Background: Spinal anesthesia-induced maternal hypotension is the most frequent complication associated with maternal morbidity and mortality during Cesarean section. The aim of this study was to compare the incidence and magnitude of hemodynamic changes in preeclamptic and non-preeclamptic parturients undergone Cesarean section under spinal anesthesia. Method: A prospective cohort study was conducted from 01 February to 28 May 2019 in preeclamptic and nonpreeclamptic parturients. We hypothesized preeclamptic parturients are at high risk of spinal anesthesia induced hypotension than non preeclamptics. A total of 122 ASA II and ASA III parturients were recruited consecutively and assigned to two groups (81non-preeclamptics, and 41 preeclamptics). Parturients with cardiac disease, twin pregnancy, chronic hypertension, gestational hypertension, superimposed hypertension, renal disease, diabetes mellitus, coagulopathy (platelet count < 80 × 10 9 /L), active labor, eclampsia, abruptio placentae, placenta praevia, any adjuvant added with local anesthetics were excluded. The data analysis was done using SPSS version 22 statistical software. Student t test, MannWhitney U test and Fisher exact test were used to compare the data. All P values < 0.05 were considered statistically significant. Result: The incidence of spinal anesthesia-induced hypotension was higher in non-preeclamptic parturients than preeclamptic parturients (55.6% vs. 34.1%, respectively) and the degree of blood pressure drop was significantly greater in the non-preeclamptic parturients compared to those with preeclampsia; As well intraoperative fluid consumption was significantly greater in the non-preeclamptics parturients compared to those with preeclamptics. Conclusion: The incidence and magnitude of spinal anesthesia-induced hypotension in parturients undergone Cesarean section were less in preeclamptic parturients than in non-preeclamptic parturients.. Based on the data from this study we recommended spinal anesthesia for preeclamptic patients, unless there is a contra indication based on preeclampsia.
Background: Residual neuromuscular block is a relatively common and often unrecognized complication of general anaesthesia in the post-anaesthesia care unit. Furthermore, it is the major contributing factor for patient's morbidity. The aim of this study was to assess the incidence and associated factors of residual neuromuscular block among patients underwent general anaesthesia at University of Gondar hospital Methods: A hospital-based observational study was conducted from March 15 to April 30/2016. A total of 384 patients were included in the study. The presence/absence of residual neuromuscular block was assessed within the first 20 minutes of PACU admission using double burst stimulation. Associated factors and sign symptoms of adverse respiratory events were also collected. Univariate analysis was performed descriptively using the Mann-Whitney U test for comparing Continuous variables. Chi-square test and Fishers exact test were used for comparing proportions. Bivariate and multivariate logistic regressions were used to identify associated factors. Results:The overall incidence of residual neuromuscular block was found to be 12.9%. The age of patient, being female (AOR=3.5, 95% CI;1.789-6.857), intraoperative high cumulative dose of muscle relaxants (AOR=1.23, 95% CI;1.12-1.35), and use of pancuronium (AOR=5.14, 95% CI;1.16-22.797) were factors associated with residual neuromuscular block. A total of 107(28.08%) patients had ARE. Conclusion and recommendation:residual neuromuscular block was a severe complication of general anaesthesia in the study patients. Adverse respiratory events are common in patients with residual neuromuscular block. We recommend use of intermediate acting muscle relaxants.
Background Spinal anesthesia-induced maternal hypotension is the most frequent complication associated with maternal morbidity and mortality during cesarean section. The aim of this study was to compare the incidence and magnitude of hemodynamic changes in preeclamptic and non-preeclamptic parturients undergone cesarean section under spinal anesthesia. Method A prospective cohort study was conducted from February to May 2019 in University of Gondar comprehensive specialized hospital. A total of 122 ASA II and ASA III parturients were recruited consecutively and assigned to two groups (81non-preeclamptics, and 41 preeclamptics). The data analysis was done by SPSS version 22 statistical software. The data were tested for normality with Shapiro Wilk U-test and normally distributed data were compared by using the independent student’s t-test. Whereas non-normally distributed data were compared using the Mann-Whitney U- test. Fisher’s exact test was used for intergroup comparison of proportion. All P values <0.05 were considered statistically significant. Result The incidence of spinal anesthesia-induced hypotension was higher in non-preeclamptic parturients than preeclamptic parturients (55.6% vs. 34.1%, respectively) and the degree of blood pressure drop was significantly greater in the non-preeclamptic parturients compared to those with preeclampsia; As well intraoperative fluid consumption was significantly greater in the non-preeclamptics parturients compared to those with preeclamptics. Conclusion The incidence and magnitude of spinal anesthesia-induced hypotension in parturients undergone cesarean section were less in preeclamptic parturients than in non-preeclamptic parturients. Therefore, don’t deny spinal anesthesia for preeclamptic parturients due to fear of profound hypotension, unless there is a contraindication for spinal anesthesia.
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