Does obesity complicate regional anesthesia and result in longer decision to delivery time for emergency cesarean section?
Background Maternal obesity can cause problems with anesthesia and surgery which may be reflected in emergency cesarean sections (CS) as an increased decision‐to‐delivery interval (DDI). Aim To study the association of elevated maternal BMI with DDI and the failure of regional anesthesia. Methods Ei...
Gespeichert in:
| Veröffentlicht in: | Acta anaesthesiologica Scandinavica 2017-07, Vol.61 (6), p.609-618 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 618 |
|---|---|
| container_issue | 6 |
| container_start_page | 609 |
| container_title | Acta anaesthesiologica Scandinavica |
| container_volume | 61 |
| creator | Väänänen, A. J. Kainu, J. P. Eriksson, H. Lång, M. Tekay, A. Sarvela, J. |
| description | Background
Maternal obesity can cause problems with anesthesia and surgery which may be reflected in emergency cesarean sections (CS) as an increased decision‐to‐delivery interval (DDI).
Aim
To study the association of elevated maternal BMI with DDI and the failure of regional anesthesia.
Methods
Eight hundred and forty‐two consecutive emergency CSs during a period of 1 year in a tertiary hospital were studied retrospectively. DDIs were analyzed in Crash and < 30‐min urgency categories (n = 528), while the time required to establish regional anesthesia and its success were analyzed for all emergency CS cases.
Results
The urgency distribution of the CSs was 11%, 52%, and 37% in Crash, < 30‐min, and > 30‐min urgency categories respectively. Increased BMI was associated with longer DDI time in the < 30‐min urgency category (33(13–176) vs. 38(18–118) min; P < 0.05 for BMI < 30 and > 35 group respectively). Regional anesthesia failures (new regional anesthesia, conversion to general anesthesia, or complaint of pain during surgery) took place in 3.7%, 6.8%, and 8.5% in the BMI < 30, 30–35, and > 35 groups respectively (P = 0.021). Epidural top‐up resulted in shorter DDI and time delay between arrival at the operating room and skin incision across all urgency and BMI groups than combined spinal epidural (CSE) anesthesia.
Conclusion
Higher BMI was associated with longer DDI and more regional anesthesia failures. Epidural top‐up was faster than CSE for establishing CS anesthesia. |
| doi_str_mv | 10.1111/aas.12891 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1889385592</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1889385592</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3531-6a18e1502ce5e387a7d85a48a97032bf96db18d958862c36b903e28e8b9624063</originalsourceid><addsrcrecordid>eNp1kU2P0zAQhi0EYruFA38AWeLCHtL6I3bsE6oW2EVaiQNwjhxnWrxy4mInoPDrmdKFAxK-zHj86JHGLyEvONtwPFvnyoYLY_kjsuLS2kqrRj8mK8YYrxRvxAW5LOUer7K29im5EKbmTa3sivx8m6DQ1EEJ00J9Go4xeDcBzXAIaXSRuhHK9BXfHbY9zsscJxpGGtN4gEx78KEgSqeEfQzfIS90CgPQfcoUBsgHGD26obgMbqQF_IT8m2fkyd7FAs8f6pp8ef_u8_Vtdffx5sP17q7yUkleaccNcMWEBwXSNK7pjXK1cbZhUnR7q_uOm94qY7TwUneWSRAGTGe1qJmWa_L67D3m9G3GZdohFA8x4mZpLi03xkqjlBWIvvoHvU9zxl9AyrJaN40VJ-rqTPmcSsmwb485DC4vLWftKZAWA2l_B4Lsywfj3A3Q_yX_JIDA9gz8CBGW_5va3e7TWfkLEbKU_Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1904677922</pqid></control><display><type>article</type><title>Does obesity complicate regional anesthesia and result in longer decision to delivery time for emergency cesarean section?</title><source>Wiley Online Library - AutoHoldings Journals</source><source>MEDLINE</source><creator>Väänänen, A. J. ; Kainu, J. P. ; Eriksson, H. ; Lång, M. ; Tekay, A. ; Sarvela, J.</creator><creatorcontrib>Väänänen, A. J. ; Kainu, J. P. ; Eriksson, H. ; Lång, M. ; Tekay, A. ; Sarvela, J.</creatorcontrib><description><![CDATA[Background
Maternal obesity can cause problems with anesthesia and surgery which may be reflected in emergency cesarean sections (CS) as an increased decision‐to‐delivery interval (DDI).
