Research Article
Comparison of the outcomes of spinal and general anesthesia for cesarean section in pregnant women with COVID-19
Abstract
We aimed to examine the efficacy and safety of spinal or general anesthesia for cesarean section (C/S) delivery in parturient with coronavirus illness (COVID-19). We carried out a retrospective cohort in our tertiary care centre's anesthesiology and reanimation department. We gathered the data from the medical files of 108 pregnant women (average age: 33.44±12.65 years) with COVID-19 who underwent cesarean section (C/S) with either general (Group I, n=30) or spinal anesthesia (Group II, n=78). We compared preoperative, intraoperative, postoperative respiratory, cardiac, hematological, and biochemical indicators between spinal and general anesthesia groups. Patients in Group I were significantly older (p<0.001), had longer APTT (p=0.015), PT (p=0.005), INR (p=0.003), higher levels of AST (p=0.012), CK (p=0.001), CRP (p<0.001), as well as longer duration of ICU stay (p<0.001), and hospitalization (p<0.001). Group II had higher preoperative levels of troponin T (p=0.001). In Group I, the levels of procalcitonin (p=0.002), lactate (p<0.001), AST (p<0.010), ALT (p=0.001), CRP (p<0.001), and total bilirubin (p<0.001) were significantly higher than Group II. Group II displayed increased levels of white blood cell count (p=0.023), CK (p=0.047), and LDH (p=0.001). Our data demonstrated that the selection of the mode of anesthesia must provide safe, patient-centered care and safeguard every member of the obstetric team from COVID-19 infection. During planning for cesarean section (C/S), certain care and special precautions should be employed, and the type of anesthesia must be selected on an individualized basis.
References
- Ring LE, Martinez R, Bernstein K, Landau R. What obstetricians should know about obstetric anesthesia during the COVID-19 pandemic. Semin Perinatol. 2020;44:151277.
- Bauer ME, Bernstein K, Dinges E, Delgado C, El-Sharawi N, Sultan P, et al. Obstetric Anesthesia During the COVID-19 Pandemic. Anesth Analg. 2020;131:7-15.
- Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C, et al. Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. N Engl J Med. 2020;382:970-971.
- Mullins E, Evans D, Viner RM, O'Brien P, Morris E. Coronavirus in pregnancy and delivery: rapid review. Ultrasound Obstet Gynecol. 2020;55:586-592.
- Schwartz DA. An Analysis of 38 Pregnant Women With COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes. Arch Pathol Lab Med. 2020;144:799-805.
- Bani Hani DA, Alsharaydeh I, Bataineh AM, Al Athamneh M, Qamileh I, Al-Baik A, et al. Successful Anesthetic Management in Cesarean Section for Pregnant Woman with COVID-19. Am J Case Rep. 2020;21:e925512.
- Zeng L, Xia S, Yuan W, Yan K, Xiao F, Shao J, et al. Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China. JAMA Pediatr. 2020;174:722-725.
- Bampoe S, Odor PM, Lucas DN. Novel coronavirus SARS-CoV-2 and COVID-19. Practice recommendations for obstetric anaesthesia: what we have learned thus far. Int J Obstet Anesth. 2020;43:1-8.
- Liang H, Acharya G. Novel corona virus disease (COVID-19) in pregnancy: What clinical recommendations to follow? Acta Obstet Gynecol Scand. 2020;99:439-442.
- Harenberg JL, Church R, Tubog TD. Anesthesia Considerations of a Pregnant Woman With COVID-19 Undergoing Cesarean Delivery: A Case Report. AANA J. 2020;88:47-53.
- Karasu D, Kilicarslan N, Ozgunay SE, Gurbuz H. Our anesthesia experiences in COVID-19 positive patients delivering by cesarean section: A retrospective single-center cohort study. J Obstet Gynaecol Res. 2021 May 13:10.1111/jog.14852. doi: 10.1111/jog.14852.
- Dabrowska D, Lock GJ. Staying ahead of the curve: modified approach to emergency caesarean section under general anaesthesia in COVID-19 pandemic. Turk J Anaesthesiol Reanim. 2020;48:174–179.
- Chen R, Zhang Y, Huang L, Cheng BH, Xia ZY, Meng QT. Safety and efficacy of different anesthetic regimens for parturients with COVID-19 undergoing cesarean delivery: a case series of 17 patients. Can J Anesth. 2020;67:655–663.
