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논문 기본 정보

자료유형
학술저널
저자정보
Eman A. Ismail (Assiut University Faculty of Medicine)
저널정보
대한마취통증의학회(구 대한마취과학회) Korean Journal of Anesthesiology Korean Journal of Anesthesiology Vol.68 No.5
발행연도
2015.1
수록면
469 - 475 (7page)

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Background: Sickle cell anemia (SCA) increases the rate of maternal and fetal complications. This pilot study was designed to compare the maternal and fetal outcomes of spinal versus general anesthesia (GA) for parturients with SCA undergoing cesarean delivery. Methods: Forty parturients with known SCA scheduled for elective Cesarean delivery were randomized into spinal anesthesia (n = 20) and GA groups (n = 20). Perioperative hemodynamic parameters were recorded. Postpartum complications were followed up. Opioid consumption was calculated. Blood loss during surgery and the number of patients who received intraoperative or postpartum blood transfusion were recorded. Patient satisfaction with the type of anesthesia was assessed. The Apgar score at 1 and 5 min, neonatal admission to the intensive care unit, and mortality were also recorded. Results: Blood loss was significantly higher in the GA than spinal group (P = 0.01). However, the number of patients who received an intraoperative or postpartum blood transfusion was statistically insignificant. Significantly more patients developed intraoperative hypotension and bradycardia in the spinal than GA group. Opioid use during the first 24 h was significantly higher in the GA than spinal group (P < 0.0001). More patients had vaso-occlusive crisis in the GA than spinal group without statistical significance (P = 0.4). There was one case of acute chest syndrome in the GA group. No significant differences were observed in postoperative nausea and/or vomiting, patient satisfaction, or hospital length of stay. Neonatal Apgar scores were significantly better in the spinal than GA group at 1 and 5 min (P = 0.006 and P = 0.009, respectively). Neonatal intensive care admission was not significantly different between the two groups, and there was no neonatal mortality. Conclusions: Spinal anesthesia may have advantages over GA in parturients with SCA undergoing Cesarean delivery.

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참고문헌 (17)

참고문헌 신청
Silva-Pinto AC / 2014 / Sickle cell disease and pregnancy : analysis of 34 patients followed at the Regional Blood Center of Ribeirão Preto, Brazil / Rev Bras Hematol Hemoter 36:329~333 google schola Koshy M / 1991 / Management of pregnancy in sickle cell syndromes / Hematol Oncol Clin North Am 5:585~596 google schola Camous J / 2008 / Anesthetic management of pregnant women with sickle cell disease-effect on postnatal sickling complications / Can J Anaesth 55:276~283 google schola Brousse V / 2014 / Management of sickle cell disease in the community / BMJ 348:1765 google schola Black AS / 2011 / Spinal anaesthesia for ambulatory arthroscopic surgery of the knee : a comparison of low-dose prilocaine and fentanyl with bupivacaine and fentanyl / Br J Anaesth 106:183~188 google schola

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