Aim
To study the association of elevated maternal BMI with DDI and the failure of regional anesthesia.
Methods
Eight hundred and forty‐two consecutive emergency CSs during a period of 1 year in a tertiary hospital were studied retrospectively. DDIs were analyzed in Crash and < 30‐min urgency categories (n = 528), while the time required to establish regional anesthesia and its success were analyzed for all emergency CS cases.
Results
The urgency distribution of the CSs was 11%, 52%, and 37% in Crash, < 30‐min, and > 30‐min urgency categories respectively. Increased BMI was associated with longer DDI time in the < 30‐min urgency category (33(13–176) vs. 38(18–118) min; P < 0.05 for BMI < 30 and > 35 group respectively). Regional anesthesia failures (new regional anesthesia, conversion to general anesthesia, or complaint of pain during surgery) took place in 3.7%, 6.8%, and 8.5% in the BMI < 30, 30–35, and > 35 groups respectively (P = 0.021). Epidural top‐up resulted in shorter DDI and time delay between arrival at the operating room and skin incision across all urgency and BMI groups than combined spinal epidural (CSE) anesthesia.
Conclusion
Higher BMI was associated with longer DDI and more regional anesthesia failures. Epidural top‐up was faster than CSE for establishing CS anesthesia.]]></description><identifier>ISSN: 0001-5172</identifier><identifier>EISSN: 1399-6576</identifier><identifier>DOI: 10.1111/aas.12891</identifier><identifier>PMID: 28417459</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adult ; Analgesia, Obstetrical ; Anesthesia ; Anesthesia, Conduction - adverse effects ; Anesthesia, Conduction - methods ; Anesthesia, Epidural ; Anesthesia, Obstetrical - adverse effects ; Anesthesia, Obstetrical - methods ; Anesthesia, Spinal ; Body mass ; Body Mass Index ; Categories ; Cesarean section ; Cesarean Section - methods ; Clinical Decision-Making ; Conversion ; Delay ; Emergency Medical Services ; Female ; Humans ; Obesity ; Obesity - complications ; Operative Time ; Pain ; Pregnancy ; Regional analysis ; Retrospective Studies ; Skin ; Surgery ; Time lag ; Time-to-Treatment ; Treatment Failure</subject><ispartof>Acta anaesthesiologica Scandinavica, 2017-07, Vol.61 (6), p.609-618</ispartof><rights>2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd</rights><rights>2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2017 The Acta Anaesthesiologica Scandinavica Foundation</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3531-6a18e1502ce5e387a7d85a48a97032bf96db18d958862c36b903e28e8b9624063</citedby><cites>FETCH-LOGICAL-c3531-6a18e1502ce5e387a7d85a48a97032bf96db18d958862c36b903e28e8b9624063</cites><orcidid>0000-0003-2385-7448</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Faas.12891$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Faas.12891$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28417459$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Väänänen, A. J.</creatorcontrib><creatorcontrib>Kainu, J. P.</creatorcontrib><creatorcontrib>Eriksson, H.</creatorcontrib><creatorcontrib>Lång, M.</creatorcontrib><creatorcontrib>Tekay, A.</creatorcontrib><creatorcontrib>Sarvela, J.</creatorcontrib><title>Does obesity complicate regional anesthesia and result in longer decision to delivery time for emergency cesarean section?</title><title>Acta anaesthesiologica Scandinavica</title><addtitle>Acta Anaesthesiol Scand</addtitle><description><![CDATA[Background
Maternal obesity can cause problems with anesthesia and surgery which may be reflected in emergency cesarean sections (CS) as an increased decision‐to‐delivery interval (DDI).
Aim
To study the association of elevated maternal BMI with DDI and the failure of regional anesthesia.
Methods
Eight hundred and forty‐two consecutive emergency CSs during a period of 1 year in a tertiary hospital were studied retrospectively. DDIs were analyzed in Crash and < 30‐min urgency categories (n = 528), while the time required to establish regional anesthesia and its success were analyzed for all emergency CS cases.
Results
The urgency distribution of the CSs was 11%, 52%, and 37% in Crash, < 30‐min, and > 30‐min urgency categories respectively. Increased BMI was associated with longer DDI time in the < 30‐min urgency category (33(13–176) vs. 38(18–118) min; P < 0.05 for BMI < 30 and > 35 group respectively). Regional anesthesia failures (new regional anesthesia, conversion to general anesthesia, or complaint of pain during surgery) took place in 3.7%, 6.8%, and 8.5% in the BMI < 30, 30–35, and > 35 groups respectively (P = 0.021). Epidural top‐up resulted in shorter DDI and time delay between arrival at the operating room and skin incision across all urgency and BMI groups than combined spinal epidural (CSE) anesthesia.
