Resident training in obstetric anesthesia in the United States.

Abstract:

BACKGROUND:Limited information exists on obstetric anesthesia experience and training within residency training programs in the United States. METHODS:A survey was sent to every academic anesthesiology training program in the United States (n=120), with follow-up reminders to non-responders. The survey included 14 questions divided into staffing, didactic teaching and epidemiology regarding the practice of obstetric anesthesia at each academic institution. RESULTS:A response rate of 78% (93/120) was achieved. The returned surveys were grouped into three tiers by the number of deliveries/year from the lowest (Group 1) to the highest (Group 3). The total number of obstetric deliveries at each institution ranged from 340 to 15 800. The average number of residents/month rotating on obstetric anesthesia was 2.6 and the number of months spent on the obstetric anesthesia service was 2.7. The average number of obstetric anesthesia lectures given was 12 per month. A total of 21.5 obstetric anesthesia fellows were reported to train at these institutions, with fellows being more common in larger institutions. Group 1 institutions were more likely to have anesthesiologists covering the main operating room and obstetric suite simultaneously. The average number of obstetric anesthesia staff members/institution was 4.3. The average cesarean section rate was 27.8%, with 5.8% being performed under general anesthesia. Neuraxial techniques were used in an average of 70.3% of laboring parturients, with combined spinal epidurals accounting for 24.6% of the techniques. CONCLUSION:The average number of obstetric deliveries per year for institutions with a resident training program was 3498+/-2383. Dedicated obstetric anesthesia staffing was more common when >3700 deliveries/year were performed; the presence of this staffing corresponded with a reduction in the use of general anesthesia for cesarean deliveries. Few differences in the resident lecture didactic exposure were observed in terms of numbers of lectures and months on the obstetric anesthesia service, although a significantly greater number of clinical cases was available to each resident in those institutions with greater overall numbers of obstetric cases.

journal_name

Int J Obstet Anesth

authors

Panni MK,Camann WR,Tsen LC

doi

10.1016/j.ijoa.2006.04.013

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

284-9

issue

4

eissn

0959-289X

issn

1532-3374

pii

S0959-289X(06)00100-2

journal_volume

15

pub_type

杂志文章
  • A comparison of epidural ropivacaine 0.75% and bupivacaine 0.5% with fentanyl for elective caesarean section.

    abstract:BACKGROUND:Early studies suggested that ropivacaine had clinical advantages over bupivacaine with respect to cardiotoxicity and motor block, and that it was suitable for epidural caesarean section. This study was set up to compare epidural 0.75% ropivacaine with a popular bupivacaine/fentanyl mixture for elective caesa...

    journal_title:International journal of obstetric anesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/j.ijoa.2005.01.002

    authors: Christelis N,Harrad J,Howell PR

    更新日期:2005-07-01 00:00:00

  • A comparison of catheter vs needle injection of local anesthetic for induction of epidural anesthesia for cesarean section.

    abstract::It is generally believed that bolus injections of local anesthetic through an epidural needle produce a more rapid onset of blockade, but at the expense of an increased incidence and severity of hypotension, whereas intermittent injections through a catheter take longer to achieve adequate anesthesia but with a lower ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0959-289x(97)80006-4

    authors: Husain FJ,Herman NL,Karuparthy VR,Knape KG,Downing JW

    更新日期:1997-04-01 00:00:00

  • Choice of anaesthetic agents for caesarean section: a UK survey of current practice.

    abstract:BACKGROUND:A national survey of current practice and preferred drug choices for both induction and maintenance of general anaesthesia for caesarean section was undertaken. METHODS:Following approval by the Obstetric Anaesthetists' Association, all UK consultant members were invited to respond to an electronic survey. ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2012.09.001

    authors: Murdoch H,Scrutton M,Laxton CH

    更新日期:2013-01-01 00:00:00

  • Subcapsular liver hematoma causing cardiac tamponade in HELLP syndrome.

    abstract::HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome is an obstetric complication with heterogeneous presentation, multisystem involvement and variable prognosis, but which usually resolves after delivery. We report a case of HELLP syndrome with subcapsular hematoma of the liver causing extrapericardia...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2012.04.007

    authors: Kinthala S,Fakoory M,Greaves T,Kandamaran L,Thomas H,Moe S

    更新日期:2012-07-01 00:00:00

  • Concealed paracetamol overdose treated as HELLP syndrome in the presence of postpartum liver dysfunction.

    abstract::Paracetamol is the most frequently used analgesic during pregnancy and the most common drug involved in suicidal overdose in the UK. Manifestation of toxicity classically occurs over four phases with clinical and laboratory features resembling HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome. We repo...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2014.01.006

    authors: Mills AT,Davidson ME,Young P

    更新日期:2014-05-01 00:00:00

  • Severe respiratory depression in the obstetric patient after intrathecal meperidine or sufentanil.

