The decision to delivery interval in emergency caesarean
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چکیده
One important task of the emergency anaesthesia service is to Background: provide rapid, safe and effective anaesthesia for emergency caesarean sections (ECS). A Decision to Delivery Interval (DDI) <30 minutes for ECS is a quality indicator for this service. The aim of this study was to assess the DDI and the impact of chosen anaesthetic technique (general anaesthesia (GA), spinal anaesthesia (SPA) with opioid supplementation, or “top-up” of labour epidural analgesia (tEDA) with local anaesthesia and fentanyl mixture) and work shift for ECS at Danderyds Hospital, Sweden. A retrospective chart review of ECS at Danderyds Hospital was Methods: performed between January and October 2016. Time between decision for CS, start of anaesthesia, time for incision and delivery, type of anaesthetic technique, and time of day, working hours or on call and day of week, Monday – Friday, and weekend was compiled and analysed. Time events are presented as mean ± standard deviation. Non-parametric tests were used. In total, 135 ECS were analysed: 92% of the cases were delivered Results: within 30 minutes and mean DDI for all cases was 17.3±8.1 minutes. GA shortened the DDI by 10 and 13 minutes compared to SPA and tEDA (p<0.0005). DDI for SPA and tEDA did not differ. There was no difference in DDI regarding time of day or weekday. Apgar <7 at 5’ was more commonly seen in ECS having GA (11 out of 64) compared to SPA (2/30) and tEDA (1/41) (p<0.05). GA shortens the DDI for ECS, but the use of SPA as well as tEDA Conclusion: with opioid supplementation maintains a short DDI and should be considered when time allows. Top-up epidural did not prolong the DDI compared to SPA. The day of week or time of ECS had no influence on the anaesthesia service as measured by the DDI. Referee Status: AWAITING PEER REVIEW 08 Nov 2017, :1977 (doi: ) First published: 6 10.12688/f1000research.13058.1 08 Nov 2017, :1977 (doi: ) Latest published: 6 10.12688/f1000research.13058.1 v1 Page 1 of 9 F1000Research 2017, 6:1977 Last updated: 08 NOV 2017
منابع مشابه
National cross sectional survey to determine whether the decision to delivery interval is critical in emergency caesarean section.
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