Neme Derartu, Aweke Zemedu, Jemal Bedru, Mulgeta Hailemariam, Regasa Teshome, Garolla Geracho, Zemedkun Abebayehu, Sintayhu Ashagrie
Dilla University, Ethiopia.
Wolaita Sodo University, Ethiopia.
Ann Med Surg (Lond). 2022 Apr 23;77:103654. doi: 10.1016/j.amsu.2022.103654. eCollection 2022 May.
The main aim of this study is to compare hemodynamic stability and feto-maternal outcome between general and spinal anesthesia in pre-eclampsia patients undergoing C/S.
A prospective cohort study was used with a calculated sample size of 266. Comparison of numerical variables between study groups was done using unpaired student t-test and Manny Whitney U test for symmetric and asymmetric data respectively. A P-value <0.05 considered significant.
There is a comparable distribution of socio-demographic, obstetric variables, and baseline hemodynamic variables between groups. The change in a hemodynamic variable from baseline and during the first 24 h was also comparable between groups. The numbers of ICU admission were comparable between groups (8.03% vs. 10.41%, p = 0.549) in spinal and general anesthesia groups respectively. With regards to hospital stay patients in general anesthesia groups had longer hospital stay 5.92 days compared to 4.67 days in the spinal anesthesia group, with a statistically significant difference,(p = 0.024). The Spinal anesthesia group showed lower maternal mortality 2.6% compared to 14.8% in the general anesthesia group during the first 48th hour (p = 0.027). At the first 48 h only 7.14% of neonates in the spinal anesthesia group, and 16.6% o in the general anesthesia group had reported dead (p = 0.315).
Spinal anesthesia (SA) was alternative to general anesthesia regarding hemodynamic stability. Regarding maternal outcome, SA overall shows a better maternal outcome during the first 48 h. The numbers of ICU admission were comparable between groups. The SA group showed lower maternal mortality at the 48th hr.
本研究的主要目的是比较子痫前期患者剖宫产时全身麻醉和脊髓麻醉下的血流动力学稳定性及母婴结局。
采用前瞻性队列研究，计算样本量为266。分别使用非配对学生t检验和曼-惠特尼U检验对研究组间的数值变量进行比较，对称数据和非对称数据分别适用。P值<0.05被认为具有统计学意义。
两组间社会人口统计学、产科变量和基线血流动力学变量分布相当。两组间血流动力学变量从基线到最初24小时的变化也相当。脊髓麻醉组和全身麻醉组的重症监护病房（ICU）收治率相当（分别为8.03%和10.41%，p = 0.549）。在住院时间方面，全身麻醉组患者的住院时间较长，为5.92天，而脊髓麻醉组为4.67天，差异有统计学意义（p = 0.024）。脊髓麻醉组的孕产妇死亡率在最初48小时较低，为2.6%，而全身麻醉组为14.8%（p = 0.027）。在最初48小时，脊髓麻醉组仅有7.14%的新生儿死亡，全身麻醉组为16.6%（p = 0.315）。
在血流动力学稳定性方面，脊髓麻醉（SA）可替代全身麻醉。在孕产妇结局方面，脊髓麻醉总体上在最初48小时显示出更好成绩。两组间ICU收治率相当。脊髓麻醉组在48小时时孕产妇死亡率较低。
