Anaesthesia for operative deliveries at the University Hospital of the West Indies: a change of practice

Crawford-Sykes, A; Scarlett, M; Hambleton, Ian; Nelson, Martha; Rattray, Carole

doi:10.1590/s0043-31442005000300006

Cited by 9 publications

(14 citation statements)

References 21 publications

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“…Moreover better neonatal outcome was recorded for newborns from mothers who underwent regional anesthesia compared to general anesthesia for their CS [6]. Since 2001, more CS were being done under spinal anesthesia [7], but some countries reported higher rates of general anesthesia for CS [3]. Similarly spinal anesthesia (SA) for caesarean section has become the routine and preferred technique among Eritrean anesthetists.…”

Section: Introductionmentioning

confidence: 99%

Maternal Satisfaction and Its Associated Factors towards Spinal Anesthesia for Caesarean Section: A Cross-Sectional Study in Two Eritrean Hospitals

Idris

Weldegiorgis

Tesfamariam

2020

Anesthesiology Research and Practice

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Objective. Satisfaction of mothers during caesarean section is an important indicator for measuring quality of obstetric anesthesia. This study aimed to determine mothers’ level of satisfaction and the predicting factors of dissatisfaction towards spinal anesthesia during caesarean section. Methods. Cross-sectional study design was utilized in Orotta Maternity Hospital (OMH) and Sembel Hospital from December 2017 to February 2018, in Asmara, Eritrea. Satisfaction of the mothers was measured using a pretested questionnaire. Bivariate and multivariate logistic regression were utilized to identify predictors of dissatisfaction using SPSS (Version 22.0). Results. Involvement of mothers in the choice of anesthesia (3.3%) and explanation about the stay at operating theater (10%) were the two least reported items. As per the subscale analysis, the lowest satisfaction was observed for the preoperative assessment (16.7%). Overall, 87.9% of the mothers were satisfied with the spinal anesthetic service. Hospital at which anesthesia was administered (p<0.001), marital status (p<0.001), and intraoperative pain (p<0.001) were significant predictors of dissatisfaction towards spinal anesthesia. Moreover, the rate of refusal to have spinal anesthesia in the future was 12.5%. Conclusion. Though overall satisfaction can be considered as fair, preoperative assessment is considerably low. Hence, explaining the benefits and risks of the anesthetic techniques as well as considering patient’s opinion is very important while deciding the type of anesthesia.

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Section: Introductionmentioning

confidence: 99%

Maternal Satisfaction and Its Associated Factors towards Spinal Anesthesia for Caesarean Section: A Cross-Sectional Study in Two Eritrean Hospitals

Idris

Weldegiorgis

Tesfamariam

2020

Anesthesiology Research and Practice

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“…is a more common and safer method than general anesthesia for delivery anesthesia (7). Also, in spinal anesthesia, the likelihood of maternal pulmonary aspiration and fetal distress is minimized (8).…”

Section: Introductionmentioning

confidence: 99%

Effect of Low-Dose Intravenous Ketamine on Prevention of Headache After Spinal Anesthesia in Patients Undergoing Elective Cesarean Section: A Double-Blind Clinical Trial Study

et al. 2019

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Background: Spinal anesthesia is the most commonly used method for elective cesarean section, which is a popular technique due to its simplicity, reliability, and speed to achieve adequate anesthesia. Headache following dura perforation is the most important delayed complication following spinal and epidural anesthesia. Objectives: To evaluate the impact of low-dose intravenous ketamine in patients undergoing cesarean section under spinal anesthesia on the prevention of dura perforation headache (PDPH). Methods: This clinical trial study was performed on 64 pregnant women undergoing cesarean section at Vali-e-Asr Hospital. The patients were divided into two groups. In the case group, 0.15 mg/kg body weight ketamine was injected intravenously and in the control group, normal saline was used as the placebo. The incidence of headache and its severity at one, 4, 12, and 24 hours postoperatively, nausea and its severity were also measured and compared. Independent t-test, Mann-Whitney U and chi-square tests were used. A P value < 0.05 was considered statistically significant. Results: The data revealed that low dose intravenous ketamine significantly decreased patients' headaches (P = 0.001), the sensation of pruritus (P = 0.009), and the need for analgesic (P = 0.001). Furthermore, the sensation of postoperative nausea was less in the case group. The patients in the case and control groups had no significant difference in terms of hypertension or bradycardia (P = 0.717 and 0.939, respectively). Conclusions: The injection of ketamine as a premedication in the cesarean section can reduce the severity of postoperative headache in mothers. Therefore, it is recommended to use ketamine as an anti-headache drug in pregnant women.

