From decision to delivery ‐ how fast we are with anaesthesia in different urgency categories for caesarean section

Abstract

Background and Goal of Study: Regional anaesthesia (RA) is preferred in obstetrics as it is safer alternative to general anaesthesia (GA), for urgent caesarean section (CS) in particular. However, in CS category‐1 setting GA is traditionally used expecting shorter induction time. Our primary objective was to examine timing differences between GA and SA in different CS urgency categories. Materials and Methods: After approval of institutional ethics committee a prospective analysis of CSs in the Department of Obstetrics of a teaching hospital during February‐August of 2010 was performed. We compared CSs distribution according to urgency and method of anaesthesia in respect to mean induction time of different types of anaesthesia as well as the duration of operating theatre admission‐to‐delivery and decision‐to‐delivery intervals. GA and SA were compared. Results and Discussion: 303 CSs were carried out during study period.Timing of GA and SA in different CS urgency categories is presented in Table 1. Table 1Table 1 Image ToolsMean induction time of GA in category‐1 was significantly shorter as compared with SA (p=0.02), whereas in categories‐2, 3 and 4 there was no such difference (p=0.08, p=0.77, p=0.53 respectively).There were no significant differences between mean operating theatre admission‐to‐delivery nor mean decision‐to‐delivery intervals for general and spinal anaesthesia in all CS categories. Conclusion(s): The only significant timing difference between GA and SA is detectable in category‐1 CS regarding the time of anaesthesia induction. We conclude that SA does not affect neonatal delivery time even in urgent cases.