肽治疗的患者（18/43(42%)）出现固体胃内容物的频率明显更高（3/44(7%)），优势比9.85,95%CI 2.57-37.76, p。讨论：本研究比较了接受西马鲁肽治疗的患者与匹配对照组的胃超声检查结果，从而直接解释了基线胃排空延迟的原因。我们的研究结果强调了持续升高的肺误吸风险，即使在停用一次西马鲁肽并考虑到年龄、糖尿病状况和肥胖的情况下也是如此。在可行的情况下，应使用胃超声指导个体化麻醉管理并优化围手术期安全性。
{"title":"Gastric ultrasound in patients receiving semaglutide: a prospective, multicentre, matched control study.","authors":"Nils Vlaeminck, Peter Van de Putte, Melanie Dekeyser, Nele Baert, An Wallyn, Lynn Vernieuwe, Carine Smitz, Kristien Wouters, Jolijn Van Cauwenberghe, Vera Saldien","doi":"10.1111/anae.70129","DOIUrl":"https://doi.org/10.1111/anae.70129","url":null,"abstract":"<p><strong>Introduction: </strong>Delayed gastric emptying is a known effect of glucagon-like peptide-1 receptor agonists, such as semaglutide. While tachyphylaxis has been reported, recent clinical data indicate an increased risk of residual gastric content on pre-operative gastric ultrasound in patients who are fasted. However, the limited available data do not control for several important potential confounders.</p><p><strong>Methods: </strong>We conducted a prospective, multicentre, matched case-control study, enrolling patients receiving semaglutide treatment for diabetes mellitus or weight loss and having elective surgery. For each patient receiving semaglutide treatment, we included a matched control based on age, BMI and diabetes mellitus status in a 1:1 ratio. In both cohorts, gastric ultrasound was performed in the supine position, followed by the right lateral decubitus position. A patient was considered to have a 'full stomach' if solid gastric content was visible in any position or if the calculated gastric volume in the right lateral decubitus position exceeded 1.5 ml.kg<sup>-1</sup> of total body weight.</p><p><strong>Results: </strong>We enrolled 44 patients receiving semaglutide treatment and 44 matched controls. A full stomach was observed in 21/43 (49%) of patients receiving semaglutide treatment compared with 8/44 (18%) of controls (odds ratio 4.29, 95%CI 1.63-11.29, p = 0.003). Solid gastric contents were significantly more frequent in patients receiving semaglutide treatment (18/43 (42%)) compared with controls (3/44 (7%), odds ratio 9.85, 95%CI 2.57-37.76, p < 0.001). Calculated gastric volume did not differ significantly.</p><p><strong>Discussion: </strong>This study compared gastric ultrasound findings in patients receiving semaglutide treatment with matched controls, thereby accounting directly for baseline delayed gastric emptying. Our findings highlight a persistently elevated pulmonary aspiration risk, even after withholding one administration of semaglutide and accounting for age, diabetes mellitus status and obesity. Where available, gastric ultrasound should be used to guide individualised anaesthetic management and optimise peri-operative safety.</p>","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146103370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aine Sommerfield,Neil Hauser,David Sommerfield,Belinda Frank,Priya Sreedharan,Sadhish Shanmugam,Susan Humphreys,Fiona Taverner,Britta S von Ungern-Sternberg
INTRODUCTIONParents and caregivers play a critical role in the care of their child peri-operatively. Our team undertook previous research with parents/carers, which identified Australian parents' top 10 research priorities for paediatric anaesthesia and peri-operative medicine. While this was an important exercise, it focused on parent-reported experiences rather than the priorities of the children themselves; however, the experiences and concerns of parents/carers may not always reflect those of their child. It has been shown previously how integral it is to listen to each child's own voice to improve and create a more adaptive and safer peri-operative environment.METHODSThis research prioritisation study was developed for children and used a modified James Lind Alliance method that involved surveys, a youth community conversation and a final consensus-based prioritisation meeting, all of which were conducted online.RESULTSParticipants were children and young people aged 6-18 y living in Australia. In total, we engaged 356 children and young people. We identified the top research priorities for Australian children and young people for paediatric anaesthesia and peri-operative medicine through a rigorous process of consensus. The final top 10 priorities were agreed by consensus after a multi-step process and included how to: reduce anxiety (including needle phobia); make anaesthesia safer; avoid postoperative complications (e.g. pain, sickness, agitation); and improve communication between children and doctors.DISCUSSIONThe resulting priorities differed from those conducted in Australia for adult peri-operative medicine and from the parent/carer and clinician priorities identified previously for paediatric anaesthesia care. These research priorities can help guide future paediatric anaesthesia and peri-operative medicine research directions.
