Comparison of Outcomes Following General Anesthesia and Spinal Anesthesia During Emergency Cervical Cerclage in Singleton Pregnant Women in the Second Trimester at a Single Center

Abstract

Background Little information exists regarding the best anesthesia method for emergency cerclage. This single-center study aimed to compare the outcomes following general anesthesia and spinal anesthesia during emergency cervical cerclage in women in the second trimester of a singleton pregnancy. Material/Methods A total of 297 pregnant patients were recruited: 141 patients were assigned to the general anesthesia group and 156 patients were assigned to the spinal anesthesia group. Periprocedural data and obstetric outcomes were recorded and statistically analyzed. Results Average duration of the cerclage procedure was shorter in the general anesthesia group than in the spinal anesthesia group (25.78±9.4 min versus 30.88±10.5 min; P <0.05). No severe maternal complications, such as hematosepsis or maternal death, occurred after the procedure for either group. The neutrophil-lymphocyte ratio and C-reactive protein (CRP) increased after emergency cerclage in both groups, but at no time did the 2 groups differ significantly ( P >0.05). There was also no significant difference in the incidence of miscarriage or preterm delivery (delivery <34 gestational weeks) or in neonatal outcome between the 2 groups ( P >0.05). Conclusions The results of this study showed that there were no significant differences in maternal and neonatal outcomes, rates of miscarriage, or preterm delivery between general anesthesia and spinal anesthesia during emergency cervical cerclage in women in the second trimester of a singleton pregnancy.

Perinatal Outcomes Associated With the Modified Shirodkar Cervical Cerclage Technique

“…On the other hand, complications associated with anesthesia in the present study manifested in 10% (n=4) of pregnant women as post-puncture headache, difficulty urinating, and paresthesia, while Wang et al reported cases of hypotension in 30.1% (n=47), nausea in 32.1% (n=50), and vomiting in 17.9% (n=28) in their study [16]. These complications could have been secondary to the patient's position, the type of needle, the technique used to insert it, and the administration of medication.…”

Median effective dose of ropivacaine for prophylactic cervical cerclage in Chinese women: a dose-finding study

“…Several types of local anaesthetics have been used for cervical cerclage 16–18. Bupivacaine7 19 20 has been used for cervical cerclage in many institutions; however, the time to resolution of sensory block when using bupivacaine lasts up to 4 hours, which is much longer than the duration of cervical cerclage itself (normally 10–20 min).…”

Intrathecal 2-Chloroprocaine 3% Versus Hyperbaric Bupivacaine 0.75% for Cervical Cerclage: A Double-blind Randomized Controlled Trial

“…Yoon et al 4 demonstrated no differences in plasma oxytocin levels, uterine contractions or fetal outcome when comparing GA with propofol and enflurane to spinal anesthesia. Wang et al 5 have also shown no outcome difference between the 2 methods of anesthesia for cerclage. To date, I am unaware of any randomized trials comparing the use of propofol sedation to spinal anesthesia.…”