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Urgency of surgery and presence of maternal disease influence the choice of anaesthesia for Caesarean section at LUTH.
Niger Postgrad Med J. 2007 Jun; 14(2):114-7.NP

Abstract

AIMS AND OBJECTIVES

Worldwide, Caesarean sections are commonly done under regional anaesthesia which offers numerous advantages over general anesthesia. However there are still indications for the use of general anaesthesia in obstetric practice. This includes emergent Caesarean sections. This study sought to determine the factors that inform the decision on the choice of anaesthesia for Caesarean section in a tertiary institution in Nigeria.

PATIENTS AND METHODS

All patients scheduled for elective and emergency caesarean sections between January and December 2002 were prospectively studied. Study variables included age of mother, gestational age and parity. Urgency of surgery, indication for surgery, maternal pre-existing disease and the choice of anaesthetic technique were documented. Neonatal weight was recorded and outcome was assessed by Apgar score at 1 and 5 minutes, the presence of respiratory difficulties and the need for admission into the Neonatal unit.

RESULTS

One hundred and ninety-six patients were studied. Elective surgery was performed for 17.3%, while 47.4% and 28.6% had urgent and emergency Caesarean sections respectively. Urgency of surgery was not documented in 6.7% of cases. Previous caesarean section was the commonest indication for elective procedures (47%), foetal distress for emergency (62.5%) and previous caesarean section in labour for urgent procedures (30.1%). General anaesthesia was employed in 33.2% of patients while regional anaesthesia was used in 66.8%. Fifty per cent of emergency cases had general anaesthesia. Regional anaesthesia was used in 72% of urgent and 85.3% of elective procedures. The commonest regional technique was spinal anaesthesia (60.7%). Nineteen per cent of our patients had a co-existing medical problem, and 73% of these received a spinal anaesthetic. More neonates delivered under general anaesthesia had respiratory difficulties at birth (p=0.002) and more were admitted to the Neonatal unit (p=0.031).

CONCLUSION

The choice of anaesthesia depends on the urgency of surgery and the medical condition of the mother. General anaesthesia was more likely to be administered for bleeding emergencies and foetal distress. Spinal anaesthesia was preferred for elective and urgent cases or when maternal disease existed.

Authors+Show Affiliations

Department of Anaesthesia, College of Medicine University of Lagos, P.M.B 12003, Lagos.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17599107

Citation

Desalu, I, and B B. Afolabi. "Urgency of Surgery and Presence of Maternal Disease Influence the Choice of Anaesthesia for Caesarean Section at LUTH." The Nigerian Postgraduate Medical Journal, vol. 14, no. 2, 2007, pp. 114-7.
Desalu I, Afolabi BB. Urgency of surgery and presence of maternal disease influence the choice of anaesthesia for Caesarean section at LUTH. Niger Postgrad Med J. 2007;14(2):114-7.
Desalu, I., & Afolabi, B. B. (2007). Urgency of surgery and presence of maternal disease influence the choice of anaesthesia for Caesarean section at LUTH. The Nigerian Postgraduate Medical Journal, 14(2), 114-7.
Desalu I, Afolabi BB. Urgency of Surgery and Presence of Maternal Disease Influence the Choice of Anaesthesia for Caesarean Section at LUTH. Niger Postgrad Med J. 2007;14(2):114-7. PubMed PMID: 17599107.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Urgency of surgery and presence of maternal disease influence the choice of anaesthesia for Caesarean section at LUTH. AU - Desalu,I, AU - Afolabi,B B, PY - 2007/6/30/pubmed PY - 2007/8/19/medline PY - 2007/6/30/entrez SP - 114 EP - 7 JF - The Nigerian postgraduate medical journal JO - Niger Postgrad Med J VL - 14 IS - 2 N2 - AIMS AND OBJECTIVES: Worldwide, Caesarean sections are commonly done under regional anaesthesia which offers numerous advantages over general anesthesia. However there are still indications for the use of general anaesthesia in obstetric practice. This includes emergent Caesarean sections. This study sought to determine the factors that inform the decision on the choice of anaesthesia for Caesarean section in a tertiary institution in Nigeria. PATIENTS AND METHODS: All patients scheduled for elective and emergency caesarean sections between January and December 2002 were prospectively studied. Study variables included age of mother, gestational age and parity. Urgency of surgery, indication for surgery, maternal pre-existing disease and the choice of anaesthetic technique were documented. Neonatal weight was recorded and outcome was assessed by Apgar score at 1 and 5 minutes, the presence of respiratory difficulties and the need for admission into the Neonatal unit. RESULTS: One hundred and ninety-six patients were studied. Elective surgery was performed for 17.3%, while 47.4% and 28.6% had urgent and emergency Caesarean sections respectively. Urgency of surgery was not documented in 6.7% of cases. Previous caesarean section was the commonest indication for elective procedures (47%), foetal distress for emergency (62.5%) and previous caesarean section in labour for urgent procedures (30.1%). General anaesthesia was employed in 33.2% of patients while regional anaesthesia was used in 66.8%. Fifty per cent of emergency cases had general anaesthesia. Regional anaesthesia was used in 72% of urgent and 85.3% of elective procedures. The commonest regional technique was spinal anaesthesia (60.7%). Nineteen per cent of our patients had a co-existing medical problem, and 73% of these received a spinal anaesthetic. More neonates delivered under general anaesthesia had respiratory difficulties at birth (p=0.002) and more were admitted to the Neonatal unit (p=0.031). CONCLUSION: The choice of anaesthesia depends on the urgency of surgery and the medical condition of the mother. General anaesthesia was more likely to be administered for bleeding emergencies and foetal distress. Spinal anaesthesia was preferred for elective and urgent cases or when maternal disease existed. SN - 1117-1936 UR - https://www.unboundmedicine.com/medline/citation/17599107/Urgency_of_surgery_and_presence_of_maternal_disease_influence_the_choice_of_anaesthesia_for_Caesarean_section_at_LUTH_ L2 - https://medlineplus.gov/cesareansection.html DB - PRIME DP - Unbound Medicine ER -