Anesthesia for Urgent Cesarean Section

Fernandes, N.L.; Dyer, Robert A.

doi:10.1016/j.clp.2019.08.010

Cited by 19 publications

(14 citation statements)

References 65 publications

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“…For cesarean section anesthesia, subarachnoid or epidural injection of local anesthetics such as bupivacaine or ropivacaine or opioids is often the option of choice [ 5 ]. On this basis, adjuvant systemic sedative drugs may help to improve the effect of anesthesia and reduce the occurrence of adverse reactions [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Subarachnoid block (spinal anesthesia) or combined spinal-epidural anesthesia (spinal-epidural anesthesia) has a precise analgesic effect. It has the advantages of complete nerve block and is widely used in the cesarean section [ 5 ]. The duration of analgesia after spinal anesthesia is short, and patients after cesarean section spinal anesthesia often experience visceral pain, nausea, vomiting, and other adverse reactions [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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The Anesthetic Effect and Safety of Dexmedetomidine in Cesarean Section: A Meta-Analysis

Pang

Zhu

Yan

et al. 2022

BioMed Research International

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Objective. To evaluate the anesthetic effect and safety of dexmedetomidine in cesarean section. Methods. The Cochrane Library, EMBASE, and PubMed databases (established until September 2020) were searched by computer. Two authors independently screened and extracted literature related to the application of dexmedetomidine in the cesarean section according to inclusion and exclusion criteria. The control group received either subarachnoid block (lumbar anesthesia) or combined lumbar anesthesia and epidural anesthesia (combined lumbar epidural anesthesia) with bupivacaine or combined bupivacaine and fentanyl. The observation group was additionally given dexmedetomidine based on the control group, to analyze the anesthetic effect and safety of dexmedetomidine in cesarean section. Results. A total of 580 cesarean delivery women were included in 8 studies, and the results showed that the peak time of sensory block in the observation group was shorter than that in the control group (standard mean difference = − 0.28 ; 95% confidence interval: -0.48, -0.08; P = 0.006 ), sensory block lasted longer than that in the control group (standard mean difference = 1.49 ; 95% confidence interval: 1.21, 1.78; P < 0.00001 ), the sedation rate was higher than that in the control group, the onset of the first postoperative pain was significantly delayed compared with that in the control group, and the incidence of postoperative pain, nausea and vomiting, postoperative chills, and fever was lower than that in the control group ( P < 0.05 ). Conclusion. Dexmedetomidine combined with lumbar anesthesia or combined lumbar epidural anesthesia for women in cesarean section has more clinical benefits and better safety.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Anesthetic Effect and Safety of Dexmedetomidine in Cesarean Section: A Meta-Analysis

Pang

Zhu

Yan

et al. 2022

BioMed Research International

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“…We used laryngeal mask to support the airway to meet the increasing oxygen consumption during the delivery. Laryngeal mask as the second-generation supraglottic airway device with the benefits of less stress response [ 13 ] and better physical and psychological comforts [ 14 ] is safe in general anesthesia for cesarean section without severe fetal compromise, [ 15 ] and it is easier to insert and well tolerated in spontaneous breathing without muscle relaxant than tracheal intubation. Because of the enough time of fasting and water deprivation of this patient, the laryngeal mask provided a safe airway and was removed quickly after operation without causing pulmonary aspiration in our case.…”

Section: Discussionmentioning

confidence: 99%

Transversus abdominis plane block provides effective and safe anesthesia in the cesarean section for an amyotrophic lateral sclerosis parturient

Wang¹,

Zhang²,

Li³

et al. 2021

Medicine

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Rationale:Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with the fatal course of muscle weakness. The published experience of anesthesia management in the cesarean section with ALS parturient is scant.Patient concerns:A 34-year-old woman was admitted to our center complaining of obvious dysphagia together with atrophy and weakness of quadriceps at 24 weeks of her pregnancy. Cesarean was planned at 36 weeks’ gestation due to the rapid deterioration of the mother.Diagnoses:The results of neurological examination, electromyography and spinal magnetic resonance imaging suggested ALS according to the EI Escorial World Federation of Neurology criteria.Interventions:Ultrasound-guided transversus abdominis plane block with 0.6 minimum alveolar concentration sevoflurane was used in this ALS parturient during her cesarean section procedure.Outcomes:This anesthesia strategy successfully met the demands of the surgery, helped avoid prolonged ventilation and prevent maternal respiratory complications.Lessons:Transversus abdominis plane block with subanesthetic concentrations of sevoflurane can provide effective and safe anesthesia in the cesarean section for a patient with ALS.

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“…[ 21 ] Fernandes and Dyer emphasized that urgent LSCS required an individualized approach and the type of anesthesia should be based not only upon urgency of LSCS but also patient factors. [ 22 ]…”

Section: Discussionmentioning

confidence: 99%

Comparison of postoperative pulmonary outcomes in patients undergoing cesarean section under general and spinal anesthesia: A single-center audit

et al. 2021

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Introduction: Regional anesthesia (RA), i.e., spinal or epidural anesthesia when performed for lower segment cesarean section (LSCS) provides excellent surgical conditions, avoiding manipulation of the maternal airway, maternal satisfaction, and good postoperative analgesia. However, in situations like fetal distress (fetal heart rate abnormalities), obstetric indications (abruption of placenta, antenatal placental bleeding, cord prolapse), maternal refusal for RA, contraindications to neuraxial anesthesia (anticoagulation, coagulopathy), and at times failed RA general anesthesia (GA) is administered. Several studies have demonstrated greater mortality and morbidity when LSCS is done under GA when compared to neuraxial block. Methods: After necessary approval, we retrospectively reviewed data over a period of 1 year (January 1, 2020–December 31, 2020) of LSCS under GA versus RA. The aim was to compare immediate postoperative complications, postoperative pulmonary complications up to 4 weeks from the time of elective and emergency LSCS under either RA or GA. Results: Of the 753 patients who underwent LSCS in one calendar year, there were 272 (36.12%) elective and 481 (63.87%) emergency LSCS. The number of elective LSCS under neuraxial block was 219 (29.09%) and under GA were 53 (7.03%). Emergency LSCS done under neuraxial block were 268 (35.59%) and under GA were 213 (28.28%). There were no adverse pulmonary complications at the end of 4 weeks in either group. Conclusion: RA provides maternal satisfaction and excellent perioperative analgesia in LSCS. Safe GA can be achieved with proper airway planning, if case is attended by at least two anesthesiologist with adequate preoperative fasting, and postoperative monitoring.

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Anesthesia for Urgent Cesarean Section

Cited by 19 publications

References 65 publications

The Anesthetic Effect and Safety of Dexmedetomidine in Cesarean Section: A Meta-Analysis

The Anesthetic Effect and Safety of Dexmedetomidine in Cesarean Section: A Meta-Analysis

Transversus abdominis plane block provides effective and safe anesthesia in the cesarean section for an amyotrophic lateral sclerosis parturient

Comparison of postoperative pulmonary outcomes in patients undergoing cesarean section under general and spinal anesthesia: A single-center audit

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