    abstract::Two cases of severe respiratory depression in the obstetric population are presented. The first occurred after intrathecal injection of a modest dose (50 mg) of meperidine. The second followed intrathecal administration of 10 microg of sufentanil after intravenous fentanyl. These cases illustrate the potential gravity...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/s0959-289x(97)80086-6

    authors: Jaffee JB,Drease GE,Kelly T,Newman LM

    更新日期:1997-07-01 00:00:00

  • The incidence of maternal fever during labor is less with intermittent than with continuous epidural analgesia: a randomized controlled trial.

    abstract:BACKGROUND:This prospective, randomized study was performed to see if intermittent labor epidural analgesia was protective against maternal intrapartum fever, compared to continuous epidural infusion. METHODS:Ninety-two healthy, term, nulliparous women in spontaneous labor were assigned to either intermittent (ILEA) o...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ijoa.2007.07.006

    authors: Mantha VR,Vallejo MC,Ramesh V,Phelps AL,Ramanathan S

    更新日期:2008-04-01 00:00:00

  • Effect of μ-opioid receptor A118G polymorphism on the ED50 of epidural sufentanil for labor analgesia.

    abstract:BACKGROUND:A common polymorphism of the μ-opioid receptor gene (OPRM1, p.118A/G), which has been shown to effect the response to neuraxial opioids, occurs in 30% of Caucasian women. This double-blind up-down sequential allocation study was designed to examine the effect of p.118A/G on the ED50 of epidural sufentanil fo...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2011.10.001

    authors: Camorcia M,Capogna G,Stirparo S,Berritta C,Blouin JL,Landau R

    更新日期:2012-01-01 00:00:00

  • Insertion of an intrathecal catheter following accidental dural puncture: a meta-analysis.

    abstract:BACKGROUND:Inserting an intrathecal catheter after accidental dural puncture in parturients to prevent postdural puncture headache is becoming increasingly popular. We aimed to identify relevant published articles investigating this intervention and subject data to a meta-analysis. METHODS:A systematic literature sear...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,meta分析

    doi:10.1016/j.ijoa.2012.10.004

    authors: Heesen M,Klöhr S,Rossaint R,Walters M,Straube S,van de Velde M

    更新日期:2013-01-01 00:00:00

  • Congenital complete heart block in the setting of severe pre-eclampsia requiring urgent cesarean section.

    abstract::Congenital complete heart block is a rare phenomenon that may be discovered during pregnancy in patients who were previously asymptomatic. Peripartum management of these patients mandates a multidisciplinary approach with careful planning regarding indications for pacing, appropriate anesthetic technique, and continge...

    journal_title:International journal of obstetric anesthesia

    pub_type:

    doi:10.1016/j.ijoa.2020.07.012

    authors: Preston D,Klucsarits S,Moon T,Nasir D

    更新日期:2020-11-01 00:00:00

  • Acute starvation in pregnancy: a cause of severe metabolic acidosis.

    abstract::We report a case of starvation-induced metabolic ketoacidosis in a previously healthy 29-year-old, nulliparous woman at 32 weeks of gestation. She was admitted to hospital with mild preeclampsia associated with persistent nausea and vomiting that progressed to severe preeclampsia requiring urgent control of hypertensi...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2010.11.004

    authors: Patel A,Felstead D,Doraiswami M,Stocks GM,Waheed U

    更新日期:2011-07-01 00:00:00

  • Obstetric anaesthesia in Hungary.

    abstract::A nation-wide survey of pain relief in childbirth in Hungary was carried out in 1993. Information was provided on 104 137 deliveries in 98 units. The frequencies of different methods of pain relief for vaginal delivery were as follows: systemic opiates in 7387 cases (8.3%), epidural analgesia in 4611 cases (5.2%) and ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/s0959-289x(97)80029-5

    authors: Beke A,Takács G,Sziller I,Fedák L,Papp Z

    更新日期:1997-10-01 00:00:00

  • Determination of ChloraPrep® drying time before neuraxial anesthesia in elective cesarean delivery. A prospective observational study.

    abstract:BACKGROUND:ChloraPrep® is a skin antiseptic commonly used before neuraxial anesthesia. It is believed that skin must be allowed to dry to prevent nerve damage by seeding ChloraPrep® solution into the neuraxis. We aimed to determine ChloraPrep® drying time in pregnant women before initiation of neuraxial anesthesia. ME...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2018.10.012

    authors: Gunka V,Soltani P,Astrakianakis G,Martinez M,Albert A,Taylor J,Kavanagh T

