Key result
Compared with general anesthesia, intravertebral anesthesia resulted in significantly shorter postoperative ICU stays (3.35 and 4.01 vs 7.99 days) and mechanical ventilation times in pregnant women with severe pulmonary arterial hypertension.
Why the study?
Does intravertebral anesthesia improve hemodynamics and clinical outcomes compared to general anesthesia in pregnant women with severe PAH undergoing caesarean section?
Observational (n=75)
Randomly divided (stated in text, though study is described as retrospective)
No
Does intravertebral anesthesia improve hemodynamics and clinical outcomes compared to general anesthesia in pregnant women with severe PAH undergoing caesarean section?
Absolute Event Rate: 3.35% vs 7.99%
p-value: p=<0.05
Intravertebral anesthesia is preferred over general anesthesia in pregnant women with severe PAH undergoing caesarean section due to better hemodynamic stability and shorter ICU/hospital stays.
May support intravertebral anesthesia to shorten ICU and ventilation times in severe PAH pregnancies; hypothesis-generating, requires RCTs.
In the present study we aimed to analyze the effects of different anesthesia methods on the hemodynamics of caesarean section, outcomes after caesarean section and hormone changes in pregnancy complicated with severe pulmonary arterial hypertension (PAH). A total of 75 pregnancy complicated with severe PAH that were treated in Jining First People's Hospital from January 2016 to January 2017 were selected. Three groups were set according to the anesthesia methods, including the subarachnoid combined epidural anesthesia group (group I, n=25), the epidural anesthesia group (group II, n=25) and the general anesthesia group (group III, n=25). Effects on the outcomes of caesarean section of pregnancy complicated with PAH were observed. Sex hormone levels before and 24, 48 and 72 h after the operation were measured. There were remarkable changes in the postoperative hemodynamics compared with those before anesthesia, but changes in groups I and II were significantly smaller than those in group III (P<0.05). No significant differences in maternal mortality rate, neonatal mortality rate and neonatal asphyxia rate among the three groups were found (P>0.05). Time of postoperative mechanical ventilation, ICU residence and hospitalization in groups I and II were shorter than those in group III, the differences were statistically significant (P<0.05). Postoperative levels of sex hormones, including estradiol (E2), human chorionic gonadotrophin (HCG), prolactin (PRL) and plasma total testosterone (TT) decreased, while postoperative levels of sex hormones follicle stimulating hormone (FSH), luteinizing hormone (LH) and progestogen increased, and differences in the decreased E2 and TT at each time-point were statistically significant (P<0.05). In conclusion, there is no remarkable difference in the effects of three anesthesia methods on pregnancy outcomes. However, compared with general anesthesia, intravertebral anesthesia achieve shorter time of postoperative mechanical ventilation, ICU residence and hospitalization in pregnancy complicated with severe PAH, which is preferred in pregnancy without contraindication of the anesthesia.
No takes yet. Share an insight, caveat, or question.
Wang et al. (2018) conducted an observational in Severe pulmonary arterial hypertension in pregnancy (n=75). Intravertebral anesthesia (combined spinal/epidural or epidural) vs. General anesthesia was evaluated on Intensive care unit (ICU) staying time in days (p=<0.05). Compared with general anesthesia, intravertebral anesthesia resulted in significantly shorter postoperative ICU stays (3.35 and 4.01 vs 7.99 days) and mechanical ventilation times in pregnant women with severe pulmonary arterial hypertension.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: