دورية أكاديمية
أعرض في EDS

Outcomes for 298 breastfed neonates whose mothers received ketamine and diazepam for postpartum tubal ligation in a resource-limited setting.

التفاصيل البيبلوغرافية
العنوان: Outcomes for 298 breastfed neonates whose mothers received ketamine and diazepam for postpartum tubal ligation in a resource-limited setting.
المؤلفون: Gilder ME; Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand., Tun NW; Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand., Carter A; Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand., Tan FFSL; Hospital Nij Smellinghe, Compagnonsplein 1, 9202 NN, Drachten, Netherlands., Min AM; Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand., Eh H; Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand., Aye P; Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand., Carrara VI; Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Angkurawaranon C; Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. chaisiri.a@cmu.ac.th., McGready R; Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, Thailand.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
المصدر: BMC pregnancy and childbirth [BMC Pregnancy Childbirth] 2021 Feb 09; Vol. 21 (1), pp. 121. Date of Electronic Publication: 2021 Feb 09.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100967799 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2393 (Electronic) Linking ISSN: 14712393 NLM ISO Abbreviation: BMC Pregnancy Childbirth Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Breast Feeding* , Postpartum Period* , Sterilization, Tubal*, Diazepam/*administration & dosage , Ketamine/*administration & dosage, Adjuvants, Anesthesia/administration & dosage ; Adult ; Analgesics/administration & dosage ; Female ; Humans ; Infant, Newborn ; Lactation ; Middle Aged ; Premedication ; Retrospective Studies ; Thailand ; Young Adult
مستخلص: Background: Anesthesia in lactating women is frequently indicated for time-sensitive procedures such as postpartum tubal ligation. Ketamine and diazepam are two of the most commonly used anesthetic agents in low resource settings, but their safety profile in lactating women has not been established.
Methods: Medical records of post-partum tubal ligations between 2013 and 2018 at clinics of the Shoklo Malaria Research Unit were reviewed for completeness of key outcome variables. Logistic regression identified presence or absence of associations between drug doses and adverse neonatal outcomes: clinically significant weight loss (≥95th percentile) and neonatal hyperbilirubinemia requiring phototherapy.
Results: Of 358 records reviewed, 298 were lactating women with singleton, term neonates. There were no severe outcomes in mothers or neonates. On the first postoperative day 98.0% (290/296) of neonates were reported to be breastfeeding well and 6.4% (19/298) had clinically significant weight loss. Phototherapy was required for 13.8% (41/298) of neonates. There was no association between either of the outcomes and increasing ketamine doses (up to 3.8 mg/kg), preoperative oral diazepam (5 mg), or increasing lidocaine doses (up to 200 mg). Preoperative oral diazepam resulted in lower doses of intraoperative anesthetics. Doses of intravenous diazepam above 0.1 mg/kg were associated with increased risk (adjusted odds ratio per 0.1 mg/kg increase, 95%CI) of weight loss (1.95, 95%CI 1.13-3.35, p = 0.016) and jaundice requiring phototherapy (1.87, 95%CI 1.11-3.13, p = 0.017).
Conclusions: In resource-limited settings ketamine use appears safe in lactating women and uninterrupted breastfeeding should be encouraged and supported. Preoperative oral diazepam may help reduce intraoperative anesthetic doses, but intravenous diazepam should be used with caution and avoided in high doses in lactating women.
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فهرسة مساهمة: Keywords: Anesthesia; Diazepam; Ketamine; Lactation; Resource-limited; Safety; Tubal ligation
المشرفين على المادة: 0 (Adjuvants, Anesthesia)
0 (Analgesics)
690G0D6V8H (Ketamine)
Q3JTX2Q7TU (Diazepam)
تواريخ الأحداث: Date Created: 20210210 Date Completed: 20210517 Latest Revision: 20210517
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC7874624
DOI: 10.1186/s12884-021-03610-1
PMID: 33563234
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2393
DOI:10.1186/s12884-021-03610-1