Local anesthesia is more efficient in pregnant patients with pulmonary arterial hypertension (PAH) than general anesthesia in terms of blood oxygen saturation and systolic and diastolic blood pressure following surgery, as well as mechanical ventilation time, intensive care unit admission time, length of stay, and mortality rate.

This is according to a new study by Chinese researchers published in the Archives of Gynecology and Obstetrics.

The results of our study might offer a reference for clinicians to select proper anesthesia methods for pregnant patients with PAH,” the researchers wrote.


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Pregnancy and labor present a considerable risk of mortality in women with PAH, and Cesarean section is considered to be a life-saving procedure for both the mother and the baby. 

To investigate the effects of different anesthesia methods used during Cesarean section on maternal and neonatal outcomes in pregnant women with PAH, a team of researchers led by Shujuan Chu from the Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan, China conducted a literature review and meta-analysis.

They selected 18 articles containing information about 628 patients who underwent local anesthesia and 481 patients who underwent general anesthesia. 

They found that blood oxygen saturation following surgery and maternal mortality were lower in patients who underwent local anesthesia than in those who underwent general anesthesia. On the contrary, the postoperative systolic and diastolic blood pressures were higher in patients who received local anesthesia than in those who had general anesthesia.

Finally, the mechanical ventilation time, intensive care unit admission time, and length of stay were shorter in patients who underwent local anesthesia than in those who underwent general anesthesia.

Based on these findings, the authors concluded that local anesthesia is superior to general anesthesia and should be preferred in pregnant women with PAH who are having a Cesarean section.

Reference

Ming Y, Wu Z, Wu Z, Chu S. Effects of different anesthesia methods on maternal and neonatal outcomes in pregnant patients with pulmonary arterial hypertension: a meta-analysis. Arch Gynecol Obstet. Published online October 14, 2021. doi:10.1007/s00404-021-06274-6