Background: Since the onset of COVID-19, recommendations suggest the use of neuraxial anesthesia, over general anesthesia for cesarian section to avoid the risks of aerosolization associated with intubation and extubation. But the safety of performing spinal anesthesia is unclear especially for post spinal hypotension, during the presence of active COVID-19. According to a few studies there was a controversial discussion about the safety of regional anesthesia. In this study we aimed to compare the incidence of hypotension in COVID-19 pregnant patients between non-COVID 19 pregnant patients in the literature to see if the spinal anesthesia is safe or if it poses an additional risk. Materials and Methods: Medical records of COVID-19 pregnant women for cesarean section from the beginning of the pandemic up to December 2020 were retrospectively retrieved. All the demographic-vital data, including systolic and diastolic blood pressure (SBP-DBP), ephedrine-atropine doses, infusion volumes, and nausea and vomiting were retrospectively analyzed. Results: Spinal anesthesia induced hypotension was seen 54 of the patients (21,69%). And vasopressors (Ephedrine) were used to all hypotensive patients. Demographic data’s, the amount of bupivacaine and crystalloid volume which used before the spinal anesthesia showed no differences between hypotensive and non-hypotensive patients. Conclusion: This is the first retrospective study which shows 249 COVID 19 patients’ data in one center that no significant difference was seen in the incidence of hypotension associated with spinal anesthesia for COVID-19 cesarean section compared to non-COVID group in literature. We recommend using of regional anesthesia safely for patients and anesthesiologists during active COVID-19 patients.
416 pregnant women gave birth spontaneously and 251 underwent cesarian section. We attempted spinal anesthesia for cesarian sections because all regional anesthesia organizations advised regional anesthesia for obstetric surgery. However, spinal anesthesia for cesarean delivery is not a foolproof method. Material and Method: We used a retrospective analysis of 251 COVID 19 cesarean section anesthesia to determine the incidence of failed spinal anesthesia, management strategies, and risk variables that contribute to failure. Results: The total number of failed spinal anesthesia instances was 14 (5.58%), with 1% of complete failures and 4% of partial failures. One patient was given spinal anesthesia for the 2nd attempt (0.4%), while the other two were given general anesthesia (0.79%). In failed spinal cases, sedation was utilized. Patients received varied dosages of midazolam, fentanyl, ketamine, and propofol. Conclusion:The rate of failed spinal anesthesia among COVID 19 pregnant women was similar to, even lower than, the rate of failed spinal anesthesia in the general population. Despite all the negative consequences, such as wearing PPE and moving around, vision and hearing problems due to PPE, anesthesiologist fear about being infected by the patient or patient anxiety about infection, the future and babies' health is the reason for this result.
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