Comparison of the outcomes of spinal and general anesthesia for cesarean section in pregnant women with COVID-19

Abstract

We aimed to examine the efficacy and safety of spinal or general anesthesia for cesarean section (C/S) delivery in parturient with coronavirus illness (COVID-19). We carried out a retrospective cohort in our tertiary care centre's anesthesiology and reanimation department. We gathered the data from the medical files of 108 pregnant women (average age: 33.44±12.65 years) with COVID-19 who underwent cesarean section (C/S) with either general (Group I, n=30) or spinal anesthesia (Group II, n=78). We compared preoperative, intraoperative, postoperative respiratory, cardiac, hematological, and biochemical indicators between spinal and general anesthesia groups. Patients in Group I were significantly older (p<0.001), had longer APTT (p=0.015), PT (p=0.005), INR (p=0.003), higher levels of AST (p=0.012), CK (p=0.001), CRP (p<0.001), as well as longer duration of ICU stay (p<0.001), and hospitalization (p<0.001). Group II had higher preoperative levels of troponin T (p=0.001). In Group I, the levels of procalcitonin (p=0.002), lactate (p<0.001), AST (p<0.010), ALT (p=0.001), CRP (p<0.001), and total bilirubin (p<0.001) were significantly higher than Group II. Group II displayed increased levels of white blood cell count (p=0.023), CK (p=0.047), and LDH (p=0.001). Our data demonstrated that the selection of the mode of anesthesia must provide safe, patient-centered care and safeguard every member of the obstetric team from COVID-19 infection. During planning for cesarean section (C/S), certain care and special precautions should be employed, and the type of anesthesia must be selected on an individualized basis.

Keywords

• cesarean section;
• general anesthesia;
• COVID-19;
• pregnancy;
• spinal anesthesia.

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