    更新日期:2019-05-01 00:00:00

  • Blood conservation techniques in obstetrics: a UK perspective.

    abstract::In the UK, maternal mortality due to haemorrhage appears to be rising, with obstetric haemorrhage accounting for 3-4% of the red cells transfused. Allogeneic blood transfusion carries risks such as administration errors, transmitted infections and immunological reactions. The supply of blood is decreasing, partly due ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,评审

    doi:10.1016/j.ijoa.2007.01.014

    authors: Catling S

    更新日期:2007-07-01 00:00:00

  • Retrospective study to investigate fresh frozen plasma and packed cell ratios when administered for women with postpartum hemorrhage, before and after introduction of a massive transfusion protocol.

    abstract:BACKGROUND:Administration of packed red blood cells (PRBC) and fresh frozen plasma (FFP) to women with postpartum hemorrhage (PPH) before and after introduction of a massive transfusion protocol. METHODS:The retrospective PPH study cohort of two tertiary centers was identified using blood bank records, verified by pat...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.ijoa.2018.08.001

    authors: Weiniger CF,Yakirevich-Amir N,Sela HY,Gural A,Ioscovich A,Einav S

    更新日期:2018-11-01 00:00:00

  • Anesthesia for non-obstetric surgery during pregnancy in a tertiary referral center: a 16-year retrospective, matched case-control, cohort study.

    abstract:INTRODUCTION:This retrospective, matched case-control cohort study describes the incidence, indications, anesthesia techniques and outcomes of pregnancies complicated by surgery in a single tertiary-referral hospital. METHODS:Retrospective review of the hospital records of 171 patients who had non-obstetric surgery in...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2019.01.006

    authors: Devroe S,Bleeser T,Van de Velde M,Verbrugge L,De Buck F,Deprest J,Devlieger R,Rex S

    更新日期:2019-08-01 00:00:00

  • Anesthetic management of a parturient with Stiff person syndrome for urgent cesarean delivery.

    abstract::Stiff person syndrome is a rare neurologic disorder with an estimated incidence of 1:1000000. The underlying pathophysiology is truncal and proximal limb muscle stiffness resulting from continuous co-contracture of agonist and antagonist muscle groups concomitant with superimposed episodic muscle spasms. Loss of gamma...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2016.05.006

    authors: Boettcher BT,Muravyea M,Kuo C,Drexler C,Pagel PS

    更新日期:2016-08-01 00:00:00

  • Prophylactic infusion of phenylephrine is effective in attenuating the decrease in regional cerebral blood volume and oxygenation during spinal anesthesia for cesarean section.

    abstract:BACKGROUND:Hypotension induced by spinal anesthesia for cesarean section causes a decrease in maternal regional cerebral blood volume and oxygenation. We used near-infrared spectroscopy to determine whether prophylactic infusion of phenylephrine attenuates these decreases. METHODS:Sixty patients undergoing bupivacaine...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ijoa.2018.09.006

    authors: Hirose N,Kondo Y,Maeda T,Matsui M,Matsuda M,Suzuki T

    更新日期:2019-02-01 00:00:00

  • Temporizing treatment for the respiratory-compromised gravida: an observational study of maternal and neonatal outcome.

    abstract::Acute lung disease may originate in pregnancy because of the pregnancy itself or because of an intercurrent etiology. The purpose of this study was to describe the effect of prolonged antepartum mechanical ventilatory support on the mother and the neonate when the strategy was to prolong the pregnancy rather than deli...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2006.10.015

    authors: Grisaru-Granovsky S,Ioscovich A,Hersch M,Schimmel M,Elstein D,Samueloff A

    更新日期:2007-07-01 00:00:00

  • Anaesthesia in parturients with heart disease: a five year review in an Australian tertiary hospital.

    abstract::At the Royal Women's Hospital, Queensland, between 1993 and 1997 there were 56 vaginal and 22 caesarean deliveries involving 68 women with heart disease. Over half of those women required anaesthetic input, in particular, the women who had the most serious cardiac compromise. There were two maternal deaths, four unboo...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/S0959-289X(02)00198-X

    authors: Boyle RK

    更新日期:2003-07-01 00:00:00

  • Recurrent psychogenic paresis after dural puncture in a parturient.

    abstract::We describe the case of a 29-year-old parturient who, after undergoing elective cesarean delivery, displayed symptoms of lower extremity weakness and sensory deficit. Her past medical history was significant for asymptomatic Arnold Chiari Type I malformation and asthma. She had received spinal anesthesia that failed t...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2013.01.006

    authors: Nguyen J,Abola R,Schabel J

    更新日期:2013-04-01 00:00:00

  • Neuraxial anaesthesia for caesarean section in a patient with narcolepsy and cataplexy.

