md-medicaldata

Authors

Jasminka Uram-Dubovski², Duška Ilić³, Dragan Turanjanin^1,3, Nikola Bošković^1,3, Izabella Fabri Galamboš^1,3, Anna Uram Benka<sup>1,3

1</sup>Univerzitet u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija
²Univerzitetski klinički centar Vojvodine, Klinika za ginekologiju i akušerstvo, Novi Sad, Srbija
³Univerzitet u Novom Sadu, Katedra za internu medicinu, Medicinski fakultet Novi Sad, Srbija
⁴Institut za zdravstvenu zaštitu dece i omladine Vojvodine, Novi Sad, Srbija

 

UDK: 618-089.5

The paper was received / Rad primljen: 20.01.2025.

Accepted / Rad prihvaćen: 20.02.2025.

 

Correspondence to:

Duška Ilić;
Vase Pelagića 10,
21000 Novi Sad;
Tel: 065 4577363
e-mail: duskailic12@gmail.com

 

 

Sažetak

 

 

Obstetric anesthesia still carries high risks of complications, despite advances in technology and monitoring. General anesthesia was previously the primary technique for both vaginal delivery and cesarean section. However, as the field of obstetric anesthesia has evolved, general anesthesia has increasingly been replaced by regional anesthesia in many cases. Each anesthesiological technique, whether regional or general, carries a certain risk of complications. During pregnancy, various physiological changes occur in the body (respiratory, cardiovascular, gastrointestinal), and in recent years, there has been an increase in maternal age, comorbidities, and a higher number of obese patients, which further raises the risks. It is essential for the anesthesiologist to consider these changes in pregnant woman when determining the anesthesia strategy in obstetrics, to improve the safety and outcomes for both the mother and the fetus.

 

Ključne reči:

akušerska anestezija, opšta anestezija, regionalna anestezija, komplikacije.

 

 

 

Abstract

 

Obstetric anesthesia still carries high risks of complications, despite advances in technology and monitoring. General anesthesia was previously the primary technique for both vaginal delivery and cesarean section. However, as the field of obstetric anesthesia has evolved, general anesthesia has increasingly been replaced by regional anesthesia in many cases. Each anesthesiological technique, whether regional or general, carries a certain risk of complications. During pregnancy, various physiological changes occur in the body (respiratory, cardiovascular, gastrointestinal), and in recent years, there has been an increase in maternal age, comorbidities, and a higher number of obese patients, which further raises the risks. It is essential for the anesthesiologist to consider these changes in pregnant woman when determining the anesthesia strategy in obstetrics, to improve the safety and outcomes for both the mother and the fetus.

 

Key words:

obstetric anesthesia, general anesthesia, regional anesthesia, complications.

 

 

 

 

References:

