Anesthesia; Adverse Effect, Newborn Morbidity
Conditions
Keywords
emergency cesarean section, general anesthesia, spinal, feto-maternal
Brief summary
Spinal anesthesia (SA) has become the standard technique in elective cesarean section (CS) as it results in less maternal and neonatal morbidity than general anesthesia (GA) (Grade-A recommendation, NICE). For women requiring emergency CS, rapid sequence general anesthesia (RSGA) is commonly used because this technique is faster to perform than SA. Though several randomized trials have compared the maternal and fetal outcome between these two anesthetic techniques, the studies with respect to category 1 CS (emergent conditions that hold immediate threat to life of the woman or fetus) are limited.
Detailed description
Full term pregnant females will be included in this study. They will be allocated into two groups: (Group G): will receive rapid sequence general anesthesia, and (Group S): will receive spinal anesthesia. After preoperative assessment and investigations by the attending anesthesiologist, the decision of the anesthetic approach will be decided by the attending anesthesiologist according to indications for CS. Before induction of anesthesia intravenous (IV) ranitidine 50 mg will be administered after establishing an IV access. On the operating table, vital signs will be monitored for all parturients throughout the surgery according to the standard departmental protocol. fetal well being will be assessed after delivery by using 1 minute and 5 min APGAR score and umbilical cord PH . in addition to maternal vital signs intra-operative then follow up any complications that may occur to the mother post-operative.
Interventions
PROCEDUREanesthesia of emergency cesarean section
compare General versus spinal anesthesia
Sponsors
Benha University
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
following inclusion criteria: * American Society of Anesthesiologists physical status (ASA) \< III * Age 18-40 year * Gestational age\>37 weeks * Emergency cesarean delivery * Singleton pregnancy The
Exclusion criteria
are: * Twin pregnancy * Disagreement of the patient * Neurological impairment * Congenital fetal abnormality * body mass index \> 40 kg/m2; and * Sensitivity to any of the drugs used during the emergency CS.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| APGAR score | 5 minutes after delivery | Apgar score is a method for assessment of neonatal well-being after birth (0-3: severely depressed, 4-6: moderately depressed, 7-10: excellent condition) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| decision-to-delivery interval (DDI) | from decision to operate till delivery of the baby | the interval in minutes from the time of the decision by obstetrician to the time of delivery of the baby |
| Umbilical cord PH | immediately after delivery | Arterial blood gases from umbilical cord artery were used to assess newborn's acid-base status |
| Occurrence of maternal complications postoperative | from recovery from anesthesia up to 24 hours postoperative | all mother were followed for any postoperative complications related to the anesthesia. |
| Neonatal ICU admission | from delivery of the baby up to 24 hour postoperative | Admission to the NICU in percentage of the total participants. |
| Length of hospital stay | up to 1 month | Length of stay (LOS) is the duration of a single episode of hospitalization |
Countries
Egypt
Outcome results
None listed