- Karaca U, Ozgunay SE, Ata F, Kilicarslan N, Yilmaz C, Karasu D. Our experiences of anesthesia in emergency cesarean sections. JARSS. 2020;28:275–280.
- Landau R. COVID-19 pandemic and obstetric anaesthesia. Anaesth Crit Care Pain Med. 2020;39:327–328.
- Breslin N, Baptiste C, Gyamfi-Bannerman C, Miller R, Martinez R, Bernstein K, et al. Coronavirus disease 2019 infection among asymptomatic and symptomatic pregnant women: two weeks of confirmed presentations to an affiliated pair of New York City hospitals. Am J Obstet Gynecol MFM. 2020;2:100118. doi: 10.1016/j.ajogmf.2020.100118.
- Sutton D, Fuchs K, D'Alton M, Goffman D. Universal screening for SARS-CoV-2 in women admitted for delivery. N Engl J Med. 2020;382:2163–2164.
- Siston AM, Rasmussen SA, Honein MA, Fry AM, Seib K, Callaghan WM, et al; Pandemic H1N1 Influenza in Pregnancy Working Group. Pandemic 2009 influenza A (H1N1) virus illness among pregnant women in the United States. JAMA. 2010;303:1517-1525.
- Tung A, Fergusson NA, Ng N, Hu V, Dormuth C, Griesdale DEG. Medications to reduce emergence coughing after general anaesthesia with tracheal intubation: a systematic review and network meta-analysis. Br J Anaesth. 2020 Feb 22:S0007-0912(20)30012-X.
- Herman JA, Urits I, Kaye AD, Urman RD, Viswanath O. COVID-19: Obstetric anesthesia care considerations.J Clin Anesth. 2020 Oct;65:109860. doi: 10.1016/j.jclinane.2020.109860.
- Morau E, Bouvet L, Keita H, Vial F, Bonnet MP, Bonnin M, et al; Obstetric Anaesthesia and Critical Care Club Working Group. Anaesthesia and intensive care in obstetrics during the COVID-19 pandemic. Anaesth Crit Care Pain Med. 2020;39:345-349.
- Zhong Q, Liu YY, Luo Q, Zou YF, Jiang HX, Li H, et al. Spinal anaesthesia for patients with coronavirus disease 2019 and possible transmission rates in anaesthetists: retrospective, single-centre, observational cohort study. Br J Anaesth. 2020;124:670-675. Erratum in: Br J Anaesth. 2020;125:408.
- Xia H, Zhao S, Wu Z, Luo H, Zhou C, Chen X. Emergency Caesarean delivery in a patient with confirmed COVID-19 under spinal anaesthesia. Br J Anaesth. 2020;124:216-218.
Year 2024,
Volume: 41 Issue: 1, 20 - 27, 29.03.2024
Abstract
References
- Ring LE, Martinez R, Bernstein K, Landau R. What obstetricians should know about obstetric anesthesia during the COVID-19 pandemic. Semin Perinatol. 2020;44:151277.
- Bauer ME, Bernstein K, Dinges E, Delgado C, El-Sharawi N, Sultan P, et al. Obstetric Anesthesia During the COVID-19 Pandemic. Anesth Analg. 2020;131:7-15.
- Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, Wallrauch C, et al. Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. N Engl J Med. 2020;382:970-971.
- Mullins E, Evans D, Viner RM, O'Brien P, Morris E. Coronavirus in pregnancy and delivery: rapid review. Ultrasound Obstet Gynecol. 2020;55:586-592.
- Schwartz DA. An Analysis of 38 Pregnant Women With COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes. Arch Pathol Lab Med. 2020;144:799-805.
- Bani Hani DA, Alsharaydeh I, Bataineh AM, Al Athamneh M, Qamileh I, Al-Baik A, et al. Successful Anesthetic Management in Cesarean Section for Pregnant Woman with COVID-19. Am J Case Rep. 2020;21:e925512.
- Zeng L, Xia S, Yuan W, Yan K, Xiao F, Shao J, et al. Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China. JAMA Pediatr. 2020;174:722-725.
- Bampoe S, Odor PM, Lucas DN. Novel coronavirus SARS-CoV-2 and COVID-19. Practice recommendations for obstetric anaesthesia: what we have learned thus far. Int J Obstet Anesth. 2020;43:1-8.
