Abstract：
BACKGROUND:This systematic review and meta-analysis evaluates evidence for seven risk factors associated with failed conversion of labor epidural analgesia to cesarean delivery anesthesia. METHODS:Online scientific literature databases were searched using a strategy which identified observational trials, published between January 1979 and May 2011, which evaluated risk factors for failed conversion of epidural analgesia to anesthesia or documented a failure rate resulting in general anesthesia. RESULTS:1450 trials were screened, and 13 trials were included for review (n=8628). Three factors increase the risk for failed conversion: an increasing number of clinician-administered boluses during labor (OR=3.2, 95% CI 1.8-5.5), greater urgency for cesarean delivery (OR=40.4, 95% CI 8.8-186), and a non-obstetric anesthesiologist providing care (OR=4.6, 95% CI 1.8-11.5). Insufficient evidence is available to support combined spinal-epidural versus standard epidural techniques, duration of epidural analgesia, cervical dilation at the time of epidural placement, and body mass index or weight as risk factors for failed epidural conversion. CONCLUSION:The risk of failed conversion of labor epidural analgesia to anesthesia is increased with an increasing number of boluses administered during labor, an enhanced urgency for cesarean delivery, and care being provided by a non-obstetric anesthesiologist. Further high-quality studies are needed to evaluate the many potential risk factors associated with failed conversion of labor epidural analgesia to anesthesia for cesarean delivery.
journal_name
Int J Obstet Anesthjournal_title
International journal of obstetric anesthesiaauthors
Bauer ME,Kountanis JA,Tsen LC,Greenfield ML,Mhyre JMdoi
10.1016/j.ijoa.2012.05.007subject
Has Abstractpub_date
2012-10-01 00:00:00pages
294-309issue
4eissn
0959-289Xissn
1532-3374pii
S0959-289X(12)00083-0journal_volume
21pub_type
杂志文章,meta分析,评审abstract：:We present a case of presumed amniotic fluid embolism in a 33-year-old parturient at 30 weeks of gestation, which occurred just before she was due to receive spinal anaesthesia for urgent caesarean section. While sitting, the woman suddenly lost consciousness, started having convulsions and finally suffered cardioresp...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2009.02.014
更新日期：2010-01-01 00:00:00
abstract：:A case is described of a previously healthy obese woman in her fourth pregnancy who presented for caesarean section due to cephalopelvic disproportion (CPD). Forty minutes after a spinal anaesthetic a healthy child was delivered. Shortly after the injection of ergometrine and Syntocinon into the uterus, the patient de...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/0959-289x(93)90012-7
更新日期：1993-01-01 00:00:00
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
更新日期：1997-07-01 00:00:00
abstract：:The administration of intravenous dantrolene in a parturient susceptible to malignant hyperthermia has been associated with post partum uterine atony. We examined the effect of dantrolene sodium for injection (Dantrium Intravenous) on spontaneous contractility of uterine smooth muscle from women in term pregnancy in a...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/0959-289x(95)82910-3
更新日期：1995-10-01 00:00:00
abstract：:Cystic fibrosis affects 1 in 1600-2500 live births and is inherited in an autosomal recessive manner. It primarily involves the respiratory, gastrointestinal and reproductive tracts, with impaired clearance of, and obstruction by, increasingly viscous secretions. Severe respiratory disease, diabetes and gastro-oesopha...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2013.10.006
更新日期：2014-02-01 00:00:00
abstract：:A parturient who was 35 weeks' pregnant by her husband who was known to be susceptible to malignant hyperthermia, required anaesthesia for caesarean section for bleeding placenta praevia. The patient was considered to be haemodynamically stable and the procedure was carried out uneventfully under subarachnoid block. A...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1054/ijoa.2000.0394
更新日期：2000-10-01 00:00:00
abstract：:We report a case of a parturient with documented chronic Chagas' disease with cardiac manifestations presenting for labor management and complicated by the need for emergent hysterectomy after delivery. Chagas' disease is a common human hematogenous trypanosomiasis in Central and South America which is now, because of...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/s0959-289x(96)80005-7
更新日期：1996-04-01 00:00:00
abstract：:Recent work suggests that preoperative skin infiltration with local anesthetic may lead to reduced postoperative pain. We have studied this in a randomised, prospective, double-blind trial of 40 women having cesarean section under spinal anesthesia. After establishment of the spinal block, the incision line was infilt...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/0959-289x(94)90068-x
更新日期：1994-10-01 00:00:00
abstract：:Mothers receiving combined spinal-epidural (CSE) anaesthesia for elective caesarean section (n = 188) were audited. A single dose of epidural diamorphine (2-3 mg) was given during surgery. Unless contraindicated, diclofenac 100 mg was given per rectum at the end of surgery. Postoperative analgesia was provided as oral...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/s0959-289x(99)80146-0
更新日期：1999-01-01 00:00:00
abstract：BACKGROUND:Superficial bleeding after labor epidural catheter placement is a common phenomenon. In addition to delaying securing the epidural catheter, it may loosen the adhesive catheter dressing. The primary aim of this study was to determine whether skin infiltration with epinephrine-containing rather than plain lid...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ijoa.2006.09.006
更新日期：2007-04-01 00:00:00
abstract：:An epidural catheter may be inserted with the patient either in the flexed left lateral or the sitting position. We have studied, non-invasively, the haemodynamic changes associated with these positions, using the thoracic bio-impedance method (BOMED NCCOM3 Monitor). Maternal arterial pressure and fetal heart rate wer...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/0959-289x(93)90046-k
更新日期：1993-01-01 00:00:00
abstract：BACKGROUND:Various interventions are used as prophylaxis for aspiration pneumonitis in obstetric anaesthesia. This review, based on a Cochrane systematic review currently being updated, examines whether interventions given before caesarean section reduce the risk of aspiration pneumonitis. METHODS:Twenty-two studies, ...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.ijoa.2010.12.006
更新日期：2011-04-01 00:00:00
abstract：BACKGROUND:Failed intubation is relatively common in the obstetric patient. Overall, there has been a decline in experience of general anaesthesia in obstetrics. The level of anaesthetic preparedness in the event of a difficult obstetric intubation is unknown. METHODS:With approval from the Obstetric Anaesthetists' As...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2009.01.015
更新日期：2009-10-01 00:00:00
abstract：:Patients with dystrophia myotonica requiring caesarean section pose significant problems for the anaesthetist. This report describes the successful use of a combined spinal-epidural technique for anaesthesia and postoperative analgesia in such a patient. ...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/s0959-289x(96)80051-3
更新日期：1996-10-01 00:00:00
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
更新日期：2019-05-01 00:00:00
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
更新日期：2013-01-01 00:00:00
abstract：:Standard textbooks advocate epidural rather than spinal anaesthesia for caesarean section in severe preeclampsia. The basis for this recommendation is the theoretical risk of severe hypotension but no published scientific studies have been identified to support this assertion. We therefore designed a prospective study...
