Basrah Journal of Surgery (Dec 2015)
IS SPINAL ANAESTHESIA A CONVIENIENT OPTION FOR LOWER SEGMENT CAESAREAN SECTION IN MODERATE TO SEVERE PREECLAPSIA IN PATIENTS WITH NORMAL BLOOD INDICIES?
Abstract
Abstract Caesarean section is a common technique of terminating pregnancy in pre-eclamptic patients. The anaesthesiologists are more possible to face a difficult airway in a pre-eclamptic patient. The hazard related to the haemodynamic consequences of laryngoscopy and tracheal intubation in a pre-eclamptic patient is noticeable. General anaesthesia (GA) in such patients may be an option when regional anaesthesia is contraindicated. Spinal anaesthesia (SA) may be considered as anaesthesia of choice for pre-eclamptic patient scheduled for caesarean delivery. Patients included in this study were assigned into two groups, group A, spinal (50 cases) and group B, general anaesthesia (50 patients). All patients were American Society of Anaesthesiologists (ASA) class II & III. The aim of this study is to compare the haemodynamic variability of spinal anaesthesia versus general anaesthesia in patient subjected to caesarean section. Regarding changes in mean arterial pressure and heart rate following general & spinal anesthesia; in spinal group (50 cases), the mean BP remains stable or decreased significantly following spinal injection until the end of the operation. There was significant difference between the two groups (P< 0.001) In conclusion, the majority of pre-eclamptic patients required caesarean delivery. Because of haemodynamic consequences of laryngoscopy and tracheal intubation and further arise in blood pressure during surgery, general anaesthesia is usually chosen only when regional techniques are contraindicated. This study proved that BP & HR in pre-eclamptic patients underwent caesarean section by spinal anaesthesia are more stable than haemodynamics observed in general anaesthesia.
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