Time intervals of anaesthesia-induction time and decisionto- delivery in different urgency categories for caesarean section

Abstract

Background and Goal of Study: Regional anaesthesia (RA) is a first choice for category 1 to 3 urgency caesarean sections (CS). However, general anaesthesia (GA) is sometimes performed expecting shorter delivery time. The goal of our study was to evaluate time differences between GA and RA in each urgency category (UC) of CS. Materials and Methods: A prospective study was carried out in LUHS, Dept. of Obstetrics from January to December, 2016. CS were classified using Lucas fourgrade classification system. Intervals of anaesthesia-induction time and decisionto- delivery were compared between spinal anaesthesia (SA), GA and epidural anaesthesia (EA) in each UC. Results and Discussion: There were 1677 CS included in our study. UC I - 124 (8.0%), UC II – 344 (22.3%), UC III – 431 (25.7%) and UC IV – 643 (41.7%) patients. SA was performed to 1226 (73.2%), GA – 194 (11.6%), EA to 254 (15.2%) patients. Intervals of anaesthesia-induction time and decision-to-delivery between SA, GA, EA in different UC are shown in table 1. Table 1. Time intervals between SA, GA and EA in different UC. * Significant difference. Urgency category Type of anaesthesia Anaesthesiainduction time (min) Decision-to-delivery interval (min) I SA 6.14±1.10 (34)* 46.76±19.73 (34)* I GA 2.07±1.85 (67)* 25.46±13.34 (67)* I EA 13.86±3.32 (22)* 27.68±8.13 (22)* II SA 6.82±2.13 (190)* 59.90±46.67 (177)* II GA 4.02±4.21 (34)* 69.39±92.97 (33) II EA 13.21±4.04 (120)* 37.31±19.03 (120)* III SA 7.18±2.45 (327)* 74.27±52.85 (268)* III GA 2.83±2.23 (36)* 67.72±48.43 (29)* III EA 13.74±3.18 (66)* 40.96±23.99* IV SA 9.48±4.53 (603) 120.08±111.03 (12) IV GA 9.91±7.51 (37) 131.00 (1) IV EA 13.33±2.88 (3) (0) Conclusion:GA has the shortest anaesthesia-induction time interval and EA has the shortest decision-deliver [...].