Type of anesthesia used for caesarean delivery in two hospitals of the Małopolska Province (Poland)
DOI:
https://doi.org/10.15584/medrev.2016.1.6Keywords:
cesarean section, anesthesia, advantages, disadvantagesAbstract
Background. Recent years have witnessed an increase in the number of elective caesarean deliveries. Conduction anesthesia, mainly spinal, is the type of anesthesia most frequently used for caesarean delivery.
Purpose. The survey aimed to conduct comparative analysis of anesthesia types used for caesarean deliveries in two selected hospitals of the Małopolska Province (county of Tarnow), Poland, in 2014.
Material and methods. Anesthetic records for 1097 caesarean deliveries were analyzed (including: patients’ age, anthropometric data and ASA physical status score, type of performed anesthesia, pre-anesthetic fluids, type of spinal needles and a drop in arterial blood pressure after the blockade). The parametric chi-squared test and the nonparametric Kruskal- Wallis and U-Mann Whitney tests were used to analyze the data collated. The level of significance was accepted at < 0.05.
Results. The mean age of females subjected to caesarean section equaled 32.3±5.42 and their mean ASA score was 1.02±0.15. On balance, conduction spinal anesthesia was the most frequently selected anesthetic to prevent pain, and in group B, 26G standard spinal needles and a greater dose of Marcaine were far more routinely used. The HAES solution was in group B the most frequently selected method of hydration. It was disclosed that hydration with the HAES colloidal solutions before the surgical intervention resulted in a smaller drop in ABP after anesthesia.
Conclusion. Spinal anesthesia was the most frequently selected method of anesthesia for caesarean delivery. The ABP drop was the most prevailing complication resulting from conduction anesthesia for caesarean delivery. Hydration with colloid and crystalloid fluids was implemented as a preventive measure against hypotension.
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References
Kruszyński Z. (red). Anestezjologia położnicza, Wydawnictwo PZWL, Warszawa 2007;11-12, 61-67.
Gaca M, Kokot N. Znieczulenie w ginekologii. W: Wołowicka L, Dyk D.(red). Anestezjologia i intensywna opieka. Wydawnictwo PZWL, Warszawa 2007;92-94.
Krawczyk P. Znieczulenie do cięcia cesarskiego [w:] Andreas J (red.nauk.) CEEA: podręcznik, kursy 2012-2014. Materiały polecane do Europejskiego Egzaminu z Anestezjologii i Intensywnej Terapii (EDAIC), wyd. Kraków, Fall Cop. 2014:178-190.
Martínez-Salazar GJ, Grimaldo-Valenzuela PM, Vázquez-Peña GG et al. Caesarean section: History, epidemiology, and ethics to diminish its incidence. Rev Med Inst Mex Seguro Soc 2015;53(5):608-15.
Saygı Aİ, Özdamar Ö, Gün İ et al. Comparison of maternal and fetal outcomes among patients undergoing cesarean section under general and spinal anesthesia: a randomized clinical trial. Sao Paulo Med J 2015;133(3):227-34.
Qublan HS, Merhej A, Dabbas MA et al. Spinal versus general anesthesia for elective cesarean delivery: a prospective comparative study. Clin Exp Obstet Gynecol 2001;28(4):246-8.
Havas F, Orhan Sungur M, Yenigün Y et al. Spinal anesthesia for elective cesarean section is associated with shorter hospital stay compared to general anesthesia. Agri 2013;25(2):55-63.
Afolabi BB, Lesi FE. Regional versus general anaesthesia for caesarean section. Cochrane Database Syst Rev. 2012; 17;10:CD004350. doi: 10.1002/14651858.CD004350.pub3.
Castrillo A, Tabernero C, García-Olmos LM et al. Postdural puncture headache: impact of needle type, a randomized trial. Spine J 2015;15(7):1571-6.
Shaikh JM, Memon A, Memon MA et al. Post dural puncture headache after spinal anaesthesia for caesarean section: a comparison of 25 g Quincke, 27 g Quincke and 27 g Whitacre spinal needles. J Ayub Med Coll Abbottabad 2008;20(3):10-3.
Bryson GL, Macneil R, Jeyaraj LM et al. Small dose spinal bupivacaine for Cesarean delivery does not reduce hypotension but accelerates motor recovery. Can J Anaesth 2007;54(7):531-7.
Xu F, Qian M, Wei Y et al. Postural change from lateral to supine is an important mechanism enhancing cephalic spread after injection of intrathecal 0.5% plain bupivacaine for cesarean section. Int J Obstet Anesth 2015; S0959-289X(15)00093-X. doi: 10.1016/j.ijoa.2015.06.010.
Loubert C. Fluid and vasopressor management for cesarean delivery under spinal anesthesia: Continuing professional development. Can J Anaesth 2012;59: 604–619.
McDonald S, Fernando R, Ashpole K et al. Maternal cardiac output changes after crystalloid or colloid coload following spinal anesthesia for elective cesarean delivery: A randomized controlled trial. Anesth Analg 2011;113: 803–810.
Xiao W, Duan Q, Zhao L et al. Goal-directed fluid therapy may improve hemodynamic stability in parturient women under combined spinal epidural anesthesia for cesarean section and newborn well-being. J Obstet Gynaecol Res 2015; doi: 10.1111/jog.12769.
Mercier FJ. Fluid loading for cesarean delivery under spinal anesthesia: Have we studied all the options? Anesth Analg 2011;113:677–680.
Butwick AJ, Columb MO, Carvalho B. Preventing spinal hypotension during Caesarean delivery: What is the latest? Br J Anaesth 2015; 114:183–186.
Machała W, Brzozowski R, Wiśniewski T i wsp. Nowe spojrzenie na leczenie krwotoków. Pielęgniarstwo w Anestezjologii i Intensywnej Opiece 2013;1(1):29-41.
Golisz M. HES- zły chłopiec terapii płynowej. Anestezjologia i Ratownictwo 2013;7: 404-408.
Kozek-Langenecker SA, Jungheinrich C, Sauermann W et al. The effects of hydroxyethylstarch 130/0.4 (6%) on blood loss and use of blood products in major surgery: a pooled analysis of randomized clinical trials. Anesth Analg 2008;107:382-90.
Roztwory zawierające hydroksyetyloskrobię (HES) nie będą już stosowane u pacjentów z sepsą, oparzeniami ani u pacjentów w stanie krytycznym. www.ema.europa.eu/EMA/809470/2013 (16.12.2015).
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