General Versus Regional Anesthesia for Emergency Cesarean Delivery in a High-volume High-resource Referral Center: A Retrospective Cohort Study.
Emergency
cesarean delivery
general anesthesia
regional anesthesia
Journal
Romanian journal of anaesthesia and intensive care
ISSN: 2392-7518
Titre abrégé: Rom J Anaesth Intensive Care
Pays: Romania
ID NLM: 101681752
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
entrez:
31
5
2021
pubmed:
1
6
2021
medline:
1
6
2021
Statut:
ppublish
Résumé
The choice of anesthesia for emergency cesarean delivery (CD) is one of the most important choices to make in obstetric anesthesia. In this study, we examine which type of anesthesia was used for emergency CD in our hospital, and how the choice affected the time from entry to the operation room until incision (TTI), time until delivery (TTD), and maternal/neonatal outcomes. Retrospectively, we examined all emergency CD's performed in Shaare Zedek Medical Center between January-December 2018. Results: 1059 patients met the inclusion criteria, of which 7.7% underwent general anesthesia (GA), 36.2% - conversion from labor epidural analgesia to surgical anesthesia, 52% - spinal anesthesia and 4.1% - combined spinal epidural. We did not find a significant difference between the GA and conversion epidural groups in terms of TTI or TTD. Nevertheless, GA was found to be correlated to a high rate of blood-products requirement and ICU admission. The rate of newborns with an APGAR score of less than 7, in both first and fifth second after birth, was significantly higher in the GA group, as well as the need for NICU admission. This study clearly emphasizes that the TTI are shortest when using GA or conversion of labor epidural analgesia to surgical anesthesia. Meanwhile, GA is also linked to higher rates of admissions to ICU as well as poorer neonatal outcomes compared to the other groups. Additionally, our study uncovered a low rate of GA, and relatively low rate of regional anesthesia failure, which meets the accepted standards.
Identifiants
pubmed: 34056127
doi: 10.2478/rjaic-2020-0012
pii: rjaic-2020-0012
pmc: PMC8158321
doi:
Types de publication
Journal Article
Langues
eng
Pagination
6-10Informations de copyright
© 2020 Kenas Wiskott et al.. published by Sciendo.
Déclaration de conflit d'intérêts
Conflict of interest Conflicts of interest statement: None of the co-authors have any conflicts of interest to declare.
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