scholarly journals Neonatal Apgar Score Outcomes in Spinal Versus General Anaesthesia at the University Teaching Hospital (UTH), Lusaka.

2020 ◽  
Vol 4 (4) ◽  
pp. 18-24
Author(s):  
Carol Muloshi ◽  
Keyword(s):  
Logistic Regression ◽  
Caesarean Section ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Apgar Score ◽  
University Teaching ◽  
General Anaesthetic ◽  
Spinal Anaesthetic ◽  
The University ◽  
General Anaesthesia Group

Background: The knowledge gap was from the fact that the type of anaesthetic drug administered during caesarean section can have effects on neonatal outcome like low Apgar score with most hospitals in developed countries now using more modern inhalational anaesthetic agents with fewer or no cardio-respiratory depressant effects e.g. Isoflurane or Sevoflurane. However at UTH, halothane is still being used for maintenance of general anaesthesia despite well documented cardio-respiratory depressant effects with very limited research done on its effects on neonatal Apgar score. The Apgar score is a means of rapid evaluation of the physical condition of infants shortly after birth. Thus this study investigated the effects of general anaesthesia with halothane versus spinal anaesthesia on neonatal Apgar score. Objective and study design: With the view of determining the type of anaesthesia administered during caesarean section with the least effects on neonatal wellbeing shortly after birth, a prospective observational cohort study was conducted at the University Teaching Hospital between May 2015 and January 2016.The scientific objective was to determine the effects of general anaesthesia with halothane versus spinal anaesthesia on neonatal Apgar score. This study involved 70 neonates, 54 were born from mothers that had undergone caesarean section under spinal anaesthesia and 16 from mothers that had undergone general anaesthesia. The data was analysed using SPSS version 16.0. Inferential analysis was conducted using logistic regression. Results: 20 neonates out of 54 (37%) in the spinal anaesthetic group had an Apgar score less than 8 at 1 minute[Fig 1]. Out of the 16 neonates in the general anaesthesia group, 14 (87.5%) had Apgar score less than 8 at 1 minute[Fig 1]. One (1.9%) neonate had an Apgar score less than 8 at 5 minutes in the spinal anaesthesia group. While 4 (25%) neonates had Apgar score less than 8 in the GA group[Fig2] The logistic regression at 1 minute Showed that it is over 11 times more likely to get a low Apgar with a general anaesthetic as compared to a spinal anaesthetic (OR 11.9), [Table 3]. The Apgar score at 1 minute in the Spinal anaesthesia group was statistically significantly higher than the general anaesthesia group (p=0.002). The logistic regression at 5 minutes Showed that it is over 17 times more likely to get a low Apgar with a general anaesthetic as compared to a spinal anaesthetic (OR 17.7), [Table 4]. Further, the 5 minutes Apgar score in the spinal anaesthesia group was statistically significantly higher than the general anaesthesia group (p=0.014),[Table 4]. Conclusion: With the results pointing to the fact that there is significant difference in neonatal Apgar score outcomes in spinal versus general anaesthesia, the researcher therefore rejected the null hypothesis. It is therefore inferred that spinal anaesthesia method has better neonatal outcomes by Apgar score measure than general anaesthesia method.

scholarly journals Corrected Scoliosis, Cholinesterase Deficiency, and Cesarean Section: A Case Report

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Roy Somers ◽  
Yves Jacquemyn ◽  
Luc Sermeus ◽  
Marcel Vercauteren
Keyword(s):  
Case Report ◽  
Caesarean Section ◽  
Cesarean Section ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Regional Anaesthesia ◽  
Previous Caesarean Section ◽  
Corrective Surgery ◽  
Ultrasound Guided ◽  
Severe Scoliosis

We describe a patient with severe scoliosis for which corrective surgery was performed at the age of 12. During a previous caesarean section under general anaesthesia pseudocholinesterase deficiency was discovered. Ultrasound guided spinal anaesthesia was performed enabling a second caesarean section under loco-regional anaesthesia.

