Department of Anesthesiology and Reanimation, Ankara City Hospital, Ankara Şehir Hastanesi Üniversiteler Mahallesi 1604, Cadde No: 9, Çankaya, Ankara, Turkey.
J Anesth. 2022 Aug;36(4):514-523. doi: 10.1007/s00540-022-03086-z. Epub 2022 Jun 12.
The study aims to compare anesthesia methods, clinical course, and maternal and fetal outcomes of symptomatic and asymptomatic pregnant women undergoing cesarean operation with confirmed COVID-19.
254 pregnant women with COVID-19 who had a cesarean section in our hospital between March 2020 and March 2021 were included in the study. Demographic information, laboratory test results, radiological data, treatments, anesthesia methods, and prognoses of the patients were evaluated retrospectively.
On admission, 160 (63%) patients were asymptomatic (Group A), and 94 (37%) patients were symptomatic (Group S). The ratio of patients who needed oxygen therapy in the obstetric ward (p < 0.001) and intraoperative period (p < 0.001) and ICU admission (p = 0.005) was higher in Group S. Neutrophil-to-lymphocyte ratio (NLR), ferritin, procalcitonin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were higher in Group S. In both groups, spinal anesthesia was performed predominantly. The rate of general anesthesia was significantly higher in Group S (16.0% vs. 4.4%, p = 0.003). No difference was found in the amount of sedatives during the spinal anesthesia.
Close follow-up of the laboratory values and comorbidities (especially asthma) of pregnant will provide information about the clinical course as in other patient groups. Spinal anesthesia is a safe and sufficient anesthesia method in both symptomatic and asymptomatic COVID-19 pregnant women when performed by experienced hands.
本研究旨在比较有症状和无症状的确诊 COVID-19 行剖宫产孕妇的麻醉方法、临床经过以及母婴结局。
回顾性分析 2020 年 3 月至 2021 年 3 月在我院行剖宫产术的 254 例 COVID-19 孕妇的临床资料，评估患者的人口统计学信息、实验室检查结果、影像学数据、治疗方法、麻醉方法和预后。
入院时，160 例（63%）患者无症状（A 组），94 例（37%）患者有症状（S 组）。S 组患者在产科病房（p<0.001）和术中（p<0.001）以及 ICU 住院（p=0.005）需要吸氧的比例较高。S 组患者的中性粒细胞与淋巴细胞比值（NLR）、铁蛋白、降钙素原、天门冬氨酸氨基转移酶（AST）和丙氨酸氨基转移酶（ALT）水平较高。两组均以椎管内麻醉为主，S 组全身麻醉率明显高于 A 组（16.0% vs. 4.4%，p=0.003）。S 组椎管内麻醉期间镇静剂用量无差异。
密切关注实验室值和合并症（尤其是哮喘）将为其他患者群体提供有关临床经过的信息。在有经验的医生操作下，椎管内麻醉是有症状和无症状 COVID-19 孕妇安全且充分的麻醉方法。
