Key result
General anesthesia linked to ~328% greater postoperative antihypertensive need vs spinal anesthesia in severe preeclampsia.
Why the study?
Does spinal anesthesia compared to general anesthesia improve postoperative maternal morbidities in pregnant women with preeclampsia undergoing cesarean delivery?
Observational
No
Does spinal anesthesia compared to general anesthesia improve postoperative maternal morbidities in pregnant women with preeclampsia undergoing cesarean delivery?
Odds Ratio: 4.276 (95% CI 1.531–11.942)
p-value: p=0.009
General anesthesia is associated with a greater need for postoperative antihypertensive medication in patients with severe preeclampsia undergoing cesarean delivery compared to spinal anesthesia.
May favor spinal anesthesia in severe preeclampsia cesareans; hypothesis-generating and requires randomized confirmation before practice change.
Objective: The aim of this study is to investigate the effect of different anesthesia types administered to patients with preeclampsia on postoperative maternal morbidities.Methods: Medical records of pregnant women complicated with preeclampsia delivered by cesarean from January 2010 to December 2016 in our clinic were retrospectively reviewed.Results: There was not a statistically significant difference between patients receiving spinal anesthesia and general anesthesia in terms of additional parenteral analgesic requirement at postoperative period (p = 0.520). The length of stay in hospital and δHb (preoperative hemoglobin value minus postoperative hemoglobin value) were not different between spinal anesthesia and general anesthesia groups (p = 0.140 and 0.648, respectively). The rate of postoperative antihypertensive medication requirement was statistically significant in patients with severe preeclampsia who underwent general anesthesia (p = 0.009, x2 = 6.867, odds ratios = 4.276 (1.531–11.942)). The time passing to reach the first normal blood pressure level in patients with severe preeclampsia was 11.95 ± 9.11 h in patients with spinal anesthesia, 10.55 ± 4.95 h in patients with general anesthesia, and the difference was not statistically significant (p = 0.504).Conclusion: The need for antihypertensive medication is greater in patients with severe preeclampsia receiving general anesthesia. There is a need for comprehensive, prospective, and randomized controlled trials to establish the relationship between postpartum morbidity and the different types of anesthesia.
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Ulubaşoğlu et al. (2017) conducted an observational in Preeclampsia. General anesthesia vs. Spinal anesthesia was evaluated on Postoperative antihypertensive medication requirement in patients with severe preeclampsia (OR 4.276, 95% CI 1.531-11.942, p=0.009). General anesthesia was associated with a significantly higher need for postoperative antihypertensive medication compared to spinal anesthesia in patients with severe preeclampsia (OR 4.276; 95% CI 1.531-11.942; p=0.009).
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