- Liang H, Acharya G. Novel corona virus disease (COVID-19) in pregnancy: What clinical recommendations to follow? Acta Obstet Gynecol Scand. 2020;99:439-442.
- Harenberg JL, Church R, Tubog TD. Anesthesia Considerations of a Pregnant Woman With COVID-19 Undergoing Cesarean Delivery: A Case Report. AANA J. 2020;88:47-53.
- Karasu D, Kilicarslan N, Ozgunay SE, Gurbuz H. Our anesthesia experiences in COVID-19 positive patients delivering by cesarean section: A retrospective single-center cohort study. J Obstet Gynaecol Res. 2021 May 13:10.1111/jog.14852. doi: 10.1111/jog.14852.
- Dabrowska D, Lock GJ. Staying ahead of the curve: modified approach to emergency caesarean section under general anaesthesia in COVID-19 pandemic. Turk J Anaesthesiol Reanim. 2020;48:174–179.
- Chen R, Zhang Y, Huang L, Cheng BH, Xia ZY, Meng QT. Safety and efficacy of different anesthetic regimens for parturients with COVID-19 undergoing cesarean delivery: a case series of 17 patients. Can J Anesth. 2020;67:655–663.
- Karaca U, Ozgunay SE, Ata F, Kilicarslan N, Yilmaz C, Karasu D. Our experiences of anesthesia in emergency cesarean sections. JARSS. 2020;28:275–280.
- Landau R. COVID-19 pandemic and obstetric anaesthesia. Anaesth Crit Care Pain Med. 2020;39:327–328.
- Breslin N, Baptiste C, Gyamfi-Bannerman C, Miller R, Martinez R, Bernstein K, et al. Coronavirus disease 2019 infection among asymptomatic and symptomatic pregnant women: two weeks of confirmed presentations to an affiliated pair of New York City hospitals. Am J Obstet Gynecol MFM. 2020;2:100118. doi: 10.1016/j.ajogmf.2020.100118.
- Sutton D, Fuchs K, D'Alton M, Goffman D. Universal screening for SARS-CoV-2 in women admitted for delivery. N Engl J Med. 2020;382:2163–2164.
- Siston AM, Rasmussen SA, Honein MA, Fry AM, Seib K, Callaghan WM, et al; Pandemic H1N1 Influenza in Pregnancy Working Group. Pandemic 2009 influenza A (H1N1) virus illness among pregnant women in the United States. JAMA. 2010;303:1517-1525.
- Tung A, Fergusson NA, Ng N, Hu V, Dormuth C, Griesdale DEG. Medications to reduce emergence coughing after general anaesthesia with tracheal intubation: a systematic review and network meta-analysis. Br J Anaesth. 2020 Feb 22:S0007-0912(20)30012-X.
- Herman JA, Urits I, Kaye AD, Urman RD, Viswanath O. COVID-19: Obstetric anesthesia care considerations.J Clin Anesth. 2020 Oct;65:109860. doi: 10.1016/j.jclinane.2020.109860.
- Morau E, Bouvet L, Keita H, Vial F, Bonnet MP, Bonnin M, et al; Obstetric Anaesthesia and Critical Care Club Working Group. Anaesthesia and intensive care in obstetrics during the COVID-19 pandemic. Anaesth Crit Care Pain Med. 2020;39:345-349.
- Zhong Q, Liu YY, Luo Q, Zou YF, Jiang HX, Li H, et al. Spinal anaesthesia for patients with coronavirus disease 2019 and possible transmission rates in anaesthetists: retrospective, single-centre, observational cohort study. Br J Anaesth. 2020;124:670-675. Erratum in: Br J Anaesth. 2020;125:408.
- Xia H, Zhao S, Wu Z, Luo H, Zhou C, Chen X. Emergency Caesarean delivery in a patient with confirmed COVID-19 under spinal anaesthesia. Br J Anaesth. 2020;124:216-218.
There are 23 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Anaesthesiology |
| Journal Section | Research Article |
| Authors | |
| Publication Date | March 29, 2024 |
| Submission Date | July 6, 2023 |
| Acceptance Date | January 10, 2024 |
| Published in Issue | Year 2024 Volume: 41 Issue: 1 |
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