1. Jadon A. Complications of regional and general anaesthesia in obstetric practice. Indian J Anaesth 2010;54:415-20.
2. Delgado C, Ring L, Mushambi MC. General anaesthesia in obstetrics. BJA Education 2020;20(6):201-7.
3. Kazma JM, Anker van den J, Allegaert K, Dallmann A, Ahmadzia HK. Anatomical and physiological alterations of pregnancy. J Pharamacokinet Pharmacodyn 2020;47:271-85.
4. Kodali BS, Chandrasekhar S, Bulich LN, Topulos GP, Datta S. Airway changes during labor and delivery. Anesthesiology 2008;108:357-62.
5. Soma-Pillay P, Catherine NP, Tolppanen H, Mebazaa A, Tolppanen H, Mebazza A. Physiological changes in pregnancy. Cardiovasc J AFR 2016;27(2):89-94.
6. Carp H, Jayaram A, Stoll M. Ultrasound examination of the stomach contents of parturients. Anesth Analg 1992;74:683-7.
7. Shnaider, A, Koren G. Anesthesia and Obstetrics: A Review od Current Practice. Can J Anesth 2013;60(10):1055-67.
8. Morrison J, Howars R. The Effect of Hypotension on Utereplacental Perfusion in Obstetric Anesthesia. Obstet Gynecol Surv 2016;71(2):112-8.
9. Mushambi MC, Kinsella SM, Popat M, Swales H, Ramaswamy KK, Winton AL, et al. Obstetric Anaesthetists’ Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics. Anaesthesia 2015;70(11):1286-306.
10. Shimppam W, Preston R, Douglas J, Taylor J, Albert A, Chau A. High-flow nasal oxygen vs. standard flow-rate facemask pre-oxygenation in pregnant patients: a randomised physiological study. Anaesthesia 2019;74:450-6.
11. Pandit JJ, Andrade J, Bogod DG, Hitchman JM, Jonker WR, Lucas N, et al. The 5th National Audit Project (NAP5) on acidental awarness during general anaesthesia: summary of main findings and risk factors. Anaesthesia 2014; 69(10):1089-101.
12. Devroe S, Van de Velde M, Rex S. General anesthesia for caesarean section. Curr Opin Anaesthesiol 2015;28:240-6.
13. Zaouter C, Calderon J, Hemmerling TM. Videolaryngoscopy as a new standard of care. Br J Anaesth 2015;114:181-3.
14. Blajic I, Hodzovic I, Lucovnik M, Mekis D, Novak-Jankovic V, Stopar Pintaric T. A randomised comparison of C-MACTM and King VisionR  videolaryngoscopes with direct laryngoscopy in 180 obstetric patients. Int J Obstet Anesth 2019;39:35-41.
15. Choi PT, Galinski SE, Takeuchi L, Lucas S, Tamayo C, Jadad AR. PDPH is a common complication of neuraxial blocade in parturients: a meta-analysis of obstetrical studies. Can J Anaesth 2003;50:460-9.
16. Spancer HC. Postdural puncture headache: what matters in technique. Red Anesth Pain Med 1998;23:374-9.
17. Halpern S, Preston R. Post dural puncture headache and spinal needle desing. Anesthesiology 1994;81:1376-83.
18. Zeidon A, Farhat O, Maaliki H, Baraka A. Does PDPH left untreated lead to subdural haematoma?Case resport and review of literature. Int J Obs Anesth 2006;57:163-5.
19. Grieff J, Cousins MJ. Sub-arachnoid and extradural anaesthesia. In: Nimmo WS, Row Botham DJ, Smith G, editors. Anaesthesia 2nd ed. London: Blackwell Scientific Publication;1994. p. 1411-54.
20. Gunadyn B, Karaca G. Prevention strategy for Postdural puncture headache. Acta Anesthesiol Bel 2006;57:163-5.
21. Rigler ML, Drasner K, Krejcie TC, Yelich SJ, Scholnick FT, DeFontes J, et al. Cauda  equina syndrome after continuous spinal anesthesia. Anesth Analg 1991;72:275-81.
22. Horlocker TT. Rgesional anesthesia and analgesia in parturients with reciving thromboprophylaxis. Reg Anesth 1996;21:503-7.
23. Baron J, Decaux-Jacolot A. Influence of venous return on baroreflex control of heart rate during lumber spinal and epidural anesthesia in humans. Anesthesiology 1986;64:188-93.
24. Dyer RA, Farina Z, Joubert IA, Du Toit P, Meyer M, Torr G, et al. Crystalloid preloas versus rapid crystalloid administration after induction of spinal anaesthesia (Co-load) for elective Caesarean section. Anaesth Intensive Care 2004;32:351-7.
25. Burns SM, Cowan CM, Wilkes RG. Prevention and management of hypotension during spinal anaesthesia for elective caesaren section: a survey of practice. Anaesthesia 2001;56:777-98.
26. Caplan RA, Ward RJ, Posner K, Cheney FW. Unexpected cardiac arrest during spinal anesthesia: a closed claims analysis of predisposing factors. Anesthesiology 1998;68:5-11.
27. Tolcher MC, Fisher WE, Clark SL. Nonobstetric surgery during pregnancy. Obstet Gynecol 2018;132:395-403.
28. Pearl JP, Price RR, Tonkin AE, Richardson WS, Stefanidis D. SAGES guidelines for use of laparoscopy during pregnancy. Surg Endosc 2017;31:3767-82.
29. Hawkins JL. Excess in moderation: general anesthesia for cesarean delivery. Anesth Analg 2015;120:1175-7.
30. Wright JD, Pri-Paz S, Herzog TJ, Shah M, Bonanno C, Lewin SN, et al. Predictors of massive blood loss in women with placenta accreta. Am J Obstet Gynecol 2011;205:38.e1-6.
31. Chong Y, Zahang A, Wang Y, Chen Y, Zhao Y. An ultrasonic scoring system to predict the prognosis of placentaaccreta: a prospective cohort study. Medicine (Baltimore) 2018;97,e1211.
32. Markley JC, Farber MK, Perlman NC, Crusi DA. Neuraxial anesthesia during Casarean delivery for placenta previa with suspected morbidly adherent placenta; a retrospective analysis. Anesth Analg 2018;127:930-8.
33. Bogod D. Pain during caesaren section. BJOG 2016;123:753.
    

PDF: 09-Uram Dubovski J. et al MD-Medical Data 2025;17(1) 063-066.pdf