Chattopadhyay Suman, Das Ashok, Pahari Subrata
Department of Anaesthesiology, Medical College & Hospital, 88 College Street, Kolkata 700073, India ; BC 103, Salt Lake, Kolkata 700064, India.
Department of Anaesthesiology, Medical College & Hospital, 88 College Street, Kolkata 700073, India.
J Pregnancy. 2014;2014:325098. doi: 10.1155/2014/325098. Epub 2014 Apr 17.
This prospective observational study compared the effects of general and spinal anesthesia in 173 severe preeclamptic women undergoing emergency cesarean section. 146 (84.5%) patients underwent spinal anesthesia (SA) and 27 (15.5%) patients had general anesthesia (GA). Most of the patients were primigravid and nulliparous. Intraoperatively SA group required more intravenous fluid and vasopressor support, while GA group required more preoperative labetalol injection for blood pressure control. Overall 13.3% of patients required critical care, particularly GA group (44.4% versus 7.5%; P < 0.001). Patients receiving GA had a higher mortality (25.9% versus 1.4%; P < 0.001). The length of hospital stay was comparable. Significantly more neonates of patients receiving GA were found to be preterm (77.8% versus 44.5%; P < 0.01) and required advanced resuscitation. GA group also had higher neonatal mortality (29.6% versus 11%; P < 0.05). To conclude, severe preeclamptic mothers receiving general anesthesia and their babies required more critical care support. Maternal as well as neonatal mortality was significantly higher with general anesthesia.
这项前瞻性观察性研究比较了173名接受急诊剖宫产的重度子痫前期妇女接受全身麻醉和脊髓麻醉的效果。146名（84.5%）患者接受了脊髓麻醉（SA），27名（15.5%）患者接受了全身麻醉（GA）。大多数患者为初产妇且未生育。术中SA组需要更多的静脉输液和血管升压药支持，而GA组需要更多的术前拉贝洛尔注射来控制血压。总体而言，13.3%的患者需要重症监护，尤其是GA组（44.4%对7.5%；P<0.001）。接受GA的患者死亡率更高（25.9%对1.4%；P<0.001）。住院时间相当。接受GA的患者中，显著更多的新生儿为早产儿（77.8%对44.5%；P<0.01），且需要高级复苏。GA组的新生儿死亡率也更高（29.6%对11%；P<0.05）。总之，接受全身麻醉的重度子痫前期母亲及其婴儿需要更多的重症监护支持。全身麻醉下产妇和新生儿的死亡率均显著更高。
