Browsing by Author "Lemos, Paulo"
Now showing 1 - 9 of 9
Results Per Page
Sort Options
- Epidural top-up for caesarean section: a retrospective observational studyPublication . Guimarães, Henrique; Silva, Telmo; Pombo, André; Araújo, Ana; Nunes, Catarina S.; Cabido, Hermínia; Lemos, Paulo
- Knowledge and vews of common citizens regarding ambulatory surgery: a pilot international surveyPublication . Lemos, Paulo; Rodrigues, Inês V.; Nogueira, Daniela R.; Medeiros, Inês F.; Pinto, Nuno R.; Gothen, Margarida C.; Salgado, Beatriz D.; Poças, João C.; Miguel, Isabel R.; Santos, Carolina I.; Carvalho, Helena M.; Morais, Ana S.; Oliveira, Maria J.; Nunes, Catarina S.Background and Aims: Ambulatory surgery (AS) has increased rapidly in most countries since the 1990’s. There is an increasing effort by national healthcare systems to disseminate clinical information about this type of surgical environment to their populations. We conducted a public survey to understand what citizens think about AS and its organization in countries across the world. Methods: This prospective observational study used a survey presented on a tablet computer. Subjects were asked about their surgical experience and those submitted to AS were asked about their satisfaction rate. Subjects were also asked if they associate AS to a surgical programme and the level of information obtained from their National Health Services. Results: 400 citizens from 47 different countries were divided in six geographical areas, European (n=4, North, Central, East and South) and non-European (n=2, Developed and Non-Developed Countries / Emergent Economies). 51.0% reported they had heard of AS, and 29.3% had undergone an AS procedure. Those who had undergone AS, reported a high level of satisfaction with the procedure, with no differences in geographical areas (P=0.229). 90.5% would recommend AS to relatives and friends. Nevertheless, those interviewed wished to have more information related to AS from their National Health Authorities (NHA). This was significant in East, South-European, and Non-Developed NonEuropean countries (P<0.001). Conclusion: The majority of the citizens relates AS as a surgical programme. Although more than 90% of all interviewed would recommend this surgical setting, all agree that more information related to AS should be available from their NHA.
- Online group consultation on labor analgesia for pregnant women: is it feasible?Publication . Tomás, Ana Sofia; Dias, Raquel M.; Cabido, Hermínia; Nunes, Catarina S.; Lemos, PauloIntroduction: Our department of anesthesiology has been conducting weekly, for several years, a group consultation to educate childbearing people about labor analgesia. The emergence of the COVID-19 pandemic forced an adaptation to a virtual consultation format. Since there are no studies about online group consultation on labor analgesia in order to understand its role, an anonymous questionnaire was created and applied. The objective was to evaluate this new consultation format, namely the ease of access, usefulness of the content provided, and its impact on the satisfaction and experience of childbirth. Materials and methods: An observational prospective study was conducted. A questionnaire was sent by email after childbirth to all childbearing people participating in the online consultation from January 20, 2021, to March 2, 2022. SPSS Statistics version 28.0 (IBM Corp. Released 2021. IBM SPSS Statistics for Windows, Version 28.0. Armonk, NY: IBM Corp) was used for statistical analysis. Internal consistency was analyzed using Cronbach’s alpha. Results: A total of 563 participants were eligible, and 404 (71.8%) completed questionnaires were analyzed. A few technical problems were reported. The participants considered their privacy respected, and more than 90% were satisfied with the content of the online consultation, the opportunity to pose questions, and the help managing expectations. Considering face-to-face consultation, 89.6% of patients considered the online format an effective alternative, 63.2% believed it could replace the old model, and 96.3% would recommend it. Conclusions: Our study demonstrates that online consultation on labor analgesia was a good strategy during the COVID-19 pandemic and has the potential to be used in this format in the future.