{"title":"Research priorities for paediatric peri-operative medicine identified by Australian children and young people.","authors":"Aine Sommerfield,Neil Hauser,David Sommerfield,Belinda Frank,Priya Sreedharan,Sadhish Shanmugam,Susan Humphreys,Fiona Taverner,Britta S von Ungern-Sternberg","doi":"10.1111/anae.70126","DOIUrl":"https://doi.org/10.1111/anae.70126","url":null,"abstract":"INTRODUCTIONParents and caregivers play a critical role in the care of their child peri-operatively. Our team undertook previous research with parents/carers, which identified Australian parents' top 10 research priorities for paediatric anaesthesia and peri-operative medicine. While this was an important exercise, it focused on parent-reported experiences rather than the priorities of the children themselves; however, the experiences and concerns of parents/carers may not always reflect those of their child. It has been shown previously how integral it is to listen to each child's own voice to improve and create a more adaptive and safer peri-operative environment.METHODSThis research prioritisation study was developed for children and used a modified James Lind Alliance method that involved surveys, a youth community conversation and a final consensus-based prioritisation meeting, all of which were conducted online.RESULTSParticipants were children and young people aged 6-18 y living in Australia. In total, we engaged 356 children and young people. We identified the top research priorities for Australian children and young people for paediatric anaesthesia and peri-operative medicine through a rigorous process of consensus. The final top 10 priorities were agreed by consensus after a multi-step process and included how to: reduce anxiety (including needle phobia); make anaesthesia safer; avoid postoperative complications (e.g. pain, sickness, agitation); and improve communication between children and doctors.DISCUSSIONThe resulting priorities differed from those conducted in Australia for adult peri-operative medicine and from the parent/carer and clinician priorities identified previously for paediatric anaesthesia care. These research priorities can help guide future paediatric anaesthesia and peri-operative medicine research directions.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"72 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTIONAs survival rates after critical illness improve, increasing numbers of ICU survivors experience post-intensive care syndrome (PICS), with physical, cognitive and psychiatric impairments. However, there is a lack of robust population-level estimates on incidence rates to guide the implementation of measures to address this issue.METHODSWe conducted a retrospective nationwide cohort study using the South Korean National Health Insurance Service database. Adults admitted to any ICU who were alive ≥ 12 months after hospital discharge were included. To estimate the incidence of PICS, we did not include patients with any PICS-related diagnosis in the year before the index ICU admission. Post-intensive care syndrome was defined as a new diagnosis in at least one domain - physical, cognitive or psychiatric - within 12 months of hospital discharge.RESULTSAmong 234,069 ICU survivors with no prior PICS diagnosis, 130,110 (55.6%) developed PICS within 12 months of hospital discharge. Risk factors included older age (odds ratio (OR) 1.01, 95%CI 1.01-1.01); female sex (OR 1.17, 95%CI 1.15-1.19); lower income, particularly among Medical Aid beneficiaries (OR 1.16, 95%CI 1.12-1.21); pre-existing disability (mild-to-moderate: OR 1.12; 95%CI 1.09-1.15; severe: OR 1.08, 95%CI 1.05-1.12); higher comorbidity burden such as cerebrovascular disease (OR 1.88, 95%CI 1.84-1.92), dementia (OR 3.11, 95%CI 2.91-3.31) or chronic pulmonary disease (OR 1.25, 95%CI 1.22-1.28); and exposure to mechanical ventilation (OR 1.40, 95%CI, 1.36-1.44) or continuous renal replacement therapy (OR 1.12, 95%CI 1.05-1.12).DISCUSSIONIn a nationwide cohort of 234,069 ICU survivors, over half developed PICS within 12 months, with physical impairment most common. These findings quantify the survivorship burden attributable to critical illness and underpin the need for structured, multidisciplinary follow-up and rehabilitation for high-risk groups.