Conclusion
Higher BMI was associated with longer DDI and more regional anesthesia failures. Epidural top‐up was faster than CSE for establishing CS anesthesia.]]></description><subject>Adult</subject><subject>Analgesia, Obstetrical</subject><subject>Anesthesia</subject><subject>Anesthesia, Conduction - adverse effects</subject><subject>Anesthesia, Conduction - methods</subject><subject>Anesthesia, Epidural</subject><subject>Anesthesia, Obstetrical - adverse effects</subject><subject>Anesthesia, Obstetrical - methods</subject><subject>Anesthesia, Spinal</subject><subject>Body mass</subject><subject>Body Mass Index</subject><subject>Categories</subject><subject>Cesarean section</subject><subject>Cesarean Section - methods</subject><subject>Clinical Decision-Making</subject><subject>Conversion</subject><subject>Delay</subject><subject>Emergency Medical Services</subject><subject>Female</subject><subject>Humans</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Operative Time</subject><subject>Pain</subject><subject>Pregnancy</subject><subject>Regional analysis</subject><subject>Retrospective Studies</subject><subject>Skin</subject><subject>Surgery</subject><subject>Time lag</subject><subject>Time-to-Treatment</subject><subject>Treatment Failure</subject><issn>0001-5172</issn><issn>1399-6576</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU2P0zAQhi0EYruFA38AWeLCHtL6I3bsE6oW2EVaiQNwjhxnWrxy4mInoPDrmdKFAxK-zHj86JHGLyEvONtwPFvnyoYLY_kjsuLS2kqrRj8mK8YYrxRvxAW5LOUer7K29im5EKbmTa3sivx8m6DQ1EEJ00J9Go4xeDcBzXAIaXSRuhHK9BXfHbY9zsscJxpGGtN4gEx78KEgSqeEfQzfIS90CgPQfcoUBsgHGD26obgMbqQF_IT8m2fkyd7FAs8f6pp8ef_u8_Vtdffx5sP17q7yUkleaccNcMWEBwXSNK7pjXK1cbZhUnR7q_uOm94qY7TwUneWSRAGTGe1qJmWa_L67D3m9G3GZdohFA8x4mZpLi03xkqjlBWIvvoHvU9zxl9AyrJaN40VJ-rqTPmcSsmwb485DC4vLWftKZAWA2l_B4Lsywfj3A3Q_yX_JIDA9gz8CBGW_5va3e7TWfkLEbKU_Q</recordid><startdate>201707</startdate><enddate>201707</enddate><creator>Väänänen, A. J.</creator><creator>Kainu, J. P.</creator><creator>Eriksson, H.</creator><creator>Lång, M.</creator><creator>Tekay, A.</creator><creator>Sarvela, J.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2385-7448</orcidid></search><sort><creationdate>201707</creationdate><title>Does obesity complicate regional anesthesia and result in longer decision to delivery time for emergency cesarean section?</title><author>Väänänen, A. J. ; Kainu, J. P. ; Eriksson, H. ; Lång, M. ; Tekay, A. ; Sarvela, J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3531-6a18e1502ce5e387a7d85a48a97032bf96db18d958862c36b903e28e8b9624063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Analgesia, Obstetrical</topic><topic>Anesthesia</topic><topic>Anesthesia, Conduction - adverse effects</topic><topic>Anesthesia, Conduction - methods</topic><topic>Anesthesia, Epidural</topic><topic>Anesthesia, Obstetrical - adverse effects</topic><topic>Anesthesia, Obstetrical - methods</topic><topic>Anesthesia, Spinal</topic><topic>Body mass</topic><topic>Body Mass Index</topic><topic>Categories</topic><topic>Cesarean section</topic><topic>Cesarean Section - methods</topic><topic>Clinical Decision-Making</topic><topic>Conversion</topic><topic>Delay</topic><topic>Emergency Medical Services</topic><topic>Female</topic><topic>Humans</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Operative Time</topic><topic>Pain</topic><topic>Pregnancy</topic><topic>Regional analysis</topic><topic>Retrospective Studies</topic><topic>Skin</topic><topic>Surgery</topic><topic>Time lag</topic><topic>Time-to-Treatment</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Väänänen, A. J.</creatorcontrib><creatorcontrib>Kainu, J. P.</creatorcontrib><creatorcontrib>Eriksson, H.</creatorcontrib><creatorcontrib>Lång, M.</creatorcontrib><creatorcontrib>Tekay, A.</creatorcontrib><creatorcontrib>Sarvela, J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Acta anaesthesiologica Scandinavica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Väänänen, A. J.</au><au>Kainu, J. P.</au><au>Eriksson, H.</au><au>Lång, M.</au><au>Tekay, A.</au><au>Sarvela, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does obesity complicate regional anesthesia and result in longer decision to delivery time for emergency cesarean section?</atitle><jtitle>Acta anaesthesiologica Scandinavica</jtitle><addtitle>Acta Anaesthesiol Scand</addtitle><date>2017-07</date><risdate>2017</risdate><volume>61</volume><issue>6</issue><spage>609</spage><epage>618</epage><pages>609-618</pages><issn>0001-5172</issn><eissn>1399-6576</eissn><abstract><![CDATA[Background
Maternal obesity can cause problems with anesthesia and surgery which may be reflected in emergency cesarean sections (CS) as an increased decision‐to‐delivery interval (DDI).
