dc.contributor.author |
Sidhu, NS |
|
dc.contributor.author |
Cavadino, A |
|
dc.contributor.author |
Ku, H |
|
dc.contributor.author |
Kerckhoffs, P |
|
dc.contributor.author |
Lowe, M |
|
dc.coverage.spatial |
England |
|
dc.date.accessioned |
2023-08-02T00:06:05Z |
|
dc.date.available |
2023-08-02T00:06:05Z |
|
dc.date.issued |
2021-08 |
|
dc.identifier.citation |
(2021). Anaesthesia, 76(8), 1060-1067. |
|
dc.identifier.issn |
0003-2409 |
|
dc.identifier.uri |
https://hdl.handle.net/2292/65144 |
|
dc.description.abstract |
Accidental dural puncture is a recognised complication of labour epidural placement and can cause a debilitating headache. We examined the association between labour epidural case volume and accidental dural puncture rate in specialist anaesthetists and anaesthesia trainees. We performed a retrospective cohort study of labour epidural and combined spinal-epidural nerve blocks performed between 1 July 2013 and 31 December 2017 at Waitemata District Health Board, Auckland, New Zealand. The mean (SD) annual number of obstetric epidural and combined spinal-epidural procedures for high-case volume specialists was 44.2 (15.0), and for low-case volume specialists was 10.0 (6.8), after accounting for caesarean section combined spinal-epidural procedures. Analysis of 7976 labour epidural and combined spinal-epidural procedure records revealed a total of 92 accidental dural punctures (1.2%). The accidental dural puncture rate (95%CI) in high-case volume specialists was 0.6% (0.4-0.9%) and in low-case volume specialists 2.4% (1.4-3.9%), indicating probable skill decay. The odds of accidental dural puncture were 3.77 times higher for low- compared with high-case volume specialists (95%CI 1.72-8.28, p = 0.001). Amongst trainees, novices had a significantly higher accidental dural puncture complication rate (3.1%) compared with registrars (1.2%), OR (95%CI) 0.39 (0.18-0.84), p = 0.016, or fellows (1.1%), 0.35 (0.16-0.76), p = 0.008. Accidental dural puncture complication rates decreased once trainees progressed past the 'novice' training stage. |
|
dc.format.medium |
Print-Electronic |
|
dc.language |
eng |
|
dc.publisher |
Wiley |
|
dc.relation.ispartofseries |
Anaesthesia |
|
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
|
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
|
dc.subject |
Humans |
|
dc.subject |
Spinal Puncture |
|
dc.subject |
Analgesia, Epidural |
|
dc.subject |
Analgesia, Obstetrical |
|
dc.subject |
Retrospective Studies |
|
dc.subject |
Cohort Studies |
|
dc.subject |
Pregnancy |
|
dc.subject |
Labor, Obstetric |
|
dc.subject |
Adult |
|
dc.subject |
Female |
|
dc.subject |
clinical competence |
|
dc.subject |
epidural analgesia: complications |
|
dc.subject |
patient safety |
|
dc.subject |
post dural puncture headache |
|
dc.subject |
quality measures: patient care |
|
dc.subject |
Clinical Research |
|
dc.subject |
Vaccine Related |
|
dc.subject |
Science & Technology |
|
dc.subject |
Life Sciences & Biomedicine |
|
dc.subject |
Anesthesiology |
|
dc.subject |
epidural analgesia |
|
dc.subject |
complications |
|
dc.subject |
quality measures |
|
dc.subject |
patient care |
|
dc.subject |
BODY-MASS INDEX |
|
dc.subject |
HOSPITAL VOLUME |
|
dc.subject |
OPERATIVE MORTALITY |
|
dc.subject |
ANESTHESIA |
|
dc.subject |
ANALGESIA |
|
dc.subject |
HEADACHE |
|
dc.subject |
CONSENT |
|
dc.subject |
SKILL |
|
dc.subject |
COMPLICATION |
|
dc.subject |
INSERTION |
|
dc.subject |
1103 Clinical Sciences |
|
dc.subject |
1109 Neurosciences |
|
dc.subject |
3202 Clinical sciences |
|
dc.subject |
3203 Dentistry |
|
dc.title |
The association between labour epidural case volume and the rate of accidental dural puncture. |
|
dc.type |
Journal Article |
|
dc.identifier.doi |
10.1111/anae.15370 |
|
pubs.issue |
8 |
|
pubs.begin-page |
1060 |
|
pubs.volume |
76 |
|
dc.date.updated |
2023-07-20T00:53:39Z |
|
dc.rights.holder |
Copyright: The authors |
en |
dc.identifier.pmid |
33492698 (pubmed) |
|
pubs.author-url |
https://www.ncbi.nlm.nih.gov/pubmed/33492698 |
|
pubs.end-page |
1067 |
|
pubs.publication-status |
Published |
|
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RetrictedAccess |
en |
pubs.subtype |
Journal Article |
|
pubs.elements-id |
836451 |
|
pubs.org-id |
Medical and Health Sciences |
|
pubs.org-id |
Population Health |
|
pubs.org-id |
Epidemiology & Biostatistics |
|
pubs.org-id |
School of Medicine |
|
pubs.org-id |
Anaesthesiology |
|
dc.identifier.eissn |
1365-2044 |
|
pubs.record-created-at-source-date |
2023-07-20 |
|
pubs.online-publication-date |
2021-01-25 |
|