{"title":"Post-intensive care syndrome after critical illness: incidence and predictors in a nationwide cohort.","authors":"Tak Kyu Oh,In-Ae Song","doi":"10.1111/anae.70131","DOIUrl":"https://doi.org/10.1111/anae.70131","url":null,"abstract":"INTRODUCTIONAs survival rates after critical illness improve, increasing numbers of ICU survivors experience post-intensive care syndrome (PICS), with physical, cognitive and psychiatric impairments. However, there is a lack of robust population-level estimates on incidence rates to guide the implementation of measures to address this issue.METHODSWe conducted a retrospective nationwide cohort study using the South Korean National Health Insurance Service database. Adults admitted to any ICU who were alive ≥ 12 months after hospital discharge were included. To estimate the incidence of PICS, we did not include patients with any PICS-related diagnosis in the year before the index ICU admission. Post-intensive care syndrome was defined as a new diagnosis in at least one domain - physical, cognitive or psychiatric - within 12 months of hospital discharge.RESULTSAmong 234,069 ICU survivors with no prior PICS diagnosis, 130,110 (55.6%) developed PICS within 12 months of hospital discharge. Risk factors included older age (odds ratio (OR) 1.01, 95%CI 1.01-1.01); female sex (OR 1.17, 95%CI 1.15-1.19); lower income, particularly among Medical Aid beneficiaries (OR 1.16, 95%CI 1.12-1.21); pre-existing disability (mild-to-moderate: OR 1.12; 95%CI 1.09-1.15; severe: OR 1.08, 95%CI 1.05-1.12); higher comorbidity burden such as cerebrovascular disease (OR 1.88, 95%CI 1.84-1.92), dementia (OR 3.11, 95%CI 2.91-3.31) or chronic pulmonary disease (OR 1.25, 95%CI 1.22-1.28); and exposure to mechanical ventilation (OR 1.40, 95%CI, 1.36-1.44) or continuous renal replacement therapy (OR 1.12, 95%CI 1.05-1.12).DISCUSSIONIn a nationwide cohort of 234,069 ICU survivors, over half developed PICS within 12 months, with physical impairment most common. These findings quantify the survivorship burden attributable to critical illness and underpin the need for structured, multidisciplinary follow-up and rehabilitation for high-risk groups.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"20 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adele Macgregor,Andrew McCombie,Elizabeth Hall,R Ross Kennedy
INTRODUCTIONDisparities in obstetric care in Aotearoa, New Zealand, significantly impact Māori and Pacific women, resulting in higher rates of maternal and neonatal morbidity and mortality. This study investigated the relationship between ethnicity and utilisation of epidural analgesia at our hospital to identify disparities in its provision and inform future research into the contributing factors.METHODSThis population-based retrospective cohort study included all deliveries at Christchurch Hospital, Christchurch, Aotearoa New Zealand, over a 4-year period. We performed separate univariable and multivariable logistic regression analyses for primiparous and multiparous women to examine how ethnicity, maternal characteristics and obstetric factors affect epidural utilisation.RESULTSThe study included 22,970 deliveries, with an overall epidural rate for vaginal deliveries of 23.1% (n = 3449). The rate was lower among Māori (18.4%) and Pacific (9.9%) women. There was no significant difference in epidural utilisation between Māori and European women during their first birth (OR 0.87, 95%CI 0.70-1.04, p = 0.12). However, Māori women were less likely to receive an epidural in subsequent births (OR 0.75, 95%CI 0.60-0.92, p < 0.01). Pacific women showed significantly lower epidural rates compared with European women across both parity groups (primiparous OR 0.61, 95%CI 0.44-0.84, p < 0.01 and multiparous OR 0.18, 95%CI 0.09-0.31, p < 0.01), even after controlling for confounders.DISCUSSIONThis study outlines the disparities in the utilisation of epidural analgesia at our hospital across various patient demographics. It highlights the need for further qualitative research investigating potential barriers to equitable access to effective labour pain management.
