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Speed of spinal vs general anaesthesia for category-1 caesarean section: a simulation and clinical observation-based study.
Anaesthesia. 2013 Jul; 68(7):753-9.A

Abstract

Controversy exists as to whether effective spinal anaesthesia can be achieved as quickly as general anaesthesia for a category-1 caesarean section. Sixteen consultants and three fellows in obstetric anaesthesia were timed performing spinal and general anaesthesia for category-1 caesarean section on a simulator. The simulation time commenced upon entry of the anaesthetist into the operating theatre and finished for the spinal anaesthetic at the end of intrathecal injection and for the general anaesthetic when the anaesthetist was happy for surgery to start. In the second clinical part of the study, the time from intrathecal administration to 'adequate surgical anaesthesia' (defined as adequate for start of a category-1 caesarean section) was estimated in 100 elective (category-4) caesarean sections. The median (IQR [range]) times (min:s) for spinal procedure, onset of spinal block and general anaesthesia were 2:56 (2:32-3:32 [1:22-3:50]), 5:56 (4:23-7:39 [2:9-13:32]) and 1:56 (1:39-2:9 [1:13-3:12]), respectively. The limiting factor in urgent spinal anaesthesia is the unpredictable time needed for adequate surgical block to develop.

Authors+Show Affiliations

Department of Anesthesia, British Columbia Women's Hospital and Health Centre, Vancouver, British Columbia, Canada; King's Mill Hospital, Sutton-in-Ashfield, Nottinghamshire, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

23675953

Citation

Kathirgamanathan, A, et al. "Speed of Spinal Vs General Anaesthesia for Category-1 Caesarean Section: a Simulation and Clinical Observation-based Study." Anaesthesia, vol. 68, no. 7, 2013, pp. 753-9.
Kathirgamanathan A, Douglas MJ, Tyler J, et al. Speed of spinal vs general anaesthesia for category-1 caesarean section: a simulation and clinical observation-based study. Anaesthesia. 2013;68(7):753-9.
Kathirgamanathan, A., Douglas, M. J., Tyler, J., Saran, S., Gunka, V., Preston, R., & Kliffer, P. (2013). Speed of spinal vs general anaesthesia for category-1 caesarean section: a simulation and clinical observation-based study. Anaesthesia, 68(7), 753-9. https://doi.org/10.1111/anae.12290
Kathirgamanathan A, et al. Speed of Spinal Vs General Anaesthesia for Category-1 Caesarean Section: a Simulation and Clinical Observation-based Study. Anaesthesia. 2013;68(7):753-9. PubMed PMID: 23675953.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Speed of spinal vs general anaesthesia for category-1 caesarean section: a simulation and clinical observation-based study. AU - Kathirgamanathan,A, AU - Douglas,M J, AU - Tyler,J, AU - Saran,S, AU - Gunka,V, AU - Preston,R, AU - Kliffer,P, Y1 - 2013/05/15/ PY - 2013/04/17/accepted PY - 2013/5/17/entrez PY - 2013/5/17/pubmed PY - 2013/11/13/medline SP - 753 EP - 9 JF - Anaesthesia JO - Anaesthesia VL - 68 IS - 7 N2 - Controversy exists as to whether effective spinal anaesthesia can be achieved as quickly as general anaesthesia for a category-1 caesarean section. Sixteen consultants and three fellows in obstetric anaesthesia were timed performing spinal and general anaesthesia for category-1 caesarean section on a simulator. The simulation time commenced upon entry of the anaesthetist into the operating theatre and finished for the spinal anaesthetic at the end of intrathecal injection and for the general anaesthetic when the anaesthetist was happy for surgery to start. In the second clinical part of the study, the time from intrathecal administration to 'adequate surgical anaesthesia' (defined as adequate for start of a category-1 caesarean section) was estimated in 100 elective (category-4) caesarean sections. The median (IQR [range]) times (min:s) for spinal procedure, onset of spinal block and general anaesthesia were 2:56 (2:32-3:32 [1:22-3:50]), 5:56 (4:23-7:39 [2:9-13:32]) and 1:56 (1:39-2:9 [1:13-3:12]), respectively. The limiting factor in urgent spinal anaesthesia is the unpredictable time needed for adequate surgical block to develop. SN - 1365-2044 UR - https://www.unboundmedicine.com/medline/citation/23675953/Speed_of_spinal_vs_general_anaesthesia_for_category_1_caesarean_section:_a_simulation_and_clinical_observation_based_study_ L2 - https://doi.org/10.1111/anae.12290 DB - PRIME DP - Unbound Medicine ER -