General anaesthesia versus combined spinal epidural anaesthesia in the presence of mild to moderate pericardial effusion: A study of volunteers undergoing caesarean section

摘要

Study objective This study evaluated the haemodynamic effects of general anaesthesia versus combined spinal epidural anaesthesia in patients undergoing caesarean section in the presence of mild to moderate pericardial effusion. Design A prospective randomized study. Setting The study setting included a hospital where a surgical team performed elective caesarean section in the presence of mild to moderate pericardial effusion. Patients and interventions Thirty healthy patients were randomly divided into two groups, general anaesthesia (GA) (group I) and combined spinal epidural (CSE) anaesthesia (group II). Measurements and main results Heart rate, central venous pressure, mean arterial blood pressure, and pulmonary capillary wedge pressure were measured 10 min before anaesthesia, after 20 and 30 min of anaesthesia, and 30 min after recovery. Blood loss was significantly lower in group II [465.33 (72.78) ml] as compared to group I [548.20 (22.73) ml]. The pain score in group II was significantly lesser [1.66 (0.72)], than in group I [2.60 (0.73)]. The HR was significantly higher in group I as compared to that in group II at 20 and 30 min after anaesthesia, and 30 min after surgery, being 81.53 (2.72), 94.80 (3.12) and 82.8 (2.85) (beats/min), respectively. However, the CVP was significantly higher in the group I at 20 and 30 min after induction, being 8.40 (0.63) and 7.80 (0.67) (cmH2O) respectively. The MAP was significantly higher in group II than in group I at 20 and 30 min after induction, being 80.86 (1.30) and 81.00 (1.00) (mmHg) respectively. The PCWA was significantly higher in group I compared to group II at 20 and 30 min after induction, being 10.13 (1.35) and 11.80 (0.94) (mmHg), respectively. Conclusion CSE anaesthesia appeared to be more advantageous, in patients undergoing caesarean section with mild to moderate pericardial effusion, with less haemodynamic changes, decreased blood loss, and better postoperative analgesia than general anaesthesia patients.