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(99)80003-x
更新日期：1999-04-01 00:00:00
abstract：:Pulmonary atresia witha ventricular septal defect and major aortopulmonary collateral arteries is an extremely rare congenital disorder characterized by a high risk of maternal mortality. We present the case of a 24-year-old primigravid woman with uncorrected pulmonary atresia, ventricular septal defect and major aort...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2018.05.009
更新日期：2018-11-01 00:00:00
abstract：:In order to estimate how long a medication can remain prepared before the integrity or concentration of the drug is compromised, we assessed the sterility and potency of medications commonly used in our obstetric anesthesia practice. Our goal was to evaluate the following drugs over a 30-day period: epinephrine, atrop...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1054/ijoa.2002.0983
更新日期：2002-10-01 00:00:00
abstract：:The 2009-12 MBRRACE-UK report highlighted the deaths of two women in whom dural puncture had occurred during insertion of a labour epidural catheter. One woman received an epidural blood patch, the other did not, but both suffered with chronic headaches following discharge from hospital. Neither woman was adequately f...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.ijoa.2018.12.006
更新日期：2019-05-01 00:00:00
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
更新日期：2008-04-01 00:00:00
abstract：:This study explores which concentrations of local anesthetics might be expected to inhibit the growth of Staphylococcus aureus. Serial dilutions were made of 0.5% and 0.75% bupivacaine, 2% and 5% lidocaine, 2% and 3% chloroprocaine, and 0.2% and 1% ropivacaine. To each concentration of local anesthetic solution, Muell...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1054/ijoa.2001.0934
更新日期：2002-04-01 00:00:00
abstract：:Neurofibromatosis type 2 is an extremely rare form of neurofibromatosis characterized by central nervous system involvement with bilateral vestibular schwannomas and spinal tumors. Anesthetic management of a parturient with neurofibromatosis type 2 has not been fully reported, and the condition is challenging to obste...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2005.02.007
更新日期：2005-10-01 00:00:00
abstract：:Gastro-oesophageal reflux (GOR) and regurgitation were investigated with an oesophageal pH electrode, inserted after the induction of general anaesthesia with methohexitone, in 100 patients undergoing termination of pregnancy, 50 in the first trimester and 50 in the second. GOR occurred in 17 patients, 8 in the first ...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/0959-289x(92)90015-v
更新日期：1992-05-01 00:00:00
abstract：:Primary pulmonary hypertension, though uncommon, is found relatively frequently in women of childbearing age and carries a high peripartum mortality. We present a patient with severe primary pulmonary hypertension who underwent two cesarean sections 3 and 6 years after the diagnosis of primary pulmonary hypertension w...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/s0959-289x(96)80072-0
更新日期：1996-01-01 00:00:00
abstract：:We present our experience in the anesthetic management of two parturients with pseudoxanthoma elasticum. The first had an epidural catheter inserted for labor analgesia and ultimately had a forceps delivery. The second had a cesarean section under epidural anesthesia and had a complicated postoperative course. There w...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/s0959-289x(02)00161-9
更新日期：2003-01-01 00:00:00
abstract：BACKGROUND:We investigated the correlation between lumbar epidural analgesia onset time and pain intensity at 60 and 120 min after initiation. METHODS:We conducted a prospective observational study of nulliparous women receiving lumbar epidural analgesia (initial bolus 15 mL bupivacaine 0.1% with fentanyl 3.33 μg/mL),...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/j.ijoa.2019.05.008
更新日期：2019-11-01 00:00:00
abstract：BACKGROUND:Spinal anesthesia is a standard technique for cesarean section but can cause hypotension which may be related to venous pooling secondary to progesterone-induced decreases in vascular tone. This study investigated the use of a sequential compression mechanical pump with thigh-high sleeves with compression cy...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ijoa.2012.01.003
更新日期：2012-04-01 00:00:00
abstract：:The marked reduction in the number of cases related to the provision of anaesthesia, included in the triennial Reports on Confidential Enquiries into Maternal Deaths in the UK, may limit the educational value of such reports for anaesthetists in the future. The collection, analysis and reporting of untoward events rel...
journal_title：International journal of obstetric anesthesia
pub_type： 杂志文章
doi：10.1016/s0959-289x(96)80041-0
更新日期：1996-10-01 00:00:00
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
更新日期：2020-11-01 00:00:00