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“…This shift from general anaesthesia to regional for caesarean section is also a common event elsewhere. 12,13 In a West Indian hospital, the proportion of general anaesthesia for caesarean section decreased from 85% in 1979 to 44% in 1989 1 and may have decreased further. This worldwide trend is due to the perceived advantages of maternal safety and foetal well-being at birth.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 The reason for the shift is not far-fetched and may not be unconnected with the hazards of general anaesthesia. The difficult failed intubation, regurgitation/aspiration pneumonitis, and hypoxaemia constitute major causes of anaesthetic maternal mortality.…”

Section: Introductionmentioning

confidence: 99%

Trends in Regional Anaesthesia for Caesarean Section in a Nigerian Tertiary Health Centre

Lamina¹

2010

West African Journal of Medicine

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BACKGROUND: Most caesarean sections were previously performed under general anaesthesia but there has been an increasing trend worldwide in the use of regional anaesthesia as the preferred method of anaesthesia for caesarean delivery. OBJECTIVE: To evaluate the trend of practice of regional anaesthesia for caesarean section in a tertiary hospital in South-western part of Nigeria. METHODS: The obstetric operating room records at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria were reviewed for a twenty-year period: January 1986 to December 2005. The anaesthetic techniques for caesarean section and the level of training of the attending anaesthetist were noted. RESULTS: A total of 1,785 patients were delivered by caesarean section during the twenty-year period . Most patients [1578(88.4%)] had caesarean section under general anaesthesia while 207(11.6%) had regional anaesthesia. Subarachnoid block accounted for 89(5%) of the patients and 118(6.6%) had the caesarean section under epidural block. One hundred and ten (21.5%) of the regional techniques were in the first quarter of the 20-year period. This figure fell to eight (2%) in the second quarter; zero in the third quarter and rose to 82(13.7%) in the last quarter demonstrating an increasing trend of regional technique for caesarean section. Majority of the epidural blocks were conducted by nurseanaesthetists while the subarachnoid blocks were administered by anaesthetists. CONCLUSION: There is an overall low practice or usage of regional anaesthetic for caesarean section. A trend towards increasing administration of regional technique for caesarean section is demonstrated. A dedicated period for hand on the job workshop in regional blocks may enhance early and prompt acquisition of relevant skills in regional anaesthesia for caesarean delivery. WAJM 2009; 28(6): 380-383.Keywords: Caesarean section, anaesthesia for, general anaesthesia, regional anaesthesia.

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Anaesthesia for operative deliveries at the University Hospital of the West Indies: a change of practice

Cited by 9 publications

References 21 publications

Maternal Satisfaction and Its Associated Factors towards Spinal Anesthesia for Caesarean Section: A Cross-Sectional Study in Two Eritrean Hospitals

Maternal Satisfaction and Its Associated Factors towards Spinal Anesthesia for Caesarean Section: A Cross-Sectional Study in Two Eritrean Hospitals

Effect of Low-Dose Intravenous Ketamine on Prevention of Headache After Spinal Anesthesia in Patients Undergoing Elective Cesarean Section: A Double-Blind Clinical Trial Study

Trends in Regional Anaesthesia for Caesarean Section in a Nigerian Tertiary Health Centre

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