DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20181771

Evaluation of anaesthetic techniques for caesarean

Alaka Banerjee, Dhrubajyoti Sarkar, Banasree Bhadra

Abstract


Background: The anaesthetic technique to be used in Caesarean section is determined according to factors such as urgency, presence of coexisting health problems, preference of patient and preference and experience of the anaesthetist and surgeon.

Methods: This is a retrospective study of all the caesarean deliveries that occurred in the period between 1st Jan 2010 to 31st Dec 2017 in the department of obstetrics and Gynaecology in Silchar Medical College. The anaesthesia techniques used for caesarean sections were evaluated in this study. Anaesthesia methods were recorded as general anaesthesia (GA) and regional anaesthesia (RA), and RA was classified into spinal anaesthesia (SA), epidural anaesthesia (EA) and combined spinal epidural anaesthesia (CSEA) subgroups.

Results: During the study period a total of 75685 patients delivered and 25805 patients had undergone caesarean section. The caesarean section rate at the institution comes to be around 34.1%. Among the indications, it was observed that foetal distress (32.8%) was the commonest cause followed by post caesarean pregnancy (26.76%). The majority of the CS (75.6%) were done as an emergency procedure. Regional anaesthesia was the most frequently used method both in emergency (92.87%) and elective caesarean section (84.21%). SA was the commonest used RA (89.2%).

Conclusions: In recent years, the rate of regional anaesthesia administration in caesarean section is gradually increasing, and the spinal anaesthesia technique is the mostly preferred regional anaesthesia. There is need to explore the use of the other forms of regional anaesthesia also.


Keywords


Caesarean section, General anaesthesia, Regional anaesthesia

Full Text:

PDF

References


Morgan GE, Mikhail MS, Murray MJ. Morgan: Clinical anaesthesiology. Ankara;2008:890921.

Birnbach DJ, Browne IM. Anesthesia for obstetrics. In: Miller’s Anesthesia. Miller RD. 7th Edition. New York: Churchill Livingstone; 2009:2203-2240.

Purtuloglu T, Ozkan S, Teksoz E, Dere K, Şen H, Yen T, et al. Elektif sezaryen uygulanan olgularda genel ve spinal anestezinin maternal ve fetal etkilerinin karşılaştırılması. Comparison of maternal and fetal effects of general and spinal anesthesia in patients undergoing elective cesarean section. Gülhane Tıp Dergisi. 2008;50:91-7.

Dahl V, Spreng UJ. Anaesthesia for urgent (grade 1) caesarean section. Curr Opin Anaesthesiol. 2009;22:352-6.

Hawkins JL. Anesthesia related maternal mortality. Clin Obstet Gynecol. 2003;46:679-87.

Dresner MR, Freeman JM. Anaesthesia for caesarean section. Best Pract Res Clin Obstet Gynaecol. 2001;15:127-43.

Sarı MA, Küçükgüçlü S, Özbilgin Ş, Günenç FS, Mercan S, Esen A, et al. Retrospective Evaluation of Anaesthetic Techniques for Caesarean. Turkish J Anaesthesiology reanimation. 2015 Dec;43(6):373.

Prasad MK, Rani K. Retrospective evaluation of Anaesthetic method used in Caesarean sections: Changing trends. Indian J App Res. 2018 Feb 13;7(5).

Davies NJH, Cashman JN. Çev; Turan IÖ. Obstetri, Lee’s Synopsis of Anaesthesia. Güneş kitapevleri. 2008:657-80.

Manjulatha B, Sravanthi TP. Caesarean section rates in a Teaching Hospital: a ten-year review. IOSR J Dent Med Sci. 2015;14(8):1-5.

Barber EL, Lundsberg LS, Belanger K, Pettker CM, Funai EF, Illuzzi JL. Indications contributing to the increasing cesarean delivery rate. Obstet Gynecol. 2011;118(1):29-38.

Liu S, Rusen ID, Joseph KS, Liston R, Kramer MS, Wen SW, Kinch R. Recent trends in caesarean delivery rates and indications for caesarean delivery in Canada., Maternal Health Study Group of the Canadian Perinatal Surveillance System J Obstet Gynaecol Can. 2004;26(8):735-42.

Gupta M, Garg V. The rate and indications of caesarean section in a teaching hospital at Jaipur, India. Int J Reprod Contracept Obstet Gynecol. 2017;6:1786-92.

Ministry of Health Maternal and Child Health and Family Planning General Directorate. Cesarean birth and action management guide. Damla Matbaacılık, Reklamcılık ve Yayıncılık Tic. Ltd. Şti. Ankara; 2010:7.

Kocamanoğlu İS, Sarıhasan B, Şener B, Tür A, Şahinoğlu H, Sunter T. Sezaryen operasyonlarında uygulanan anestezi yöntemleri ve komplikasyonları: 3552 olgunun retrospektif değerlendirilmesi. Turkiye Klinikleri J Med Sci. 2005;25:810-6.

Chen YH, Rau RH, Keller JJ, Lin HC. Possible effects of anaesthetic management on the 1-yr followed-up risk of herpes zoster after Caesarean deliveries. Br J Anaesth. 2012;108:278-82.

Rukewe A, Fatiregun A, Adebayo K. Anaesthesia for caesarean deliveries and maternal complications in a Nigerian teaching hospital. Afr J Med Med Sci. 2014;43:5-10.

Marcus HE, Behrend A, Schier R, Dagtekin O, Teschendorf P, Böttiger BW, et al. Anesthesiological management of Caesarean sections: nationwide survey in Germany. Anaesthesist. 2011;60:916-28.

Sabate S, Gomar C, Canet J, Fernandez C, Fernandez M, Fuentes A. Obstetric anesthesia in Catalonia, Spain. Med Clin (BARC). 2006;126:40-5.

Aksoy M, Aksoy AN, Dostbil A, Gürsaç ÇM, Ahıskalıoğlu A. Anaesthesia techniques for caesarean operations: retrospective analysis of last decade. Turk J Anaesth Reanim. 2014;42:128-32.

Okafor UV, Ezegwui HU, Ekwazi K. Trends of different forms of anaesthesia for caesarean section in South-eastern Nigeria. J Obstet Gynaecol. 2009;29:392-5.