Clinical Focus


  • Anesthesia

Academic Appointments


  • Clinical Instructor, Anesthesiology, Perioperative and Pain Medicine

Professional Education


  • Residency: South East Thames School of Anaesthesia Training (2020) United Kingdom
  • Residency: Barts and the London School of Anaesthesia (2014) United Kingdom
  • Internship: Dorset County Hospital (2011) United Kingdom
  • Medical Education: Hull York Medical School (2009) United Kingdom

All Publications


  • Enhancing recovery after cesarean delivery - A narrative review. Best practice & research. Clinical anaesthesiology O'Carroll, J., Carvalho, B., Sultan, P. 2022; 36 (1): 89-105

    Abstract

    Enhanced recovery after cesarean delivery (ERAC) is increasingly being implemented worldwide with the aim to improve patient care for women undergoing this procedure. ERAC is associated with superior maternal outcomes including decreased length of hospital stay, opioid consumption, pain scores, times to mobilization and urinary catheter removal and hospitalization costs,without increasing hospital readmission rates. A number of preoperative, intraoperative, and postoperative interventions have been incorporated into ERAC protocols. The evidence base for each intervention varies, and there is a lack of consensus as to which are the best and most appropriate interventions. The quality of evidence of studies evaluating ERAC is low, and the measurements for reporting its success are varied and disparate. Protocols rarely assess patient-reported outcome measures, patient satisfaction, or patient experience. The best measures of ERAC success are yet to be fully elucidated. Further work is required to evaluate protocols, interventions, and how best to measure the effect of ERAC.

    View details for DOI 10.1016/j.bpa.2022.01.001

    View details for PubMedID 35659963

  • Development and validation of a Portuguese version of Obstetric Quality of Recovery-10 (ObsQoR-10-Portuguese). Anaesthesia, critical care & pain medicine Mathias, L., Carlos, R. V., Siaulys, M., Gabriades, P., Guo, N., Domingue, B., O'Carroll, J., Carvalho, B., Sultan, P. 2022: 101085

    Abstract

    BACKGROUND: We aimed to develop and validate a Portuguese version of the Obstetric Quality of Recovery-10 (ObsQoR-10-Portuguese) patient-reported outcome measure and evaluate its psychometric properties.METHODS: After ethical approval, we recruited term pregnant women undergoing uncomplicated elective cesarean delivery in a single Brazilian institution. Women were invited to complete the translated ObsQoR-10-Portuguese and EuroQoL (EQ-5D) questionnaires (including a global health visual analog scale [GHVAS]) at 24hours (±6hours) following delivery, and a subset of women an hour later. We assessed validity and reliability of ObsQoR-10-Portuguese.RESULTS: One hundred thirteen and 29 enrolled women completed the surveys at 24h and 25h (100% response rate).VALIDITY: (i) Convergent validity: ObsQoR-10-Portuguese correlated moderately with EuroQoL score (r=-0.587) and GHVAS score (r=0.568) at 24h. (ii) Discriminant validity: ObsQoR-10 discriminated well between good versus poor recovery (GHVAS score ≥ 70 versus < 70; difference in mean scores 14.2; p<0.001). (iii) Hypothesis testing: 24-h ObsQoR-10-Portuguese scores correlated with gestational age (r=0.191; p=0.043). (iv) Cross-cultural validity: Differential item functioning analysis suggested bias in 2 items. Reliability: (i) Internal consistency was good (Cronbach's alpha=0.82 and inter-item correlation=0.31). (ii) Split-half reliability was very good (Spearman-Brown Prophesy Reliability Estimate=0.80). (iii) Test re-test reliability was excellent (intra-class correlation coefficient=0.87). (iv) Floor and ceiling effects: <5% women scored either 0 or 100 (lowest and highest scores, respectively).CONCLUSION: ObsQoR-10-Portuguese is valid and reliable, and should be considered for use in Portuguese-speaking women to assess their quality of inpatient recovery following cesarean delivery.

    View details for DOI 10.1016/j.accpm.2022.101085

    View details for PubMedID 35487408