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我们在 COVID-19 阳性剖宫产患者中的麻醉经验:一项回顾性单中心队列研究。

Our anesthesia experiences in COVID-19 positive patients delivering by cesarean section: A retrospective single-center cohort study.

机构信息

Department of Anesthesiology and Reanimation, University of Health Sciences Turkey, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.

出版信息

J Obstet Gynaecol Res. 2021 Aug;47(8):2659-2665. doi: 10.1111/jog.14852. Epub 2021 May 13.

Abstract

AIM

Pregnancy increases susceptibility to respiratory complications of viral diseases. This study aims to evaluate our anesthesia practices in pregnant women with COVID-19 undergoing cesarean section.

METHODS

A total of 61 patients who underwent cesarean section and had positive Polymerase chain reaction (PCR) testing for COVID-19 with nasopharyngeal swabs were included in the study. Patient demographics and information about anesthesia were analyzed retrospectively from the patient medical files.

RESULTS

A total of 61 parturients undergoing cesarean section that had positive SARS-CoV-2 PCR tests were assessed. General anesthesia was applied to only three patients (4.9%), while spinal anesthesia was administered to the remaining 58 patients (95.1%). The incidence of hypotension was 25.9% in the spinal anesthesia group. Forty-one (67.2%) parturients were asymptomatic. While the rate of pneumonia in symptomatic patients was 45% (9/20), the pneumonia incidence among all SARS-CoV-2 PCR (+) parturients was 14% (9/61). Three (4.9%) COVID-19 patients required intensive care in the perioperative period. The overall mortality rate was 1.6% (1/61) among parturients with COVID-19 undergoing cesarean section, while it was 11.1% (1/9) in patients with pneumonia.

CONCLUSION

It was observed that COVID-19 is associated with mortality in pregnant women undergoing cesarean section. Spinal anesthesia was safely and effectively administered in COVID-19 parturients, especially in patients with pneumonia.

摘要

目的

妊娠会增加孕妇对病毒性疾病呼吸道并发症的易感性。本研究旨在评估我们对 COVID-19 行剖宫产的孕妇的麻醉实践。

方法

共纳入 61 例经鼻咽拭子 PCR 检测 COVID-19 阳性行剖宫产的患者。从患者病历中回顾性分析患者的人口统计学和麻醉信息。

结果

共评估了 61 例行剖宫产且 SARS-CoV-2 PCR 检测阳性的产妇。仅 3 例(4.9%)患者接受全身麻醉,其余 58 例(95.1%)患者接受椎管内麻醉。椎管内麻醉组低血压发生率为 25.9%。41 例(67.2%)产妇无症状。而在有症状的患者中,肺炎发生率为 45%(9/20),所有 SARS-CoV-2 PCR(+)产妇的肺炎发生率为 14%(9/61)。3 例(4.9%)COVID-19 患者在围手术期需要重症监护。COVID-19 行剖宫产的产妇总死亡率为 1.6%(1/61),而合并肺炎的患者死亡率为 11.1%(1/9)。

结论

COVID-19 与剖宫产产妇的死亡率相关。椎管内麻醉在 COVID-19 产妇中安全有效,特别是在合并肺炎的患者中。

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