Join now to get access to this content and more.
Become a SOAP member and have access to our benefits.
- For Review: SOAP Consensus Statement on Neuraxial Procedures in Thrombocytopenic Parturients
- Sample Centers of Excellence Applications
- ASA Corner
- SOAP Policy and Procedure Manual (P&P Manual)
- SOAP Expert Opinions
- SOAP's Learning Modules
- 2019 Annual Meeting Lecture Videos
- December 2018 - SOAP Unofficial Guide to ASA Committees Webinar
- Submit a Position
- View Job Postings
- Previous Meeting Archives
- Previous Meeting Abstract Search
- CMS Guidelines
- Member Benefits
- Newsletter Clinical Articles
- ACOG Documents
- Search our Patient Safety Archive
- Ask SOAP a Question
- Global Health Opportunities
- And more…
The incidence of non-invasive blood pressure measurement failure, as a result of shivering, during delivery in the operating room: an audit
Abstract Number: S 1
Abstract Type: Original Research
Shivering related to spinals, epidurals or combined spinal-epidurals is common in pregnant women delivering via operative delivery (caesarean or forceps). Shivering can affect non-invasive blood pressure (NIBP) monitoring on the patient’s upper arm to the extent that blood pressure measurements cannot be recorded. Investigating the incidence of NIBP failure as a result of shivering will help anesthesiologists learn more about this problem, and facilitate the design of a future project addressing this important concern. This prospective audit collected data about the incidence of failed (NIBP) as a result of maternal shivering during their operative delivery. Informed consent was waived due to the nature of the study and ethics committee approval was obtained.
Material and Methods
Over four weeks, anesthesiologists recorded the occurrence of NIBP failure and shivering during operative deliveries (forceps and/or caesarean deliveries) through a data collection sheet. All deliveries taking place in the OR during this period of time were included. The only exclusion criterion was the use of arterial line to monitor blood pressure.
One hundred and ninety patients were included, contributing to a high capture rate of 97% (total OR deliveries=196). Overall incidence of shivering was 51%. The majority of shivering patients were the ones that had a functioning labour epidural and received an epidural top-up for forceps or cesarean delivery (63.4%). Incidence of shivering on epidural patients was as high as 83%. Failure due to this shivering occurred in 38% of epidural patients. On the other hand, spinal anesthesia patients shivered in only 29% of the cases, and NIBP failure due to shivering occurred in 9% of the spinal patients.
The results show significant occurrence of NIBP failure, predominantly in epidural anaesthesia. We have documented a critical issue affecting the standard of care for NIBP monitoring. Future studies should address how to reduce the incidence of NIBP measurement failure.
Thermoregulatory effects of spinal and epidural anesthesia during cesarean delivery. Saito T et al. Reg Anesth Pain Med 1998;23:418-23
Shivering and neuraxial anesthesia. Crowley L J, Buggy D J Reg Anesth Pain Med 2008;33:241-252
Incidence of failure of upper limb automated blood pressure measurement during caesarean section. M Hamad, R Freeman, I Wrench PD06 IJOA 2001;10:218