SPINAL ANAESTHESIA USING TAYLOR’S APPROACH SAVES THE DAY IN OBESE PARTURIENT.

2021 ◽  
pp. 228-228
Author(s):  
Vishal Vashist ◽  
Roohani Mahajan ◽  
Bhanu Gupta
Keyword(s):  
Caesarean Section ◽  
General Anesthesia ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Case History ◽  
Breech Presentation ◽  
Lower Segment ◽  
Subarachnoid Block ◽  
Lower Segment Caesarean Section ◽  
History Of

Subarachnoid block is commonly employed for caesarean deliveries, by virtue of its simplicity in terms of performance, safety for the parturients as compared to general anesthesia. The case history of a 27-yearold female parturiant patient is presented. She was posted for emergency lower segment caesarean section in view of primigravida with breech presentation in labour . She was obese with bodyweight of 102 kg. She had a thick scaly plaque over the back in midline from L1 to L5 area, which is contraindication for administration of spinal anaesthesia via standard median and paramedian approach . Taylor’s approach for administration of the same was tried and proved successful, thus saving the patient from receiving general anaesthesia .

scholarly journals Repeat Spinal Anaesthesia for Caesarean section: An Experience at Paropakar Maternity and Women’s Hospital

2018 ◽  
Vol 12 (2) ◽  
pp. 58-60
Author(s):  
Ritu Pradhan ◽  
Sangeeta Shrestha ◽  
Tara Gurung ◽  
Amirbabu Shrestha
Keyword(s):  
Caesarean Section ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Intrathecal Injection ◽  
Common Adverse Effect ◽  
Haemodynamic Effects ◽  
Sensory Blockade ◽  
Repeat Administration ◽  
Complete Failure ◽  
Motor Effects

Aims: This study aims to review the haemodynamic effects of the repeat spinal anaesthesia and to identify the different doses of Bupivacaine heavy used for the repeat spinal anaesthesia for the failed spinal in caesarean section.Methods: This study was conducted by reviewing medical anaesthesia records of the cases of the repeat spinal anesthesia regarding any adverse haemodynamic effects. The second dose of bupivacaine heavy, maximum sensory blockade and intraoperative events like bradycardia, hypotension, high spinal, nausea vomiting, conversion to general anaesthesia and inadequate block were also reviewed.Results: Out of 8040 caesarean section under subarachnoid block, 51(0.63%) cases were conducted under repeat spinal anaesthesia from April 2014 to December2016. All the cases had complete spinal failure with no sensory and motor effects even after 10 minutes of the intrathecal injection. The second dose of bupivacaine heavy used was variable but reduced than the first dose. The most common adverse effect was hypotension (27.5%). 50% of cases were uneventful. One case was converted to general anaesthesia even after repeat spinal anaesthesia and 9.8% cases had high spinal above T4.Conclusions: Repeat administration of Bupivacaine heavy in reduced dose and volume can be used in complete failure of administration of first spinal anaesthesia. However, it always requires careful assessment and the judicious monitoring.

scholarly journals Spinal Anaesthesia for Caesarean Section in the Solomon Islands

1994 ◽  
Vol 22 (2) ◽  
pp. 187-191 ◽  
Author(s):  
C. J. Sparks ◽  
H. Perndt ◽  
K. Agiomea ◽  
J. Fa'Arondo
Keyword(s):  
Pacific Ocean ◽  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Pacific Islands ◽  
Solomon Islands ◽  
General Anaesthetic ◽  
Tropical Country ◽  
The Pacific ◽  
The Pacific Ocean

Results were kept on 43 spinal anaesthetics performed for caesarean section in the Solomon Islands, a developing tropical country in the Pacific Ocean. A 25-gauge Quincke needle was used and either 2.5 ml of heavy bupivacaine 0.5% or 2.0-2.5 ml of plain bupivacaine 0.5% were injected. Hypotension down to 85 mmHg occurred in four patients and there were no spinal headaches. Five patients had to be given a general anaesthetic. We recommend this technique to other doctors working in the Pacific Islands.

