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dc.contributor.authorOdor, PM
dc.contributor.authorBampoe, S
dc.contributor.authorMoonesinghe, SR
dc.contributor.authorAndrade, J
dc.contributor.authorPandit, JJ
dc.contributor.authorLucas, DN
dc.contributor.authorPan-London Perioperative Audit and Research Network (PLAN), for the DREAMY Investigators Group
dc.date.accessioned2021-04-21T10:18:19Z
dc.date.available2021-04-21T10:18:19Z
dc.identifier.citationAnaesthesia, 2021, 76 (4), pp. 460 - 471
dc.identifier.issn0003-2409
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/4534
dc.identifier.eissn1365-2044
dc.identifier.doi10.1111/anae.15250
dc.description.abstractThere are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%).
dc.formatPrint-Electronic
dc.format.extent460 - 471
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by-nc-sa/4.0
dc.subjectPan-London Perioperative Audit and Research Network (PLAN), for the DREAMY Investigators Group
dc.subjectHumans
dc.subjectSuccinylcholine
dc.subjectPropofol
dc.subjectThiopental
dc.subjectAnesthesia, General
dc.subjectObstetric Surgical Procedures
dc.subjectCesarean Section
dc.subjectLogistic Models
dc.subjectProspective Studies
dc.subjectPregnancy
dc.subjectAdult
dc.subjectMiddle Aged
dc.subjectEngland
dc.subjectFemale
dc.subjectAirway Extubation
dc.titleGeneral anaesthetic and airway management practice for obstetric surgery in England: a prospective, multicentre observational study.
dc.typeJournal Article
dcterms.dateAccepted2020-08-14
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1111/anae.15250
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc-sa/4.0
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfAnaesthesia
pubs.issue4
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR
pubs.publication-statusPublished
pubs.volume76
pubs.embargo.termsNot known
dc.contributor.icrauthorTurnbull, Clareen


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