Rukewe A, Fatiregun A, Adebayo K
Afr J Med Med Sci. 2014 Mar;43(1):5-10.
The aim of this audit was to evaluate the frequency of caesarean delivery, anaesthetic techniques employed, investigate potential trends and the rate of maternal complications associated with general or regional anaesthesia in our institution.
We reviewed data collected on all deliveries from patients' medical records, anaesthetic charts and relevant surgical notes from 1 January 2008 to 31 December 2010.
A total of 10,911 deliveries were conducted during the study period and there were 3389 caesarean sections, giving a rate of 31.1%; which showed an upward trend from 27.8% in the first year to 34% in the third year. Our data showed a predominant use of regional anaesthesia for caesarean section generally (86.2%) and 83.8% for emergency caesarean deliveries in line with global trends. The overall complication rate was 10.5%. However, 34.5% of parturients who had general anaesthesia in contrast with 6.7% who had regional techniques had anaesthesia-related complications, postoperative intensive care unit admission rather than recovery room care, intra-operative cardiac arrest and haemorrhage exceeding 1200 ml (p = 0.001). Haemodynamic fluctuations were the most common anaesthesia-related complication. Our data revealed that general anaesthesia was a significant risk factor for maternal complications.
Obstetric general anaesthesia is low in our hospital. Our result showed that general anaesthesia was a significant risk factor for maternal complications during caesarean section.
本次审计的目的是评估我院剖宫产的发生率、所采用的麻醉技术、调查潜在趋势以及与全身麻醉或区域麻醉相关的产妇并发症发生率。
我们回顾了2008年1月1日至2010年12月31日期间从患者病历、麻醉记录单及相关手术记录中收集的所有分娩数据。
研究期间共进行了10911例分娩，其中剖宫产3389例，发生率为31.1%；呈上升趋势，从第一年的27.8%升至第三年的34%。我们的数据显示，剖宫产一般主要采用区域麻醉（86.2%），急诊剖宫产采用区域麻醉的比例为83.8%，这与全球趋势一致。总体并发症发生率为10.5%。然而，接受全身麻醉的产妇中有34.5%发生了与麻醉相关的并发症，而接受区域麻醉的产妇中这一比例为6.7%，前者术后入住重症监护病房而非恢复室，术中发生心脏骤停，出血量超过1200毫升（p = 0.001）。血流动力学波动是最常见的与麻醉相关的并发症。我们的数据显示，全身麻醉是产妇发生并发症的一个重要危险因素。
我院产科全身麻醉的比例较低。我们的结果表明，全身麻醉是剖宫产期间产妇发生并发症的一个重要危险因素。
