Choice of Anesthesia for Cesarean Delivery

Juang, J. et al. Anesthesia & Analgesia. Published online: January 16 2017

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Image source: Virginia Powell – Wellcome Images // CC BY-NC-ND 4.0

Neuraxial anesthesia use in cesarean deliveries (CDs) has been rising since the 1980s, whereas general anesthesia (GA) use has been declining.

In this brief report we analyzed recent obstetric anesthesia practice patterns using National Anesthesiology Clinical Outcomes Registry data. Approximately 218,285 CD cases were identified between 2010 and 2015. GA was used in 5.8% of all CDs and 14.6% of emergent CDs.

Higher rates of GA use were observed in CDs performed in university hospitals, after hours and on weekends, and on patients who were American Society of Anesthesiologists class III or higher and 18 years of age or younger.

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Patient reported outcome of adult perioperative anaesthesia

Walker, E.M.K. et al. (2016) British Journal of Anaesthesia. 117 (6) pp. 758-766.

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Background. Understanding the patient perspective on healthcare is central to the evaluation of quality. This study measured selected patient-reported outcomes after anaesthesia in order to identify targets for research and quality improvement.

Conclusions. Anxiety and discomfort after surgery are common; despite this, satisfaction with anaesthesia care in the UK is high. The inconsistent relationship between patient-reported outcome, patient experience and patient satisfaction supports using all three of these domains to provide a comprehensive assessment of the quality of anaesthesia care.

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Human factors in obstetrics

Monks, S. & Maclennon, K. Anaesthesia & Intensive Care Medicine. Published online: 1 July 2016

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The importance of human factors is becoming increasingly recognized in the healthcare profession. Lack of situational awareness, poor communication and inadequate leadership compounded by unfamiliar teams in a rapidly deteriorating clinical situation put obstetric patients at particular risk. There is much to be learnt from other high-risk industries including aviation and the military. Increasing awareness and training in human factors and utilization of communication tools (such as SBAR) and prompts (including emergency checklists) can help to promote a safer environment.

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