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在 COVID-19 时代,一家三级保健医院急诊剖宫产术麻醉技术的选择。

Choice of anesthesia technique for emergent cesarean sections during COVID-19 era in a tertiary care hospital.

机构信息

Department Of Anesthesiology And Reanimation, Haseki Training And Research Hospital, İstanbul, Turkey.

Department Of Obstetrics And Gynecology, Haseki Training And Research Hospital, İstanbul, Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2023 Apr;29(4):458-462. doi: 10.14744/tjtes.2023.97580.

Abstract

BACKGROUND

This study explored the change of anesthesia management for emergent cesarean sections in our tertiary care hospital in the first year of pandemic. We searched primarily for the changes in spinal to general anesthesia rate and secondarily for presented adult and neonatal intensive care needs in comparison to the year before the pandemic. We also presented the postoperative PCR tests of the emergent cesarean sections as a tertiary outcome.

METHODS

We retrospectively analyzed clinical data such as anesthetic technique, need for postoperative intensive care, duration of hospital stays, postoperative PCR result, and newborn status.

RESULTS

The rate of spinal anesthesia changed remarkably from 44.1% to 72.1% after the pandemic (p=0.001). The comparison of the median duration of hospital stays of the pre-pandemic group and post-pandemic group was found significantly longer than that of the before COVID-19 group (p=0.001). The rate of need for postoperative intensive care in the after COVID-19 group was higher (p=0.058). The rate of postoperative intensive care of the newborns in the after COVID-19 group was significantly higher than that of the before COVID-19 group (p=0.001).

CONCLUSION

The spinal anesthesia rate for emergent cesarean sections increased significantly during the peak of the COVID-19 pandemic in tertiary care hospitals. Total health care services after the pandemic were enhanced as seen with elevated numbers of hospital stays, postoperative need of adult and neonatal intensive care.

摘要

背景

本研究探讨了在疫情第一年我们的三级保健医院急诊剖宫产的麻醉管理变化。我们主要寻找椎管内麻醉向全身麻醉的比率变化,其次是与大流行前一年相比成人和新生儿重症监护的需求变化。我们还将急诊剖宫产的术后 PCR 检测作为三级结果呈现。

方法

我们回顾性分析了临床数据,如麻醉技术、术后重症监护需求、住院时间、术后 PCR 结果和新生儿情况。

结果

疫情后椎管内麻醉的比例从 44.1%显著增加到 72.1%(p=0.001)。与大流行前相比,前疫情组和后疫情组的中位住院时间明显延长(p=0.001)。后疫情组术后需要重症监护的比例更高(p=0.058)。后疫情组新生儿术后需要重症监护的比例显著高于大流行前组(p=0.001)。

结论

在三级保健医院 COVID-19 疫情高峰期,急诊剖宫产的椎管内麻醉率显著增加。大流行后,整体医疗服务得到加强,表现为住院时间延长,术后需要成人和新生儿重症监护。

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COVID-19 and healthcare workers: A systematic review and meta-analysis.COVID-19 与医护人员:系统评价与荟萃分析。
Int J Infect Dis. 2021 Mar;104:335-346. doi: 10.1016/j.ijid.2021.01.013. Epub 2021 Jan 11.
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Retrospective Evaluation of Anaesthetic Techniques for Caesarean.剖宫产麻醉技术的回顾性评估
Turk J Anaesthesiol Reanim. 2015 Dec;43(6):373-80. doi: 10.5152/TJAR.2015.91069. Epub 2015 Dec 1.

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