JP Salaün , A. Baron , T. Simonet , A. Chagnot , A. Alves , R. Fauvet , S. Albadri , E. Villeneuve , L.J. Salomon , M-P. Bonnet , G. Orliaguet , J-L. Hanouz , L. Bouvet , H. Keita
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引用次数: 0
Abstract
Background
About 2% of pregnant women are exposed to general anesthesia for nonobstetric surgery. Given the possibility of adverse fetal and maternal effects associated with exposure to general anesthesia, we sought to evaluate the proportion of cases where general anesthesia could have been avoided.
Methods
This single-center pilot retrospective analysis of nonobstetric surgeries performed during pregnancy was conducted at the Caen Normandy University Hospital (2011–2020). An expert panel of seven French anesthesiologists, obstetricians determined whether general anesthesia was avoidable versus required through a majority vote based on an anonymous standardized data collection sheet. General anesthesia was considered avoidable when an alternative such as neuraxial/regional anesthesia or sedation could have been performed.
Results
General anesthesia was avoidable in 36/106 (34%) cases of nonobstetric surgery during pregnancy. Endoscopic JJ ureteral stent insertion or removal was the most common procedure where GA was considered avoidable (19/21 cases; 90%). The consensus rates within the expert panel were of 78% for general anesthesia requirement and 71% for general anesthesia avoidability (P=0.7)
Conclusions
A retrospective review of cases by an expert panel identified that general anesthesia for nonobstetric surgery during pregnancy was likely avoidable in one-third of all cases.
背景：约2%的孕妇在非产科手术中接受全身麻醉。考虑到全身麻醉可能对胎儿和母体产生不良影响，我们试图评估可以避免全身麻醉的病例比例。方法：对2011-2020年在卡昂诺曼底大学医院（Caen Normandy University Hospital）进行的孕期非产科手术进行单中心试点回顾性分析。由7名法国麻醉师、产科医生组成的专家小组根据一份匿名的标准化数据收集表，通过多数投票确定全身麻醉是否可以避免，是否需要。全麻被认为是可以避免的，当替代如神经轴/区域麻醉或镇静可以进行。结果：36/106（34%）的妊娠期非产科手术可避免全麻。内镜下JJ输尿管支架置入或取出是最常见的手术，认为GA是可以避免的(19/21例；90%)。专家小组对全麻要求的共识率为78%，对全麻可避免的共识率为71% （P=0.7）。结论：专家小组对病例的回顾性回顾发现，在所有病例中，三分之一的妊娠期非产科手术全麻可能是可避免的。
期刊介绍：
The International Journal of Obstetric Anesthesia is the only journal publishing original articles devoted exclusively to obstetric anesthesia and bringing together all three of its principal components; anesthesia care for operative delivery and the perioperative period, pain relief in labour and care of the critically ill obstetric patient.
• Original research (both clinical and laboratory), short reports and case reports will be considered.
• The journal also publishes invited review articles and debates on topical and controversial subjects in the area of obstetric anesthesia.
• Articles on related topics such as perinatal physiology and pharmacology and all subjects of importance to obstetric anaesthetists/anesthesiologists are also welcome.
The journal is peer-reviewed by international experts. Scholarship is stressed to include the focus on discovery, application of knowledge across fields, and informing the medical community. Through the peer-review process, we hope to attest to the quality of scholarships and guide the Journal to extend and transform knowledge in this important and expanding area.
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