新西兰奥特罗阿产科护理的差异对Māori和太平洋地区妇女产生了重大影响，导致孕产妇和新生儿发病率和死亡率较高。本研究调查了种族与我院硬膜外镇痛使用之间的关系，以确定其提供的差异，并为未来的影响因素研究提供信息。方法：这项以人群为基础的回顾性队列研究包括4年期间在新西兰基督城基督城医院分娩的所有产妇。我们对初产和多产妇女分别进行单变量和多变量logistic回归分析，以检验种族、产妇特征和产科因素如何影响硬膜外使用。结果该研究包括22970例分娩，阴道分娩的硬膜外总率为23.1% （n = 3449）。在Māori（18.4%）和太平洋地区（9.9%）的女性中，这一比例较低。Māori和欧洲妇女首次分娩时硬膜外应用无显著差异（OR 0.87, 95%CI 0.70-1.04, p = 0.12）。然而，Māori妇女在随后的分娩中接受硬膜外麻醉的可能性较低（OR 0.75, 95%CI 0.60-0.92, p < 0.01）。即使在控制混杂因素后，太平洋地区妇女与欧洲妇女相比，在两个胎次组中均表现出显著的硬膜外分娩率（初产OR 0.61, 95%CI 0.44-0.84, p < 0.01，多产OR 0.18, 95%CI 0.09-0.31, p < 0.01）。本研究概述了我院不同患者在硬膜外镇痛应用方面的差异。它强调需要进一步进行定性研究，调查公平获得有效的分娩疼痛管理的潜在障碍。
{"title":"Effect of ethnicity and parity on utilisation of labour epidural analgesia: a retrospective study.","authors":"Adele Macgregor,Andrew McCombie,Elizabeth Hall,R Ross Kennedy","doi":"10.1111/anae.70127","DOIUrl":"https://doi.org/10.1111/anae.70127","url":null,"abstract":"INTRODUCTIONDisparities in obstetric care in Aotearoa, New Zealand, significantly impact Māori and Pacific women, resulting in higher rates of maternal and neonatal morbidity and mortality. This study investigated the relationship between ethnicity and utilisation of epidural analgesia at our hospital to identify disparities in its provision and inform future research into the contributing factors.METHODSThis population-based retrospective cohort study included all deliveries at Christchurch Hospital, Christchurch, Aotearoa New Zealand, over a 4-year period. We performed separate univariable and multivariable logistic regression analyses for primiparous and multiparous women to examine how ethnicity, maternal characteristics and obstetric factors affect epidural utilisation.RESULTSThe study included 22,970 deliveries, with an overall epidural rate for vaginal deliveries of 23.1% (n = 3449). The rate was lower among Māori (18.4%) and Pacific (9.9%) women. There was no significant difference in epidural utilisation between Māori and European women during their first birth (OR 0.87, 95%CI 0.70-1.04, p = 0.12). However, Māori women were less likely to receive an epidural in subsequent births (OR 0.75, 95%CI 0.60-0.92, p < 0.01). Pacific women showed significantly lower epidural rates compared with European women across both parity groups (primiparous OR 0.61, 95%CI 0.44-0.84, p < 0.01 and multiparous OR 0.18, 95%CI 0.09-0.31, p < 0.01), even after controlling for confounders.DISCUSSIONThis study outlines the disparities in the utilisation of epidural analgesia at our hospital across various patient demographics. It highlights the need for further qualitative research investigating potential barriers to equitable access to effective labour pain management.","PeriodicalId":7742,"journal":{"name":"Anaesthesia","volume":"22 1","pages":""},"PeriodicalIF":10.7,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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