Summary To better understand outcomes in postpartum patients who receive peripartum anaesthetic interventions, we aimed to assess quality of recovery metrics following childbirth in a UK‐based multicentre cohort study. This study was performed during a 2‐week period in October 2021 to assess in‐ and outpatient post‐delivery recovery at 1 and 30 days postpartum. The following outcomes were reported: obstetric quality of recovery 10‐item measure (ObsQoR‐10); EuroQoL (EQ‐5D‐5L) survey; global health visual analogue scale; postpartum pain scores at rest and movement; length of hospital stay; readmission rates; and self‐reported complications. In total, 1638 patients were recruited and responses analysed from 1631 (99.6%) and 1282 patients (80%) at one and 30 days postpartum, respectively. Median (IQR [range]) length of stay postpartum was 39.3 (28.5–61.0 [17.7–513.4]), 40.3 (28.5–59.1 [17.8–220.9]), and 35.9 (27.1–54.1 [17.9–188.4]) h following caesarean, instrumental and vaginal deliveries, respectively. Median (IQR [range]) ObsQoR‐10 score was 75 ([62–86] 4–100) on day 1, with the lowest ObsQoR‐10 scores (worst recovery) reported by patients undergoing caesarean delivery. Of the 1282 patients, complications within the first 30 days postpartum were reported by 252 (19.7%) of all patients. Readmission to hospital within 30 days of discharge occurred in 69 patients (5.4%), with 49 (3%) for maternal reasons. These data can be used to inform patients regarding expected recovery trajectories; facilitate optimal discharge planning; and identify populations that may benefit most from targeted interventions to improve postpartum recovery experience.

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AimsChildren with Sturge-Weber syndrome (SWS), a neurocutaneous disorder affecting cerebral perfusion, can experience severe headache with or without transient hemiparesis. Flunarizine, a calcium antagonist, has been used in children for migraine prophylaxis. This retrospective observational review describes the use of flunarizine and its side effect profile in 20 children with Sturge-Weber syndrome. We investigated the efficacy of flunarizine in reducing headache severity, frequency and duration.Methods20 children with SWS on flunarizine treatment were studied retrospectively using a combination of health care professionals’ case note documentation. Headache severity, frequency and duration were recorded before commencement of flunarizine and at the latest clinic follow up after commencement. The Wilcoxen Sign Test was used to determine significance of the effect. Symptoms reported during flunarizine treatment were also recorded and compared with its established side effect profile.ResultsFlunarizine was used in 13 children for headache alone, and 7 children for mixed migrainous episodes and vascular events. Flunarizine significantly reduced headache severity (z-value 3.354, p=0.001), the monthly frequency of headache (z-value 2.585, p=0.01), and headache duration (z-value 2.549, p=0.011). Sedation and weight gain were the most prevalent observed side effects. There were no reports of behaviour change or extra-pyramidal movement disorders. 2 children discontinued flunarizine due to intolerable side effect.ConclusionsFlunarizine prophylaxis reduced the severity, frequency and duration of headache in children with SWS. Weight gain and sedation were observed in this cohort, but discontinuation of flunarizine was rare. Further studies are required to consolidate information on the safety of flunarizine, in order to move towards licensing its use in the UK. However, this review supports the off license use of flunarizine prophylaxis for headache in children with SWS.

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