- Patient satisfaction following day surgeryPublication . Lemos, Paulo; Pinto, Ana; Morais, Gustavo; Pereira, José; Loureiro, Rui; Teixeira, Sofia; Nunes, Catarina S.Study Objective: To evaluate patient satisfaction at discharge and 30 days after day surgery, and to identify predictive factors of patient satisfaction. Design: Observational, prospective study. Setting: Day surgery unit of a university hospital. Patients: 251 consecutive patients, aged 43 ± 15 years (56.6% women), scheduled for day surgery. Interventions: Patients were asked to answer a questionnaire. Measurements: Patients' level of satisfaction was recorded in relation to different variables, using questions of demographics, logistics, and those relating to surgery. Main Results: Over 95% of patients were satisfied with their care at both interviews; 74.5% of patients were completely satisfied at the discharge time; and only 62.4% had the same opinion 30 days after the surgery (P b 0.01). Postoperative pain control [odds ratio (OR) = 1.6], waiting time for surgery (OR = 1.4), and patient changing room conditions (OR = 1.3) were the most important factors influencing patient satisfaction at the time of discharge. Clinical outcome (OR = 3.2), clinical information (OR = 1.6), and postoperative pain control (OR = 1.3) were the main factors affecting patient satisfaction 30 days after surgery. Conclusions: Overall satisfaction following day surgery was at least 95% at discharge and at 30 days. However, complete satisfaction was present only in 75% at discharge and decreased to 62% at 30 days. Clinical outcome was strongly related to patient satisfaction at 30 days after surgery. Factors directly controlled by anesthesiologists such as postoperative pain and information provided, also had a significant impact on patient satisfaction
- Postdural puncture headache in the obstetric population: a new approach?Publication . Xavier, João Manuel; Pinho, Sílvia; Silva, Jorge; Nunes, Catarina S.; Cabido, Hermínia; Fortuna, Rosário; Araújo, Rita; Lemos, Paulo; Machado, HumbertoThe gold standard for the treatment of postdural puncture headache (PDPH) is the epidural blood patch (EBP). Regional techniques-sphenopalatine ganglion block (SPGB), greater occipital nerve block (GONB) and trigger point infiltration (TPI)-can also be used for the treatment of PDPH. Our objective was to evaluate the efficacy of these peripheral nerve blocks (PNBs) in the treatment of PDPH.
- Postoperative analgesia for caesarean section after a general anaesthesia: a retrospective observational studyPublication . Guimarães, Henrique; Silva, Telmo; Pombo, André; Nunes, Catarina S.; Cabido, Hermínia; Lemos, Paulo
- Predictive factors for cesarean delivery : a retrospective studyPublication . Duarte, Sónia; Saraiva, Alexandra; Lagarto, Filipa; Susano, Maria João; Oliveira, Ricardo; Nunes, Catarina S.; Pina, Pedro; Lemos, Paulo; Machado, Humberto S.Background: Cesarean section rates have risen markedly worldwide. Considering the potential harm caused by this mode of delivery, and the general concern in reducing its incidence, it would be useful to individualize the risk of non-planned cesareans, and if there is any possibility, reduce that risk, and anesthesiologists should take part of this risk evaluation. In recent studies, many factors have been related with a higher risk of cesarean, and controversy still surrounds labor analgesia impact on cesarean risk. The aim of this study was to search for predictive factors for nonplanned cesarean delivery. Methods: Retrospective analysis of all labors occurred in our Obstetric Department during 2014. Maternal related factors, previous obstetric history, birth weight and factors related to labor analgesia and labor progression were studied. Our primary outcome was cesarean delivery. Results: We identified two independent predictive factors for cesarean delivery: birth weight (p=0,007 OR= 1,001 CI 95% [1,0003; 1,002]) and labor length since beginning of analgesia (p<0,0001 OR= 1,00005 CI 95%[1,00003; 1,00007]). Searching correlation between registered variables, maternal body mass index was positively associated with newborn birth weight (p<0.0001, R=0.157). Conclusion: Our study showed that birth weight and labor length since beginning of epidural analgesia are independent predictor factors of non-planned cesarean delivery. Furthermore, birth weight was associated with maternal body mass index, providing health professionals a modifiable factor in which we can intervene to improve outcome. As labor progression to cesarean is of major obstetric and anesthetic concern, multidisciplinary initiatives are warranted to clearly identify important variables concurring to operative delivery.
- Risk factors associated with difficult epidural placement: a retrospective studyPublication . Saraiva, Rita; Moreira, J.; Nunes, Catarina S.; Lemos, Paulo; Costa, J.
- The use of vasopressors during anaesthesia for caesarean section: a retrospective observational studyPublication . Guimarães, Henrique; Pombo, André; Araújo, Ana; Nunes, Catarina S.; Cabido, Hermínia; Lemos, Paulo