Articles: general-anesthesia.
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Anesth Pain Med (Seoul) · Jan 2021
Comparison of the effect of general and spinal anesthesia for elective cesarean section on maternal and fetal outcomes: a retrospective cohort study.
Anesthesia is needed to ensure both maternal and fetal safety during cesarean sections. This retrospective cohort study compared maternal and fetal outcomes between general and spinal anesthesia for cesarean section based on perioperative hemodynamic parameters (pre- and postoperative systolic blood pressure, heart rate), mean difference of hematocrit and estimated blood loss, and neonatal Apgar scores at 1 and 5 min. ⋯ General group is associated with more maternal blood loss and a larger proportion of newborns with 5-min Apgar scores < 7 than spinal group during cesarean sections.
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J Coll Physicians Surg Pak · Jan 2021
Pulmonary Artery Pressure and Variations in Arterial Blood Pressure During the Induction Period of General Anesthesia in Elderly Patients.
To determine the correlation of old age, pulmonary artery pressure (PAP) and mean arterial blood pressure (MABP) during anesthetic induction in elderly patients. ⋯ Increased PAP may be involved in the association between with aging and increased risk of hypotension during induction. Key Words: General anesthesia, Hypotension, Pulmonary arterial blood pressure, Old age.
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Objective : This network meta-analysis (NMA) aimed to determine the relative efficacy and safety of pharmacological strategies used to mitigate haemodynamic instability by intubation for general anaesthesia in hypertensive parturient women undergoing caesarean section. Methods : We considered randomised controlled studies comparing the effects of pharmacological strategies used to alleviate haemodynamic instability during intubation in parturient women with hypertensive disorders of pregnancy. The primary endpoints were maximum blood pressure and heart rate after intubation, and secondary endpoints were the Apgar scores at 1 and 5 min. ⋯ The maximal heart rate was lowest for labetalol (99.9%) followed by high dose of remifentanil (81.2%) and fentanyl (61.6%). Apgar score at 1 min was higher with low-dose than with high-dose remifentanil (mean difference, 0.726; 95% confidence interval, 0.056 to 1.396; I2=0.0%). Conclusions : High-dose remifentanil produces minimum blood pressure changes, while labetalol is most effective in maintaining normal heart rate in parturient women with hypertensive disorders of pregnancy during caesarean section under general anaesthesia.
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J Coll Physicians Surg Pak · Jan 2021
Airway Management for Emergent Surgeries during COVID-19 Pandemic.
Aerosol generating procedures (AGPs) performed in the operating room during general anesthesia and surgery can contaminate the operation room environment putting the anesthetist, surgeons and paramedical staff at risk of infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The polymerase chain reaction (PCR) test for SARS-CoV-2 has low sensitivity and is time-bound. ⋯ In this communication, we summarised the modifications required in anesthesia technique during intubation and extubation of a patient's airway that would decrease the risk of virus transmission to the operation theatre staff. Key Words: COVID-19, SARS-CoV-2, Emergent surgeries, Anesthesia technique.