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

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.