A Comparative Study on the Post Operative Outcome of Subarachnoid Block and General Anaesthesia in Parturients Complicated with Eclampsia: A Prospective Study

Abstract

Introduction: It is a well-known fact that fatality following eclampsia remains high especially in developing countries with limited facilities. Ideal anaesthetic technique for caesarean delivery in stable eclamptics is yet to be determined. Aim and Objectives: To study the postoperative outcome of the subarachnoid block and general anaesthesia in parturients complicated with eclampsia. Methods: Sixty two stable eclamptic parturients scheduled for the emergency caesarean section under anaesthesia were randomised to receive either general anaesthesia or spinal anaesthesia.  Patients in spinal anaesthesia (SA group)  had 0.5% intrathecal hyperbaric bupivacaine. While those in general anaesthesia (GA group), were induced with thiopentone 4mg kg -1.  Suxamethonium 1.5 mg kg-1 was given to facilitate orotracheal intubation with the cuffed tube. Patients' perioperative findings were recorded. Results: The risk of developing postoperative respiratory failure was significantly higher in patients with general anaesthesia (9; 29%) than those with spinal anaesthesia  (0; 0%) (P=0.040, RR=0.053, 95% CI= 0.003-0.858). There was a higher risk of postoperative ventilation in patients in GA (9; 29%) than in SA (0; 0%) (P=0.040, RR=0.053, 95% CI= 0.003-0.858). Neonates who were delivered under spinal anaesthesia were also observed to have better recovery scores. The proportion of patients who stayed longer than eight days in the hospital was significantly higher in GA (P=0.0004, RR=2.0, 95% CI= 1.260-3.190). Conclusion: Eclamptic parturients who underwent Caesarean Section under spinal anaesthesia had significant better postoperative outcome than those who had general anaesthesia. Neonates that were delivered under spinal anaesthesia were also observed to have better recovery scores.