||The aim of the study is to evaluate the influence of urgency category for choosing method of anaesthesia and examine timing differences between general and spinal anaesthesia in different ceasarean section (CS) urgency categories.
The task of the research: Evaluate the distribution of CS indication according to urgency categories and identify the influence of chosen method of anaesthesia in different urgency categories. Analyse the average time necessary to induce general and spinal anaesthesia (AIT), the duration of the interval from patients arrival to the operating room to baby delivery (ADI), the interval from decision to operate on to entrance to the operating room (DAI) and the interval from decision to operate on to baby delivery (DDI) in different urgency categories. Identify the influence of DDI and neonatal outcomes, according to APGAR 1 and 5 min scores, color of the amniotic fluid and umbilical cord pH in different urgency categories.
Methods: retrospective analysis of 1541 CS was mad. Following time intervals were recorded: AIT, ADI, DAI and DDI. The operations were divided into four urgency categories. It was made general, spinal or epidural anaesthesia.
Results: General anaesthesia was chosen 54.1 % (n=67) in urgency-1 category, spinal anaesthesia – 55.2 % (n=190), 76.3 % (n=328) ir 93.7 % (n=603) in urgency-2-3-4 categories respectively. The mean AIT of spinal anaesthesia was 6.15 ± 1.11 min, general anaesthesia - 2.07 ± 1.85 min and the mean DDI was 32.63 ± 18.67 min in urgency-1 category. The mean AIT of spinal anaesthesia was 6.83 ± 2.13 min, general anaesthesia – 4.03 ± 4.21 min and the mean DDI was 47.97 ± 20.67 min in urgency-2 category.
Conclusions: there was different indications for CS in various urgency categories. General anaesthesia was the most preferred anaesthesia method in urgency-1 category and spinal anaesthesia for the rest of three of them. AIT, ADI, DAI and DDI was shorter when general anaesthesia was used compared with spinal anaesthesia in urgency-1 category.
Recommendations: rapid sequence spinal anaesthesia and indication for CS urgency categories protocol usage, wider and standardised documentation of anaesthesia timing intervals and if DDI interval is not commited – identify, documentate and eliminate all reasons of delay.