Korean J Obstet Gynecol.  2006 Dec;49(12):2550-2555.

Relationship between Initial Anesthetic methods and Perioperative Courses in Emergency Cesarean Hysterectomy

• Hong JY
• Shin JS

Abstract

OBJECTIVE
The Purpose of this study was to compare the perioperative variables in patients administered inhalation or regional anesthesia for the initial cesarean section following emergency hysterectomy under general anesthesia.
METHODS
Emergency cesarean hysterectomies performed between January 1993 and December 2004 was analyzed retrospectively. There were 65 emergency cesarean hysterectomies during the period. General anesthesia for both delivery and following hysterectomy was employed 24 cases (General group) and regional anesthesia for the initial cesarean section following general anesthesia for emergency hysterectomy was employed 41 cases (Regional group).
RESULTS
Most common indication of cesarean hysterectomy was placenta accreta in the both groups. Incidence of uterine atony without pathology was higher in the regional group than in the general group (34.1% vs. 4.2%). There was no difference in the intraoperative managements, estimated blood loss, and transfusions between the two groups. Total perioperative complications were found in 20 out of 65 cases (28.2%), and the incidence of disseminated intravascular coagulopathy (DIC) was higher in the regional group than in the general group (24.4% vs. 4.2%).
CONCLUSION
The anesthetic method did not affect the intraoperative managements although the incidence of uterine atony without pathology was higher, and perioperative DIC was more in the regional group than in the general group.

Keyword

Anesthesia; Emergency cesarean hysterectomy

MeSH Terms

Anesthesia
Anesthesia, Conduction
Anesthesia, General
Cesarean Section
Dacarbazine
Emergencies*
Female
Humans
Hysterectomy*
Incidence
Inhalation
Pathology
Placenta Accreta
Pregnancy
Retrospective Studies
Uterine Inertia
Dacarbazine