Abdelrauf Kilani and Ivan Panasevich
Department of Anaesthesia. Tripoli Medical Centre. Tripoli-Libya
JMJ Vol. 5, No 2 (Summer) 2006: 95-98
Aim of the study: There has been a sustained growth in caesarean delivery rate worldwide. From the early reports of maternal deaths from obstetric anaesthesia, it became clear that potential hazards threaten the mother and child whenever an anaesthetic needs to be administered. General anaesthesia for caesarean section is regarded as a special technique comparatively to most commonly used regional technique. There remain very few obstetric situations where general anaesthesia is essential. The aim of our study is to assess the incidence of regional and general anaesthesia in elective and emergency caesarean sections in Tripoli Medical Centre and to compare it with the incidence in other countries. Patients and Results: A retrospective study of 1103 patients undergoing caesarean sections during 6 months of 2004 in Tripoli Medical Centre has been performed. 817 parturients (74%) have been operated for emergency indications and 286 parturients (26%) as scheduled cases. 599 parturients (54.3%) have been operated under general anaesthesia and 504 parturients (45.7%) under spinal anaesthesia. 56.8 % of parturients operated for emergency indications have been operated under general anaesthesia and 43. 2 % under spinal anaesthesia. 42.7% of elective caesarean sections were performed under general anaesthesia and 52.8% under spinal anaesthesia. Conclusions: The incidence of general anaesthesia for caesarean delivery in Tripoli Medical Centre is 54.3%. This incidence is ten times higher than in some countries in Europe. Misjudgements are common among anaesthesiologists in selection of anaesthetic technique for caesarean section, especially for a scheduled procedure. There is still unjustified negative attitude of many obstetricians and parturients to regional anaesthesia for caesarean delivery.
Keywords: Obstetric anaesthesia, Caesarean section, Anaesthetic safety