HYPOTENSION DURING SPINAL ANAESTHESIA FOR CAESAREAN SECTION: IMPLICATIONS, DETECTION PREVENTION AND TREATMENT

2006 ◽  
Vol 17 (2) ◽  
pp. 157-183 ◽  
Author(s):  
KIM S KHAW ◽  
WARWICK D NGAN KEE ◽  
SHARA WY LEE
Keyword(s):  
Caesarean Section ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Regional Anaesthesia ◽  
Maternal Morbidity ◽  
Morbidity And Mortality ◽  
Maternal Deaths ◽  
Maternal Morbidity And Mortality ◽  
Prevention And Treatment

Regional anaesthesia is preferred by most anaesthetists for the majority of caesarean sections. The major advantage of regional anaesthesia is the avoidance of maternal morbidity and mortality associated with general anaesthesia. The importance of this can be seen in the most recent Report of Confidential Enquires into Maternal Deaths in which it was reported that of the direct maternal deaths attributed to anaesthesia, all six were associated with difficulties during general anaesthesia. Although a number of regional anaesthesia techniques are available, spinal anaesthesia is particularly popular because it is fast, easy to perform and provides excellent intraoperative analgesia.

scholarly journals Spinal Anaesthesia Induced Hypotension and Related Adverse Effects in Caesarean Section Delivery and Neonatal Outcome: A Comparison of Using Crystalloid Pre-Loading and Co- Loading in Caesarean Patients

2020 ◽  
Vol 5 (1) ◽  
pp. 90
Author(s):  
Taneem Mohammad ◽  
Moinul Hossain Chowdhury ◽  
Shamima Akter ◽  
Mohammad Abdul Karim Miah ◽  
Mohammad Mohsin ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Adverse Effects ◽  
Spinal Anaesthesia ◽  
Apgar Score ◽  
Neonatal Outcome ◽  
Induced Hypotension ◽  
Group I ◽  
Caesarean Section Delivery ◽  
Group Ii ◽  
The Difference

Background: Volume loading by rapid infusion of crystalloid solution before/during induction of spinal anaesthesia may effectively reduce the incidence of anaesthesia induced hypotension.Objective:To compare the efficacy of crystalloid pre-loading and co-loading to preventhypotension and related adverse effects as well aspoor neonatal outcome in caesarean section delivery under spinal anaesthesia.Methods:This single blinded randomized controlled clinical trial was conducted in the Department of Anaesthesia, Analgesia & Intensive Care, Dhaka Medical College Hospital, Dhaka, between January 2013 and December 2014. A total of 90 patients were selected –45patients of group I received co-loading with Ringer’s lactatesolution, while another 45 patients of group II received a pre-loading of the same fluid.Blood pressure and heart rate were recorded. Ephedrine and adrenaline were administered as needed to treat hypotension.APGAR scores of the newborn were recorded at 1st minute and 5th minute after delivery. Adverse effects like nausea, vomiting, light headedness and shivering was observed all through during operation and post-operative phase in all patients, if any, and recorded.Results:The incidence of hypotension was 17 (37.8%) in group I (co-loading) and 27 (60%) in group II (pre-loading), which was significantly higher in group II (p<0.05).Adverse effects – nausea, vomiting, light headedness and shivering was observed more in group II patients; however, the difference was not statistically significant. In neonates, APGAR score at 1 minute was found ≤7 in 18 (40.0%) from group I, while 28 (62.2%) from group II; the difference was statistically significant (p<0.05). No significant difference was observed in APGAR score at 5 minutes, as found ≤7 in 6 (13.3%) and 3 (6.7%) in group I andgroup II respectively.Conclusion:Severity of hypotension, increased ephedrine requirement and poor APGAR score wereevident in patients who received crystalloid pre-loading group(group II), which meanscrystalloid co-loading group(group I) procedurewas more effective in preventing spinal anaesthesia induced hypotension and secured better neonatal outcome.International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 Page: 90-95

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