Evidence map›Paper›PMID 32404093›Full record

ReviewBMC health services research2020

A retrospective review of 10-year trends in general anesthesia for cesarean delivery at a university hospital: the impact of a newly launched team on obstetric anesthesia practice.

Takamitsu Ikeda, Atsuko Kato, Masahiko Bougaki, Yuko Araki, Takuya Ohata, Seiichiro Kawashima, Yousuke Imai, Jun Ninagawa, Koji Oba, Kyungho Chang and 2 more

Registry-linked trialOpen access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06160583 (General Anesthesia in Obstetric Patients for Cesarean Section, Maternal and Perinatal Outcomes), which is not on this map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06160583 completednot on this mapstarted 2023, after this paper: background citation

General Anesthesia in Obstetric Patients for Cesarean Section, Maternal and Perinatal Outcomes

Typeobservational_patient_registrySponsorHospital Civil de GuadalajaraRan2023 to 2024Enrolled5,000ConditionsAnesthesia, Perinatal Morbidity, Maternal-Fetal Relations
3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. Trial
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  4. Observational
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  6. Review
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  12. Review
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  14. Anesthesia for Cesarean Section: Retrospective Comparative Study.International journal of women's health · 2021
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 1 country.

Takamitsu IkedaDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan. voice_575@live.jp.ORCID http://orcid.org/0000-0002-1245-2958
Atsuko KatoDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan.
Masahiko BougakiDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan.
Yuko ArakiDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan.
Takuya OhataDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan.
Seiichiro KawashimaDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan.
Yousuke ImaiDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan.
Jun NinagawaDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan.
Koji ObaDepartment of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Kyungho ChangDepartment of Anesthesiology, Teikyo University School of Medicine, Tokyo, Japan.
Kanji UchidaDepartment of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan.
Yoshitsugu YamadaDepartment of Anesthesiology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
University of Tokyo Hospital · JPMita Hospital · JPSanraku Hospital · JPTeikyo University · JPThe University of Tokyo · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe indications for general anesthesia (GA) in obstetric settings, which are determined in consideration of maternal and fetal outcome, could be affected by local patterns of clinical practice grounded in unique situations and circumstances that vary among medical institutions. Although the use of GA for cesarean delivery has become less common with more frequent adoption of neuraxial anesthesia, GA was previously chosen for pregnancy with placenta previa at our institution in case of unexpected massive hemorrhage. However, the situation has been gradually changing since formation of a team dedicated to obstetric anesthesia practice. Here, we report the results of a review of all cesarean deliveries performed under GA, and assess the impact of our newly launched team on trends in clinical obstetric anesthesia practice at our institution.

methodsOur original database for obstetric GA during the period of 2010 to 2019 was analyzed. The medical records of all parturients who received GA for cesarean delivery were reviewed to collect detailed information. Interrupted time series analysis was used to evaluate the impact of the launch of our obstetric anesthesia team.

resultsAs recently as 2014, more than 10% of cesarean deliveries were performed under GA, with placenta previa accounting for the main indication in elective and emergent cases. Our obstetric anesthesia team was formed in 2015 to serve as a communication bridge between the department of anesthesiology and the department of obstetrics. Since then, there has been a steady decline in the percentage of cesarean deliveries performed under GA, decreasing to a low of less than 5% in the latest 2 years. Interrupted time series analysis revealed a significant reduction in obstetric GA after 2015 (P = 0.04), which was associated with decreased use of GA for pregnancy with placenta previa. On the other hand, every year has seen a number of urgent cesarean deliveries requiring GA.

conclusionsThere has been a trend towards fewer obstetric GA since 2015. The optimized use of GA for cesarean delivery was made possible mainly through strengthened partnerships between anesthesiologists and obstetricians with the support of our obstetric anesthesia team.

Indexed as

Anesthesia, GeneralAnesthesia, ObstetricalCesarean SectionFemaleHealth Services ResearchHospitals, UniversityHumansPatient Care TeamPregnancyRetrospective StudiesCesarean deliveryGeneral anesthesiaMulti-disciplinary collaborationObstetric anesthesiaPlacenta previa

Identifiers

PMID32404093
PMCPMC7371464
OpenAlexW3028005383

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.