Technique of anaesthesia for different grades of caesarean section: a cross-sectional study (original) (raw)
Related papers
IOSR Journal of Dental and Medical Sciences, 2014
Objective: This study is to ascertain the preferred choice of anaesthetic technique and their reasons, among pre gnant women schedule for caesarean section during preoperative visit in Federal Teaching Hospital, Gombe. Methodology: This was a three year prospective study [from June, 2010-May, 2013] of pregnant women sched uled for either elective or emergency caesarean section. During the preoperative visit, patients were counselled and consent obtained on either regional or general anaesthesia and their reasons for the choice documented. Results: A total of 1,350 women were interviewed during the three years period of the study.]The total of four h undred and sixty one patients (n=461, 34.1%) were scheduled for emergency caesarean section, while eight hun dred and eighty nine patients (n=889, 65.9%) were scheduled for an elective caesarean sections. They were age d 17-40 years with the mean age of 27.84 +/-4.43 years. The parity ranged from 1-12. Majority of the patients 9 45 (70%) preferred regional anaesthesia, while 405 (30%) preferred general anaesthesia The common reasons f or their preference to regional anaesthesia include early contact with their babies, fear of death from general a naesthesia, want to know what is going on in the theatre, general anaesthesia is more dangerous, patient being awake, reduced blood loss, cheaper and well tolerated however, others preferred general anaesthesia because o f fears of the complications of regional anaesthesia e.g. backache, headache etc. Conclusion: We conclude that regional anaesthesia is the preferred technique of choice for most pregnant wom en undergoing caesarean sections in our centre. Detail preoperative review with emphases on counselling of the patients by the anaesthetists on the advantages of regional anaesthesia over the general anaesthesia will encou rage the high preference of regional over general anaesthesia. We therefore, recommend that preoperative revie w should be encouraged in all hospitals and in all patients undergoing either emergency or elective caesarean s ections.
MedPulse International Journal of Anesthesology
Background: General anaesthesia for caesarean delivery is associated with substantially greater maternal risk than regional anaesthesia. Most of the deaths occurring during general anaesthesia are related to airway management or aspiration. Spinal and epidural anaesthesia have therefore become more common in obstetric surgical practice. Objectives: A one year prospective observational study of caesarean sections (CS) carried out under regional anaesthesia was analysed to know the 1. Incidence and characteristics of failed regional anaesthesia leading to conversion of regional to general anaesthesia (Total/Partial "Failure" of block) in CS. 2. Identification of risk factors for "block failure "3. To identify the options used for managing an inadequate block. Methods: The present study was conducted in Anaesthesia Department of Panna Dhai Women Hospital attached to R.N.T. Medical College from 1st Feb. 2011 to 31st Jan.2012. Regional anaesthesia technique for CS included spinal (most common), epidural and combined spinal epidural (CSE) technique. Results: Incidence of failed spinal anaesthesia was 77/4038 (1.906%) [52/ 4038; 1.287%-partial spinal failure and 25/4038; 0.62%-complete spinal failure]. There was no case of failure observed in epidural or CSE. Failure rate was 13/1674 (0.77) for elective CS and 64/2403 (2.66%) for emergency CS. Conclusion; Spinal anaesthesia using hyperbaric bupivacaine produced reliable anaesthesia for caesarean section with failure rate of 0.77% in elective surgery and 2.66% in emergency surgery.
Anaesthesia Techniques for Caesarean Operations: Retrospective Analysis of Last Decade
Turkish Journal of Anesthesia and Reanimation, 2014
Objective: The technique of anaesthesia in caesarean sections is selected according to the patient's clinical presentation, experience of the anaesthesist and the patient's wishes. The purpose of this study was to evaluate the anaesthesia methods employed in our clinic in the last decade (2003-2012). Methods: Records of caesarean operations performed between 2003-2012 in the Anaesthesia department of Atatürk University Medical Faculty and stored in the hospital computer system were examined. The annual distribution of methods of anaesthesia in operations was analysed. Results: During 2003-2012, 9049 caesarean operations were performed in our clinic. General anaesthesia was used in 45% of operations and regional anaesthesia in 54%. Whereas the rate of regional anaesthesia in 2003 was 34%, this increased to 69% in 2012. The most commonly used method of regional anaesthesia was spinal anaesthesia (34%) in 2003, and spinal anaesthesia (41%) and combined spinal-epidural anaesthesia (27%) in 2012. Conclusion: The most commonly used anaesthesia technique for caesarean operations in our clinic between 2003-2012 was spinal anaesthesia. The most widely used regional anaesthetic method in our clinic was spinal anaesthesia. A significant increase in the use of the combined spinal-epidural anaesthetic technique occurred in the last two years of the study period.
Retrospective Evaluation of the Anaesthetic Method Used in Caesarean Sections
Bezmialem Science, 2015
Objective: The goal of this study was to evaluate the anaesthetic method used in patients who have undergone caesarean section. Methods: The anaesthetic reports that belong to the women who underwent caesarean section between the years 2014 and 2015 were evaluated in terms of the demographic data, anaesthetic methods, and reported complications. Results: Although 299 patients received general anaesthesia, 75 patients received regional anaesthesia during caesarean section. Mortality was not observed in any patient. Conclusion: Although regional anaesthesia is currently being used mostly in many countries for caesarean sections, our patients chose the general anaesthesia. Making the method of anaesthesia depend on patients' preferences with the exception of some special conditions such as patients' fear and anesthesiologist's additional aliments might have a role in this circumstance.
