Online ISSN: 2515-8260

Assessment of outcome of epidural anaesthesia and general anesthesia in eclampsia obstetrics patients after delivery in obstetric critical care unit

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1Dr Rahul Ghanshyam Daga, 2Dr Rashmi B Kharde, 3Dr Rohan Kharde

Abstract

Hypertensive diseases of pregnancy constitute the most common cause of maternal mortality in worldwide. The present study was conducted to compare outcome of epidural anaesthesia and general anesthesia in eclampsia obstetrics patients after delivery (Spontaneous/ LSCS) in obstetric critical care unit. Materials & Methods: 50 pregnant women with eclampsia were divided into 2 groups of 25 each. Group I were given general anaesthesia administered using a modified rapid sequence induction. Group II patients were administered epidural anaesthesia with an 18 g catheter introduced between the sacrum and fourth lumbar vertebra in the sitting position. All maternal, neonatal and anaesthetic complications were recorded. Results: Parity was 0 seen in 5 and 3 and 1+ in 20 and 22 in group I and group II respectively. The mean SBP (mm Hg) was 104.2 and 108.4 and DBP (mm Hg) was 72.4 and 76.8 in group I and group II respectively. The highest CVP was 6 and 6 and lowest was 2 and 3. The mean pre-operative platelet count and post- operative count was 195.2 and 170.2 and 158.2 and 166.4 in group I and group II respectively. Indications for caesarean section was poor labour progress seen in 7 and 6 and cervix unfavourable for IOL seen in 18 and 19 in group I and group II respectively. The mean Apgar scores > 7 at 1 min was seen in 18 in group I and 12 in group II and at 5 minutes was seen in 23 in group I and 19 in group II. Live birth was seen in 24 in group I and 25 in group II and still birth in 1 in group I. The difference was significant (P< 0.05). Conclusion: Maternal outcomes are not adversely affected by the use of epidural anaesthesia. The use of epidural anaesthesia avoided the known risks of general anaesthesia and was associated with a low incidence of relatively mild hypotension and no major complications. While major complications were observed in general anaesthesia.

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