///2010 Abstract Details
2010 Abstract Details2018-05-01T17:52:49+00:00

A short visit to observe OB anesthesia practice in 6 North-American academic centers

Abstract Number: 51
Abstract Type: Original Research

Laurent A Bollag MD1 ; Philippe Richeb MD, PhD2; Margaret Sedensky MD3; Christopher Kent MD4; Brian K Ross MD, PhD5; Ruth Landau MD6

Background

Attending the annual SOAP meeting represents an exceptional opportunity to enhance ones knowledge in OB anesthesia; however, one may be left wondering what truly happens in real-time, real life, and how OB anesthesia is practiced in academic centers. To answer this intriguing question, our division decided to organize field-trips to six North-American academic centers with an active OB anesthesia division.

Methods

Brigham & Women's Hospital Harvard School of Medicine, Stanford University School of Medicine, Northwestern University Feinberg School of Medicine, Wake Forest University School of Medicine, Mount-Sinai Hospital University of Toronto, and BC Womens Hospital and Health Centre were visited after the chief of OB anesthesia in each center was contacted and informed of our goal. Our faculty identified items of interest, including clinical protocols, equipment, data recording, high risk OB clinic, staffing, scheduling, training, education, etc. A spreadsheet was created to collect the data. Between Sept 2009 and Jan 2010, each member spent 2 days visiting one L&D and provided a summary of the visit. We present here the data related to labor analgesia, anesthesia for CS and post-CS analgesia. Since our goal was not to provide a critical comparison between academic institutions, our findings will remain blinded. We have also included data from our own department.

Results

Data are presented in the Table.

Discussion:

We would like to use this opportunity to thank the faculty at each visited institution for their time and willingness to share with us their protocols, expertise and insight. Beyond the obvious benefits of allowing our faculty to observe practice elsewhere, broaden our horizons and take notes, this out of the box experience allowed our division to re-think our clinical practice, protocols and resources. It also provided invaluable information on how academic centers practice OB anesthesia in 2010. Our major observation was that overall practice is quite similar; in particular the use of phenylephrine as first line vasopressor for spinal hypotension during CS has clearly been adopted across institutions. Areas with most variability in practice were (a) use of an epidural dose, (b) dosing of opioids during labor or for CS, (c) protocols (or lack of) for oxytocin administration during CS and (d) post-CS analgesia. These may be areas that merit further clinical research, or implementation of clinical protocols.



SOAP 2010