Some immediate serious complications of obstetric epidural analgesia and anaesthesia: a prospective study of 145 550 epidurals

Jenkins, J. G.

doi:10.1016/j.ijoa.2004.07.009

Cited by 84 publications

(32 citation statements)

References 17 publications

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“…18 In contrast, Kar and Jenkin's study of 81 322 obstetric epidurals in 2000 gave an incidence of high regional block as only 1:27 107. 19 Life-threateningly high regional block is rare, being quoted as one in every 16 200 epidurals in a further study by Jenkins in 2005, 22 but arguably guidelines are most useful when a practitioner encounters a problem with which they have no previous experience. An editorial by Yentis and Dob in 2000 reviewing the incidence of high regional block suggested a drill for high regional block in obstetrics be formalised in each obstetric unit.…”

Section: Departmental Guideline Availabilitymentioning

confidence: 99%

A national survey of obstetric anaesthesia guidelines in the UK

McGarrity

O’Connor

Young

2008

International Journal of Obstetric Anesthesia

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Section: Departmental Guideline Availabilitymentioning

confidence: 99%

A national survey of obstetric anaesthesia guidelines in the UK

McGarrity

O’Connor

Young

2008

International Journal of Obstetric Anesthesia

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“…The sample size was determined based on the best available data at the time of the preparation of the study protocol, which were data on total hemoglobin estimates (HbT) from spectral fitting obtained in a previous study [11]. …”

Section: Methodsmentioning

confidence: 99%

Spectral tissue sensing to identify intra- and extravascular needle placement — A randomized single-blind controlled trial

et al. 2017

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Safe vascular access is a prerequisite for intravenous drug admission. Discrimination between intra- and extravascular needle position is essential for procedure safety. Spectral tissue sensing (STS), based on optical spectroscopy, can provide tissue information directly from the needle tip. The primary objective of the trial was to investigate if STS can reliably discriminate intra-vascular (venous) from non-vascular punctures. In 20 healthy volunteers, a needle with an STS stylet was inserted, and measurements were performed for two intended locations: the first was subcutaneous, while the second location was randomly selected as either subcutaneous or intravenous. The needle position was assessed using ultrasound (US) and aspiration. The operators who collected the data from the spectral device were blinded to the insertion and ultrasonographic visualization procedure and the physician was blinded to the spectral data. Following offline spectral analysis, a prediction of intravascular or subcutaneous needle placement was made and compared with the “true” needle tip position as indicated by US and aspiration. Data for 19 volunteers were included in the analysis. Six out of 8 intended vascular needle placements were defined as intravascular according to US and aspiration. The remaining two intended vascular needle placements were negative for aspiration. For the other 11 final needle locations, the needle was clearly subcutaneous according to US examination and no blood was aspirated. The Mann-Whitney U test yielded a p-value of 0.012 for the between-group comparison. The differences between extra- and intravascular were in the within-group comparison computed with the Wilcoxon signed-rank test was a p-value of 0.022. In conclusion, STS is a promising method for discriminating between intravascular and extravascular needle placement. The information provided by this method may complement current methods for detecting an intravascular needle position.

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“…When compared to placebo, the analgesic effect of pethidine is modest. 1 Other authors have reported sedation but failed to demonstrate analgesia. 2 Furthermore, it has been demonstrated that parenteral opioid analgesia is far less effective then epidural or combined spinal-epidural analgesia.…”

Section: Remifentanil As a Labour Analgesicmentioning

confidence: 99%

“…Intravascular, intrathecal and subdural placements have been reported to occur with incidences of 1 in 5000, 1 in 2900 and 1 in 4200 respectively. 1 Until now there has not been a viable alternative to epidural analgesia. Pethidine is far from ideal having been described as providing ''more sedation than analgesia,'' effecting maternal gastric motility, modifying the cardiotocograph (CTG), causing fetal acidosis and having active metabolites with prolonged half lives.…”

mentioning

confidence: 99%

Remifentanil patient-controlled analgesia should be routinely available for use in labour

Hill

2008

International Journal of Obstetric Anesthesia

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Some immediate serious complications of obstetric epidural analgesia and anaesthesia: a prospective study of 145 550 epidurals

Cited by 84 publications

References 17 publications

A national survey of obstetric anaesthesia guidelines in the UK

A national survey of obstetric anaesthesia guidelines in the UK

Spectral tissue sensing to identify intra- and extravascular needle placement — A randomized single-blind controlled trial

Remifentanil patient-controlled analgesia should be routinely available for use in labour

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