0 120

Cited 0 times in

Spinal Versus General Anesthesia for Cesarean Delivery in Pregnant Women With Moyamoya Disease: A Retrospective Observational Study

 Hee Jung Kim  ;  Seung Ho Choi  ;  Hayan Kwon  ;  Eun Kyung Park  ;  Ja-Young Kwon  ;  Hyukjin Yang  ;  Seung Hyun Kim 
 ANESTHESIA AND ANALGESIA, Vol.135(3) : 617-624, 2022-09 
Journal Title
Issue Date
Anesthesia, General / adverse effects ; Anesthesia, Obstetrical* / adverse effects ; Anesthesia, Spinal* / adverse effects ; Cesarean Section ; Female ; Humans ; Hypotension / etiology ; Infant, Newborn ; Moyamoya Disease* / complications ; Pain, Postoperative ; Pregnancy ; Pregnant Women ; Retrospective Studies
Background: Moyamoya disease, a rare chronic cerebrovascular disease with a fragile vascular network at the base of the brain, can cause ischemic or hemorrhagic strokes or seizures. Precise blood pressure control and adequate analgesia are important for patients with moyamoya disease to prevent neurological events such as ischemia and hemorrhage. This study aimed to compare the intraoperative mean arterial pressure of pregnant women with moyamoya disease according to the mode of anesthesia (general anesthesia versus spinal anesthesia) used during cesarean delivery.

Methods: We retrospectively reviewed the medical records of 87 cesarean deliveries in 74 patients who had been diagnosed with moyamoya disease before cesarean delivery. The primary outcome, intraoperative maximum mean arterial pressure during anesthesia, was compared according to the type of anesthesia administered (general versus spinal anesthesia). Other perioperative hemodynamic data (lowest mean arterial pressure, incidence of hypotension, vasopressor use, and antihypertensive agent use), maternal neurologic symptoms, neonatal outcomes (Apgar scores <7, ventilatory support, and intensive care unit admission), maternal and neonatal length of stay, postoperative pain scores, and rescue analgesic use were assessed as secondary outcomes.

Results: While the lowest blood pressure during anesthesia and incidence of hypotension did not differ between the 2 groups, the maximum mean arterial pressure during anesthesia was lower in the spinal anesthesia group than that in the general anesthesia group (104.8 ± 2.5 vs 122.0 ± 4.6; P = .002). Study data did not support the claim that maternal neurologic symptoms differ according to the type of anesthesia used (5.6% vs 9.3%; P = .628); all patients recovered without any sequelae. The postoperative pain scores were lower, and fewer rescue analgesics were used in the spinal anesthesia group than in the general anesthesia group. Other maternal and neonatal outcomes were not different between the 2 groups.

Conclusions: Compared with general anesthesia, spinal anesthesia mitigated the maximum arterial blood pressure during cesarean delivery and improved postoperative pain in patients with moyamoya disease.
Full Text
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Ja Young(권자영) ORCID logo https://orcid.org/0000-0003-3009-6325
Kwon, Ha Yan(권하얀)
Kim, Seung Hyun(김승현) ORCID logo https://orcid.org/0000-0003-2127-6324
Kim, Hee-Jung(김희정) ORCID logo https://orcid.org/0000-0002-2143-3943
Park, Eun Kyung(박은경)
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0001-8442-4406
사서에게 알리기


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.