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A Comparative Study of Effects of General Anaesthesia and Subarachnoid Block For LSCS in Terms of Maternal and Foetal Outcome in Preeclmaptic Patient

Ekta Ratnani, Department of Anaesthesiology, Dr. RML Institute of Medical Sciences, Lucknow(U.P). , Pankaj Sharma1 , Ekta Ratnani2 , Om Prakash Sanjeev2 , Amitesh Pathak2 , Archana2

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Indian Journal of Anesthesia and Analgesia 4(3):p 760-766, July - September 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.34

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Abstract

Background: Preeclampsia is hypertensive and multisystem disorder of pregnancy. It is a leading cause of maternal and foetal morbidity and mortality. There is increased rate of lower segment caesarean section in preeclamptic parturient. So we designed a comparative study to assess the effects of general anaesthesia and subarachnoid block on maternal and foetal outcome in preeclamptic patients. Materials and Methods: One hundred consenting patients of age 16 to 32 years with severe preeclampsia posted for elective or emergency lower segment caesarean section were randomly assigned to one of the two groups; group GA, group SA who received general anaesthesia and subarachnoid block respectively. Variables in mother like systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR) was recorded before induction, just after induction then 5, 10, 30, 60 minutes after induction and postoperatively at 15, 30, 60, 90, 120 minutes after the completion of operation. After delivery of the baby the APGAR score at 1 min and 5 min was recorded. Result: No maternal mortality is noted in either of the two groups. Hypertension (10% group GA), hypotension (14% group SA), and pulmonary oedema 4% in GA group whereas none in SA group was seen intraoperatively. Birth asphyxia was developed in foetus 8% in group GA and 2% in group SA. Foetal APGAR score at one minute was 7.42±1.16 & 8.96±0.66 in GA and SAB respectively higher with subarachnoid block. Conclusion: subarachnoid block serves better as a mode of anaesthesia for LSCS in severe preclamptic parturients in terms of both intraoperative and postoperative morbidities.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.34

Keywords

Preeclampsia; Lower Segment Caesarian Section; Subarachnoid Block; General Anaesthesia; Maternal and Foetal Morbidity. 

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