Trends in Obstetrics Anesthesia, at Gondar University Hospital
2015
Introduction: Trend analysis in anesthesia is one way of evaluating previous practice and projecting future performance. Obstetric anesthesia is being challenged currently due to changes in population character. This shifts obstetric anesthetic practice worldwide in favor of regional technique. Methods: A cross sectional study design was used to see anesthetic practice in obstetrics. Information on Sociodemographic variables and other variables of interest were collected from anesthesia and obstetric log books. These documents were reviewed after getting ethical clearance from the Gondar University's Ethical review board and permission letter from UOG clinical director's office. All mothers for whom caesarean section was done within 15 years period were included in this study, Data entry and analysis was done using SPSS version 16 and excel 2007, charts and graphs were used to summarize the results. Result: A total of 4398 mothers under gone caesarean section within 15 years, from this 2887 (65.6%) were operated under GA and the rest 34.4% were operated under spinal anesthesia. There was a sudden shift of obstetric anesthesia from general anesthesia to spinal anesthesia starting from 2000 and the dominance of General anesthesia over spinal anesthesia re emerged starting from 2004 onwards. Conclusion: General anesthesia is still the predominant anesthetic technique in obstetric practice in University of Gondar hospital. Anesthetic technique for caesarean section needs to be revised in University of Gondar hospital based on trends of rest of the world. The objective of this study is to assess the type of anesthesia used for obstetric practice over the period of 15 years in Gondar university teaching Hospital and trends in anesthetic professionals' qualification.
Aim: To evaluate the preference of patients for elective cesarean section, also to know the most popular mode of anesthesia (spinal or general anesthesia), also to determine the relationship between anaesthesia type for caesarean section and patient satisfaction post-operation, degree of need for postoperative analgesia, and the future choice of type of anesthesia. Method: This was a cross-sectional analytical study. The questionnaire distributed in Arabic on (400) mothers having elective caesarean section at four hospitals in Riyadh city, Saudi Arabia Results: Majority of patients (68.70 %) had general anesthesiain the previous caesarean operation, while (68. 50 %) had spinalanesthesia.Also there are a relationship between anaesthesia type for caesarean section and both patient satisfaction after the operation and degree of need for postoperative analgesia, where spinal anesthesia increases both patient satisfaction with anesthesia technique, and degree of patient need for postoperative analgesia after cesarean section. Conclusion: Although spinal anesthesia is safer than general anaesthesia, being safer for both mother and fetus, allows the mother to be awake and immediately interact with her baby, but most of patients like general anesthesia because they are afraid of spinal anesthesia.
Retrospective Evaluation of Anaesthetic Techniques for Caesarean
Turkish journal of anaesthesiology and reanimation, 2015
This study aimed to evaluate the maternal, foetal and neonatal effects of anaesthetic techniques used in caesarean sections (C/S) retrospectively over 6 years at the Hospital of Medical School of Dokuz Eylül University and to compare the results with the literature from Turkey and developed countries. After obtaining approval from the ethics committee, anaesthetic and gestational data from all caesarean operations performed over a 6-year period between 2005 and 2010 was retrospectively obtained from hospital archives. During this period, a total of 10,819 labours was conducted and C/S ratio was 55% with 5953 patients. General anaesthesia was performed in 1479 patients (24.8%) and regional anaesthesia was performed in 4474 patients (75.2%) [Spinal anaesthesia for 1203 patients (26.9%), epidural anaesthesia for 830 patients (18.5%) and combined spinal-epidural anaesthesia for 2441 patients (54.6%)]. In 2010, regional anaesthesia ratio increased to 84.6%, whereas in 2005, it was 63.8%....
Trends in regional anaesthesia for caesarean section in a Nigerian tertiary health centre
West African journal of medicine
Most caesarean sections were previously performed under general anaesthesia but there has been an increasing trend worldwide in the use of regional anaesthesia as the preferred method of anaesthesia for caesarean delivery. To evaluate the trend of practice of regional anaesthesia for caesarean section in a tertiary hospital in South-western part of Nigeria. The obstetric operating room records at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria were reviewed for a twenty-year period: January 1986 to December 2005. The anaesthetic techniques for caesarean section and the level of training of the attending anaesthetist were noted. A total of 1,785 patients were delivered by caesarean section during the twenty-year period . Most patients [1578(88.4%)] had caesarean section under general anaesthesia while 207(11.6%) had regional anaesthesia. Subarachnoid block accounted for 89(5%) of the patients and 118(6.6%) had the caesarean section under epidural block. One hundred...
International Journal of Obstetric Anesthesia, 2010
Background: Anaesthetic-related maternal deaths have largely been attributed to complications of general anaesthesia. In our unit a retrospective audit conducted between 1997 and 2002 showed a 9.4% conversion rate to general anaesthesia for caesarean sections amongst women with epidural catheters in-situ. The Royal College of Anaesthetists has stated that <3% of cases should need conversion to general anaesthesia. To improve our figures, from 2004 to 2007 we prospectively audited all caesarean sections requiring general anaesthesia. Methods: Data were collected on the number of caesarean sections, initial anaesthetic technique used, need for conversion either pre-or intra-operatively and the use of labour epidural analgesia, where an epidural had been in-situ. Results: There were 2273 caesarean sections during the audit period. Neuraxial anaesthesia rates were for elective cases 95.3% , 96.3% (2005), 98.3% (2006) and 98.2% (2007) and for emergency cases 82.3% (2004), 88.6% (2005), 87.0% (2006) and 85.7% . Common reasons given for not using a regional technique were urgency of delivery (category 1) or anticipated large blood loss. Conversion rates from regional to general anaesthesia for elective cases were 0.. Improvements were seen in all but category-1 caesarean sections. Conclusions: Prospective audit has been associated with improved rates for neuraxial anaesthesia and reduced need for conversion to general anaesthesia in all but category-1 caesarean sections. The Royal College of Anaesthetists standards may need to be reviewed to become category-specific.