    abstract::We report the management of a morbidly obese parturient suffering from narcolepsy with cataplexy who presented for caesarean section. Her symptoms were controlled by modafinil and fluoxetine. We administered epidural anaesthesia successfully; surgery was uneventful and recovery was uncomplicated. We discuss some of th...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2010.07.015

    authors: Soltanifar S,Russell R

    更新日期:2010-10-01 00:00:00

  • Cesarean birth - What's in a name?

    abstract:BACKGROUND:Cesarean birth is known as both cesarean section (CS) and cesarean delivery (CD). The International Journal of Obstetric Anesthesia (IJOA) is the leading obstetric anesthesia journal, and a barometer of attitudes within the profession. The journal recently published the hundredth issue, spanning 25 years (to...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2017.09.005

    authors: Ni L,Elsaharty A,McConachie I

    更新日期:2018-05-01 00:00:00

  • Anaesthetic management of labour in two patients with Klippel-Feil syndrome.

    abstract::Two patients with Type I Klippel-Feil syndrome presented at the antenatal clinic. The first patient, who suffered from sleep apnoea, was delivered of a healthy infant by vacuum extraction. The second, who was profoundly deaf and had marked kyphoscoliosis, developed pregnancy-induced hypertension and urinary tract infe...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/s0959-289x(96)80032-x

    authors: Singh D,Mills GH,Caunt JA,Alderson JD

    更新日期:1996-07-01 00:00:00

  • Catheter failure rates and time course with epidural versus combined spinal-epidural analgesia in labor.

    abstract:BACKGROUND:The combined spinal-epidural technique for labor analgesia has several advantages over the traditional epidural technique, including faster onset, greater maternal satisfaction, and decreased need for physician boluses. Proponents of the epidural technique criticize the combined spinal-epidural technique, ar...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2016.01.004

    authors: Groden J,Gonzalez-Fiol A,Aaronson J,Sachs A,Smiley R

    更新日期:2016-05-01 00:00:00

  • Epidural opioids and previous caesarean section.

    abstract::In the following case there was delay in diagnosing uterine rupture in a patient with an epidural in situ. The danger of using large doses of local anaesthetics and opioids epidurally in patients who have had previous caesarean sections is discussed. ...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/0959-289x(95)82920-6

    authors: McBeth C

    更新日期:1995-10-01 00:00:00

  • Anesthetic management of a parturient with varicella presenting for cesarean delivery.

    abstract::Varicella (chicken pox) infection is associated with a significant risk of maternal and fetal morbidity and mortality. The choice of anesthetic technique, either neuraxial or general anesthesia, in such patients remains controversial. Anesthetic management depends not only on the extent of disease involvement and asso...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2016.06.002

    authors: Janardhan AL,Gupta N,Prakash S,Gogna RL

    更新日期:2016-12-01 00:00:00

  • Combined low-dose spinal-epidural anesthesia versus single-shot spinal anesthesia for elective cesarean delivery.

    abstract::Combined spinal-epidural anesthesia balancing low-dose intrathecal bupivacaine/fentanyl and low-dose epidural bupivacaine may be more useful than single-shot spinal anesthesia for cesarean delivery in reducing incidences of adverse effects such as hypotension and nausea and in shortening motor recovery. Combined spina...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ijoa.2005.05.009

    authors: Choi DH,Ahn HJ,Kim JA

    更新日期:2006-01-01 00:00:00

  • A randomized comparison of onset of anesthesia between spinal bupivacaine 5 mg with immediate epidural 2% lidocaine 5 mL and bupivacaine 10 mg for cesarean delivery.

    abstract:BACKGROUND:Previous studies using low-dose spinal anesthesia for cesarean delivery have focused on hypotension and efficacy. This study evaluated whether, using a combined spinal-epidural technique, there was a difference in onset of anesthesia for cesarean delivery between low-dose spinal with an immediate epidural lo...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.ijoa.2013.08.009

    authors: Wang LZ,Zhang YF,Hu XX,Chang XY

    更新日期:2014-02-01 00:00:00

  • General anesthesia for cesarean section in a Singapore maternity hospital: a retrospective survey.

    abstract::We conducted a retrospective study of all cases of cesarean section at the KK Women's and Children's Hospital over a one-year period from September 1, 2002 to August 31, 2003, with the aim of evaluating current anesthetic practice. These cases were identified using hospital databases and relevant data was extracted fr...

    journal_title:International journal of obstetric anesthesia

    pub_type: 杂志文章

    doi:10.1016/j.ijoa.2004.04.007

    authors: Kan RK,Lew E,Yeo SW,Thomas E

    更新日期:2004-10-01 00:00:00