EVOLVING PATTERN OF SPINAL ANAESTHESIA IN STABLE ECLAMPTIC PATIENTS UNDERGOING CAESAREAN SECTION AT UNIVERSITY OF BENIN TEACHING HOSPITAL, BENIN, NIGERIA

Afolayan JM, Nwachukwu CE, Esangbedo ES, Omu PO, Amadasun FE, Fadare JO,

Available online Jul 19, 2018.

[ Original ] Volume 23, Issue 4, 2014, Pages 288-295


Abstract

Background: Eclampsia is still associated with high maternal and perinatal and perinatal morbidity and mortality,
especially in resource poor countries with limited access to perinatal and critical care facilities.The ideal method of
anaesthesia for caesarean section in eclamptics is not generally agreed upon.
Methods:Review of the patients' case notes as well as records of the institution's Labour Ward Theatre, Intensive
Care Unit and Postnatal Ward was carried out between January 2011 and December 2012. Patients' clinical and
demographic data, anaesthetic management methods, maternal and perinatal outcome measures were evaluated
and analysed.
Results: Ninety-nine cases of eclampsia were reviewed, of which 87 had Caesarean section.After excluding five
patients who had intercurrent medical ailments,82 patients were finally analyzed.Of these,65 (79.3%) had spinal
anaesthesia while 17 (20.7%) had general anaesthesia.Out of the 19 (23.2%) who were transferred to the intensive
care unit, 12 (70.6%) had general anaesthesia while 7 (10.8%) had spinal anaesthesia. Of the 17 patients who had
general anaesthesia,10 (58.8%) were ventilated post operatively versus only 2 (3.1%) in spinal anaesthesia.Nine of
the 17 general anaesthesia patients (52.9%) versus only 1 of 65 spinal anaesthesia (1.5%) died in ICU. Apgar was
two fold better in the spinal anaesthesia group at 5 minutes.There was a higher risk ratio for stillbirths in the general
anaesthesia patients.
Conclusion:maternal and perinatal survival and well being are better in eclamptics who had spinal anaesthesia for
caesarean section compared to those who had general anaesthesia.


Keywords

Anaesthesia, eclampsia; maternal, perinatal outcome,

October December 2014

Volume 23 | Issue 4

Page Nos. 288-295

Online since Jul 13, 2018

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