Vorwerk T, Weilage D
Reg Anaesth. 1986 Oct;9(4):100-4.
Between 1979 and 1985, 1170 anaesthetics have been used for caesarean sections. The frequency of caesarean sections ranged from 11.9% to 14%. Since 1979, the use of general anaesthesia for caesarean sections has continually decreased from 76% to 11% in favour of regional anaesthesia, and the decrease in general anaesthesia has been most obvious since 1981. The sudden increase in the use of regional anaesthesia was caused by a fatal complication during general anaesthesia. Since 1982, peridural anaesthesia has been used most often (about 60%), followed by spinal anaesthesia (about 30%) and general anaesthesia (about 10%). Regarding peridural anaesthesia, in 94% of the cases the analgesic level was at T 3-8. In spinal anaesthesia, in 90% of the cases the analgesic level ranged from T 3 to T 8. In the latter, segments T 3-4 were reached more frequently. The analgesic effect of peridural anaesthesia was often regarded as being "as good" as the analgesic effect of spinal anaesthesia. A comparison of the anaesthetic techniques in emergency and nonemergency situations revealed that until 1981 in only 30% of the cases was regional anaesthesia performed. After 1981, there was an increase in regional anaesthesia to about 88%. An emergency indication for caesarean section existed in 75% of the cases. Regarding general anaesthesia, the most frequent secondary effects were said to be tachycardia, hypotension and ventricular extrasystoles. Serious complications rarely occurred; nevertheless, when they occurred, they were a threat to life under certain circumstances. Regarding regional anaesthesia, the most frequent secondary effects proved to be vomiting, hypotension and tachycardia.(ABSTRACT TRUNCATED AT 250 WORDS)