Comparison of general and spinal anaesthesia on haemodynamic parameters in severe preeclamptic pregnancy undergoing caesarean section

Кинжалова, С. В.; Макаров, Р А; Davidova, N.

doi:10.1097/00003643-201306001-00555

Cited by 2 publications

(5 citation statements)

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“…The 11 RCTs and a prospective nonrandomized controlled trial recruited a total of 782 women with PE from Canada 29 , India 21 , 22 , 32 , Iran 26 , the Republic of Macedonia 28 , Russia 23 – 25 , South Africa 8 , Thailand 16 , the United Kingdom 27 , and the United States 13 , 30 , 31 between 1980 and 2015. The mean age of the women ranged from 18.8 to 32 years.…”

Section: Resultsmentioning

confidence: 99%

“…A total of four RCTs (n=251) reported MAP before delivery or intraoperative (Fig. 2 A,B) 8 , 13 , 16 , 23 – 25 . Pooled estimates revealed no significant difference in MAP before delivery or intraoperative among the three anaesthesia strategies (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…A total of two RCTs (n = 130) reported data regarding the mean HR before delivery and intraoperative 8 , 23 – 25 . However, these studies only compared general anaesthesia with SA.…”

Section: Resultsmentioning

confidence: 99%

“…Although the pooled estimates were based on small-scale RCTs (Appendix 6 ), the included studies consistently exhibited lower HR trends in SA (I-square = 0%). Data on SVR were only available from an RCT with three references 23 – 25 . Patients who received SA had significantly lower SVR before delivery compared with those who received general anaesthesia, but no difference existed in mean SVR intraoperative between the two anaesthesia strategies (Appendix 7 ).…”

Section: Resultsmentioning

confidence: 99%

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A systematic review with network meta-analysis on mono strategy of anaesthesia for preeclampsia in caesarean section

Cheng

Liao

Chen

et al. 2021

Sci Rep

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The aim of this study was to reveal the effects of anaesthesia strategies on maternal mean arterial pressure (MAP), heart rate, vasopressor consumption, adverse events, and neonatal resuscitation when women with preeclampsia (PE) undergo caesarean section (CS). Three major databases were searched for randomized controlled trials (RCTs) and prospective controlled studies (PCSs). Two authors independently screened, extracted, and checked eligibility and outcome data. Outcomes involved MAP, vasopressor use, maternal adverse events, APGAR scores, and neonatal resuscitation. Pooled estimates were carried out by contrast-based network meta-analysis, and pooled effect sizes were presented with 95% confidence interval (CI). Eleven RCTs and one PCS (n = 782) formed three-node network meta-analysis, and non-significant differences were observed in MAP, 5-min APGAR score, and neonatal intubation rate among the three anaesthesia strategies. General anaesthesia had significantly lower vasopressor consumption than spinal anaesthesia did (standardised mean difference = − 1.19, 95% confidence interval [CI]: − 1.76 to − 0.63), but it had higher maternal adverse event rate (risk ratio = 2.00, 95% CI 1.16–3.47). Because no optimal anaesthesia strategy has been shown to achieve a balanced maternal and neonatal outcome, therefore a shared decision-making process may be required regarding the most suitable choice of anaesthetic strategy for individual preeclamptic mother undergoing CS. Future larger studies may need to focus on evaluating the role of vasopressors on maternal hemodynamic as well as factors affecting maternal outcomes for different anaesthetic techniques in preeclamptic women undergoing CS.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…A total of two RCTs (n = 130) reported data regarding the mean HR before delivery and intraoperative 8 , 23 – 25 . However, these studies only compared general anaesthesia with SA.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

A systematic review with network meta-analysis on mono strategy of anaesthesia for preeclampsia in caesarean section

Cheng

Liao

Chen

et al. 2021

Sci Rep

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“…Al Noor et al reported no difference in hemodynamics when compared pre- and postoperatively [ 1 ]. In contrast, there was better hemodynamic stability observed for severe pre-eclampsia patients [ 9 ]. The finding of an increased incidence of postoperative hypotension with RA compared to GA has also been observed previously [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

A Five-Year Retrospective Closed Cohort Study to Find a Superior Anaesthetic Technique for Caesarean Section From a Haemodynamic Perspective

Al Moosa,

Burad,

Jose

et al. 2023

Cureus

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Background A cesarean section (CS) is common and requires a safe and effective anesthetic technique for the safety of both the mother and the fetus. This study aims to compare the intraoperative hemodynamic safety profile with general anesthesia (GA) and regional anesthesia (RA) and propose a superior technique for cesarean from the hemodynamic perspective. Methods After obtaining ethical committee approval, a retrospective closed cohort study was conducted on patients who underwent cesarean with GA and RA. This study was conducted at a tertiary-level university hospital in Oman from January 2015 to December 2019. The investigators collected maternal and fetal data (hypotension, bradycardia, blood loss, APGAR score, fetal mortality, complications, and length of stay) from January 2015 to December 2019. The primary outcome was the incidence of intraoperative hypotension, and the secondary outcomes studied were significant blood loss and APGAR score in both anesthesia techniques. Results A total of 2500 cesarean patients were studied, of whom 1379 received RA and 1121 received GA. The overall hypotension (systolic BP<90 mm Hg) rate observed was 40.1%; it was significantly lower with GA as compared to RA (32.1% versus 46.5%, respectively, P <0.001, OR 0.545, 95% CI 0.462 to 0.643). Consequently, the requirement for vasopressors was low with GA compared to RA (1.6% versus 23.1%, P <0.001, OR 0.054, 95% CI 0.034 to 0.088). Blood loss (>1 L) was remarkably higher in GA as compared to the RA (15.5% versus 8.9%, respectively, P <0.001, OR 1.916, 95% CI 1.499 to 2.448). APGAR scores were lower with GA than RA (2.8% versus 0.9%, P <0.001). Bradycardia and fetal mortality were almost equal in both groups. Conclusion GA is associated with significantly better hemodynamic stability during the cesarean section.

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Comparison of general and spinal anaesthesia on haemodynamic parameters in severe preeclamptic pregnancy undergoing caesarean section

Cited by 2 publications

References 0 publications

A systematic review with network meta-analysis on mono strategy of anaesthesia for preeclampsia in caesarean section

A systematic review with network meta-analysis on mono strategy of anaesthesia for preeclampsia in caesarean section

A Five-Year Retrospective Closed Cohort Study to Find a Superior Anaesthetic Technique for Caesarean Section From a Haemodynamic Perspective

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