Key result
Combined spinal epidural anaesthesia resulted in significantly lower blood loss (465.33 vs 548.20 ml) and lower pain scores (1.66 vs 2.60) compared to general anaesthesia.
Why the study?
Does combined spinal epidural anaesthesia improve haemodynamic stability compared to general anaesthesia in patients with mild to moderate pericardial effusion undergoing caesarean section?
RCT (n=30)
Randomized
No
Does combined spinal epidural anaesthesia improve haemodynamic stability compared to general anaesthesia in patients with mild to moderate pericardial effusion undergoing caesarean section?
Combined spinal epidural anaesthesia provides better haemodynamic stability, less blood loss, and better postoperative analgesia than general anaesthesia in patients with mild to moderate pericardial effusion undergoing caesarean section.
Answers are grounded in this paper and cite their sources.
Supports preferring combined spinal epidural over general anaesthesia for caesarean in mild-moderate pericardial effusion; extends RCT data on regional techniques in obstetric cardiac patients.
Study objectiveThis study evaluated the haemodynamic effects of general anaesthesia versus combined spinal epidural anaesthesia in patients undergoing caesarean section in the presence of mild to moderate pericardial effusion.DesignA prospective randomized study.SettingThe study setting included a hospital where a surgical team performed elective caesarean section in the presence of mild to moderate pericardial effusion.Patients and interventionsThirty healthy patients were randomly divided into two groups, general anaesthesia (GA) (group I) and combined spinal epidural (CSE) anaesthesia (group II).Measurements and main resultsHeart rate, central venous pressure, mean arterial blood pressure, and pulmonary capillary wedge pressure were measured 10 min before anaesthesia, after 20 and 30 min of anaesthesia, and 30 min after recovery. Blood loss was significantly lower in group II [465.33 (72.78) ml] as compared to group I [548.20 (22.73) ml]. The pain score in group II was significantly lesser [1.66 (0.72)], than in group I [2.60 (0.73)]. The HR was significantly higher in group I as compared to that in group II at 20 and 30 min after anaesthesia, and 30 min after surgery, being 81.53 (2.72), 94.80 (3.12) and 82.8 (2.85) (beats/min), respectively. However, the CVP was significantly higher in the group I at 20 and 30 min after induction, being 8.40 (0.63) and 7.80 (0.67) (cmH2O) respectively. The MAP was significantly higher in group II than in group I at 20 and 30 min after induction, being 80.86 (1.30) and 81.00 (1.00) (mmHg) respectively. The PCWA was significantly higher in group I compared to group II at 20 and 30 min after induction, being 10.13 (1.35) and 11.80 (0.94) (mmHg), respectively.ConclusionCSE anaesthesia appeared to be more advantageous, in patients undergoing caesarean section with mild to moderate pericardial effusion, with less haemodynamic changes, decreased blood loss, and better postoperative analgesia than general anaesthesia patients.
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Elgebaly et al. (2012) conducted an RCT in Mild to moderate pericardial effusion (n=30). Combined spinal epidural anaesthesia vs. General anaesthesia was evaluated on Blood loss (ml). Combined spinal epidural anaesthesia resulted in significantly lower blood loss (465.33 vs 548.20 ml) and lower pain scores (1.66 vs 2.60) compared to general anaesthesia.
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