General Anesthesia for Elective Cesarean Section in a Patient with Moyamoya Disease

Objective: to evaluate and compare the influence of the options for the induction of general anesthesia for elective abdominal delivery on the condition of newborns. Materials and Methods: The study included 160 newborns, which were born via elective cesarean section under general anaesthesia. All newborns were divided into 4 groups, 40 in each, depending on the anesthetics used for the induction of general anesthesia. In the 1st group, thiopental sodium 5 mg/kg was used; in the 2nd - sodium thiopental 7 mg/kg; in the 3rd - propofol 2,5 mg/kg; in the 4th- sodium thiopental 5 mg/kg with sevoflurane (0,5 MAC). The influence of anesthesia on condition of newborns was evaluated by the Apgar scale and the neurological and adaptive capacity scale NACS.Results: statistically significant differences were not found in assessing newborns on scales. Conclusion: All the researched drugs and their doses used for the induction of general anesthesia during elective abdominal delivery do not adversely effect on the neurological and somatic status of the newborn.

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Comparison of Neonatal Effects during General Anesthesia Using Sevoflurane and Spinal Anesthesia for Elective Cesarean Section

Korean Journal of Anesthesiology ◽

10.4097/kjae.2003.45.5.622 ◽

2003 ◽

Vol 45 (5) ◽

pp. 622

Author(s):

Ki Ung Kim ◽

Ji Hyang Lee ◽

Jong Suk Ban ◽

Byung Woo Min

Keyword(s):

Cesarean Section ◽

General Anesthesia ◽

Spinal Anesthesia ◽

Elective Cesarean Section ◽

Elective Cesarean

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Comparison of Supreme laryngeal mask airway versus endotracheal intubation for airway management during general anesthesia for cesarean section: a randomized controlled trial

10.21203/rs.2.287/v4 ◽

2019 ◽

Author(s):

Wei Yu Yao ◽

Shi Yang Li ◽

Yong Jin Yuan ◽

Hon Sen Tan ◽

Nian-Lin Reena Han ◽

...

Keyword(s):

Laryngeal Mask Airway ◽

Cesarean Section ◽

Airway Management ◽

General Anesthesia ◽

Endotracheal Intubation ◽

Airway Device ◽

Elective Cesarean Section ◽

Randomized Controlled ◽

Elective Cesarean ◽

Reduced Time

Abstract Background The obstetric airway is a significant cause of maternal morbidity and mortality. Endotracheal intubation is considered the standard of care but the laryngeal mask airway (LMA) has gained acceptance as a rescue airway and has been incorporated into the obstetric airway management guidelines. In this randomized controlled equivalence trial, we compared the Supreme LMA (SLMA) with endotracheal intubation (ETT) in managing the obstetric airway during cesarean section. Methods Parturients who underwent elective cesarean section under general anesthesia were randomized to receive either an SLMA or ETT as their airway device. Our primary outcome was first-attempt insertion success. Successful insertion was defined as adequate bilateral air entry with auscultation and the presence of end-tidal carbon dioxide on the capnogram. The first-attempt insertion success rate was compared using the Chi-Square test. Secondary outcomes included time-to-ventilation, seal pressure, ventilation/hemodynamic parameters, occurrence of clinical aspiration, fetal outcomes, and maternal side effects associated with the airway device. Results We recruited 920 parturients (460 SLMA, 460 ETT) who underwent elective cesarean section under general anesthesia. Patient characteristics were similar between the groups. First attempt success was similar (Odds Ratio--ORSLMA/ETA: 1.00 (95%CI: 0.25, 4.02), p = 1.0000). SLMA was associated with reduced time to effective ventilation (Mean Difference--MD -22.96; 95%CI: -23.71, -22.21 seconds) compared to ETT group (p<0.0001). Ventilation parameters, maternal and fetal outcomes were similar between the groups, and there was no aspiration. Conclusions SLMA could be an alternative airway management technique for a carefully selected low-risk obstetric population, with similar insertion success rates, reduced time to ventilation and less hemodynamic changes compared with ETT. Our findings are consistent with the airway guidelines in recommending the second-line use of LMA in the management of the obstetric airway.

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Effect of Spinal Anesthesia versus General Anesthesia on Blood Glucose Concentration in Patients Undergoing Elective Cesarean Section Surgery: A Prospective Comparative Study

Anesthesiology Research and Practice ◽

10.1155/2019/7585043 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Khaled El-Radaideh ◽

Ala’’a Alhowary ◽

Mohammad Alsawalmeh ◽

Ahmed Abokmael ◽

Haitham Odat ◽

...

Keyword(s):

Blood Glucose ◽

Cesarean Section ◽

General Anesthesia ◽

Spinal Anesthesia ◽

Glucose Concentration ◽

Blood Glucose Concentration ◽

Elective Cesarean Section ◽

Elective Cesarean ◽

Prospective Comparative Study ◽

The Mean

Background. This prospective study compared the blood glucose concentration with spinal anesthesia or general anesthesia in patients undergoing elective cesarean section surgery. Methods. In total, 58 pregnant women who underwent elective cesarean section surgery were included in this prospective comparative study. Group S (n = 35) included patients who chose spinal anesthesia, and group G (n = 23) included patients who chose general anesthesia. The patients were allocated to the groups upon patients’ preference. For the group G, the blood glucose concentration (BGC) was obtained 5 minutes before induction, T1, and 5 minutes after induction T2. For the group S, the BGC was obtained immediately before the injection of the local anesthetic agent T1 and 5 minutes after the complete block T2. For both groups, BGC was measured 5 minutes before the end of surgery T3 and 30 minutes after the end of surgery T4. For BGC measurements, we used a blood glucose monitoring system with a lancet device to prick the finger. Results. There was no statistically significant difference in the mean blood glucose concentration between the groups S and G in T1 (78.3 ± 18.2 vs. 74.3 ± 14.7, p>0.05) and T2 (79.2 ± 18.3 vs. 84.9 ± 23.7, p>0.05). The mean BGC was statistically significantly higher in group G in comparison to group S in the times 5 minutes before (80.2 ± 18.1 vs. 108.4 ± 16.7, p<0.05) and 30 minutes after the end of surgery (80.9 ± 17.7 vs. 121.1 ± 17.4, p<0.05). Conclusion. There is a much lower increase in blood glucose concentration under spinal anesthesia than under general anesthesia. It is reasonable to suggest that the blood sugar concentration must be intraoperatively monitored in patients undergoing general anesthesia.

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