RESUMO
BACKGROUND: Pregnancy affects a woman's susceptibility to and severity of certain infectious diseases. Central neuraxial block for analgesia during labor is superior to nonneuraxial methods in efficacy, safety, and maternal satisfaction. Although Coronavirus disease (COVID-19) can be vertically transmitted from mother to fetus, little is known about the effects of COVID-19 on pregnant women or about anesthesia management and the risk of adverse effects related to neuraxial techniques in women with untreated COVID-19 during gestation. AIM: This investigation assesses the effects of neuraxial analgesia during labor of COVID-19-positive parturients on their hemodynamic stability. RESULTS: The study was conducted on 64 patients and involved 32 parturients positive for SARS-CoV-2 by polymerase chain reaction (PCR) and a similar number of control "negative" patients. The affected group had an uneventful course during gestation. Seven were positive for ground-glass opacities on chest X-rays, and none underwent computed tomography (CT) scans. Two neonates were PCR-positive for SARS-CoV-2, and all 32 neonates were released from the hospital. No clinical differences were observed between the neonates in the COVID-19 and control groups. Although parturients in both groups were hemodynamically stable, hemodynamic stability was subnormal in the COVID-19 group regarding blood pressure, oxygen saturation, heart rate, and body temperature. None of the women in either group required a vasopressor or oxygen supplementation during delivery. No other clinical differences were observed between the COVID-19 and control groups. CONCLUSION: This is the first case-controlled study testing the anesthetic implications of neuraxial labor analgesia in pregnant, COVID-19-positive women. Although management of neuraxial labor analgesia did not differ in pregnant women positive and negative for COVID-19, their hemodynamic characteristics differed significantly. Therefore, care is required to prevent adverse outcomes in pregnant women positive for COVID-19.
RESUMO
Paciente femenina de 30 años de edad, raza blanca con antecedentes patológicos personales de Atresia Tricuspídea tipo 1c, que acude al Servicio de Cirugía del Hospital Universitario Camilo Cienfuegos de Sancti Spíritus, refiriendo cuadros periódicos de cólicos biliares de difícil control que la convierte en tributaria de tratamiento quirúrgico. Fue ingresada en sala de Cardiología y presentada al Servicio de Anestesiología para el estudio de las patologías de base y su intervención quirúrgica. En este artículo se abordan con detalles todos los procederes de diagnóstico y tratamiento realizados desde el ingreso, así como el manejo anestésico perioperatorio de la paciente la cual fue dada de alta satisfactoriamente a los cinco días del acto quirúrgico(AU)
A white female patient of 30 years of age, of white race with a previous personal history of tricuspíd atresia type 1c comes to the Surgery Service of the Camilo Cienfuegos University Hospital of Sancti Spíritus, reporting periodic episodes of vesicle colic pains of difficult control that warrant a surgical treatment. She was admitted at the Cardiology Ward and presented to the Service of Anesthesiology for the study of underlying diseases and her surgical intervention. In this article, a thorough approach is made of all the procedures of diagnosis and treatment carried out from admission, as well as the perioperative anesthetic management of this patient who was satisfactorily discharged five days after the surgical act(AU)