Aim
To study the association of elevated maternal BMI with DDI and the failure of regional anesthesia.
Methods
Eight hundred and forty‐two consecutive emergency CSs during a period of 1 year in a tertiary hospital were studied retrospectively. DDIs were analyzed in Crash and < 30‐min urgency categories (n = 528), while the time required to establish regional anesthesia and its success were analyzed for all emergency CS cases.
Results
The urgency distribution of the CSs was 11%, 52%, and 37% in Crash, < 30‐min, and > 30‐min urgency categories respectively. Increased BMI was associated with longer DDI time in the < 30‐min urgency category (33(13–176) vs. 38(18–118) min; P < 0.05 for BMI < 30 and > 35 group respectively). Regional anesthesia failures (new regional anesthesia, conversion to general anesthesia, or complaint of pain during surgery) took place in 3.7%, 6.8%, and 8.5% in the BMI < 30, 30–35, and > 35 groups respectively (P = 0.021). Epidural top‐up resulted in shorter DDI and time delay between arrival at the operating room and skin incision across all urgency and BMI groups than combined spinal epidural (CSE) anesthesia.
Conclusion
Higher BMI was associated with longer DDI and more regional anesthesia failures. Epidural top‐up was faster than CSE for establishing CS anesthesia.]]></abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28417459</pmid><doi>10.1111/aas.12891</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-2385-7448</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0001-5172 |
| ispartof | Acta anaesthesiologica Scandinavica, 2017-07, Vol.61 (6), p.609-618 |
| issn | 0001-5172 1399-6576 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1889385592 |
| source | Wiley Online Library - AutoHoldings Journals; MEDLINE |
| subjects | Adult Analgesia, Obstetrical Anesthesia Anesthesia, Conduction - adverse effects Anesthesia, Conduction - methods Anesthesia, Epidural Anesthesia, Obstetrical - adverse effects Anesthesia, Obstetrical - methods Anesthesia, Spinal Body mass Body Mass Index Categories Cesarean section Cesarean Section - methods Clinical Decision-Making Conversion Delay Emergency Medical Services Female Humans Obesity Obesity - complications Operative Time Pain Pregnancy Regional analysis Retrospective Studies Skin Surgery Time lag Time-to-Treatment Treatment Failure |
| title | Does obesity complicate regional anesthesia and result in longer decision to delivery time for emergency cesarean section? |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-01T23%3A23%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Does%20obesity%20complicate%20regional%20anesthesia%20and%20result%20in%20longer%20decision%20to%20delivery%20time%20for%20emergency%20cesarean%20section?&rft.jtitle=Acta%20anaesthesiologica%20Scandinavica&rft.au=V%C3%A4%C3%A4n%C3%A4nen,%20A.%20J.&rft.date=2017-07&rft.volume=61&rft.issue=6&rft.spage=609&rft.epage=618&rft.pages=609-618&rft.issn=0001-5172&rft.eissn=1399-6576&rft_id=info:doi/10.1111/aas.12891&rft_dat=%3Cproquest_cross%3E1889385592%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1904677922&rft_id=info:pmid/28417459&rfr_iscdi=true |