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A Survey of Perioperative and Postoperative Anesthetic Practices for Cesarean Delivery

机译:剖宫产术中围手术期和术后麻醉实践调查

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摘要

The aim of this survey was to review cesarean delivery anesthetic practices. An online survey was sent to members of the Society of Obstetric Anesthesia and Perinatology (SOAP). The mode of anesthesia, preferred neuraxial local anesthetic and opioid agents, postoperative analgesic regimens, and monitoring modalities were assessed. 384 responses from 1,081 online survey requests were received (response rate = 36%). Spinal anesthesia is most commonly used for elective cesarean delivery (85% respondents), with 90% of these respondents preferring hyperbaric bupivacaine 0.75%. 79% used intrathecal fentanyl and 77% used morphine (median [range] dose 200 mcg [50–400]). 91% use respiratory rate, 61% use sedation scores, and 30% use pulse oximetry to monitor for postoperative respiratory depression after administration of neuraxial opioids. Postoperative analgesic regimens include: nonsteroidal anti-inflammatory agents, acetaminophen, oxycodone, and hydrocodone by 81%, 45%, 25%, and 27% respondents respectively. The majority of respondents use spinal anesthesia and neuraxial opioids for cesarean delivery anesthesia. There is marked variability in practices for monitoring respiratory depression postdelivery and for providing postoperative analgesia. These results may not be indicative of overall practice in the United States due to the select group of anesthesiologists surveyed and the low response rate.
机译:这项调查的目的是审查剖宫产麻醉方法。在线调查已发送给产科麻醉和围诊学会(SOAP)的成员。评估了麻醉方式,首选神经局部麻醉药和阿片类药物,术后镇痛方案以及监测方式。从1,081个在线调查请求中收到384个响应(响应率= 36%)。脊柱麻醉最常用于选择性剖宫产(85%的受访者),其中90%的受访者更倾向于高压巴比卡因0.75%。鞘内使用芬太尼的比例为79%,吗啡使用的比例为77%(中位剂量范围200 µmcg [50-400])。使用神经轴阿片类药物后,有91%的人使用呼吸频率,61%的镇静分数和30%的脉搏血氧饱和度监测术后呼吸抑制。术后镇痛方案包括:非甾体类抗炎药,对乙酰氨基酚,羟考酮和氢可酮,分别有81%,45%,25%和27%的受访者表示。大多数受访者使用脊麻和神经阿片类药物进行剖宫产麻醉。在分娩后监测呼吸抑制和提供术后镇痛的实践中存在明显差异。由于选择的麻醉医生小组和较低的响应率,这些结果可能并不表示美国的整体实践。

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