Obstetric Anesthesia in Ancient Egypt & modern Practice
Abstract Number: 120
Abstract Type: Meta Analysis/Review of the Literature
Egypt is a country in North Africa ,Covering an area of about 1,001,450 square kilometers.The culture of Ancient Egypt lived along the Nile river from before the 5th millennium BC. Ancient Egyptians had a widespread reputation for their medical knowledge. According to the Kahun papyrus:parturients squatted on birth stool & delivery was assisted by midwives. Doctors were called only in difficult labor & sought to assuage intense labor pains by giving the patient intoxicating drugs mostly beer.Egypt is the fifteenth most populous country in the world;78.8 million people at(2006).Numbers of live births according to governorates/ year 2006 is 1853746.Births by caesarean section :20%. Maternal mortality ratio (per 100 000 live births) is 130.0,while"Infant mortality rate (per 1 000 live births) both sexes is 29.0.
This survey included 2 University hospitals & one private maternity hospital.In Kasr-Aini University hospital,We have around 20,000 deliveries/year. Rate of Cs is around 25%, mostly performed under spinal anesthesia with spinal needle G22,with 2ml of Bupivacaine 0.5%+15mic fentanyl. G.A is given for emergency Cs or critically ill parturients.Epidural analgesia for vaginal delivery is reserved to selected cases due to financial reasons(high cost of epidural kit).
In AL-Azhar University ,there are 2 hospitals: babel-shareah (Male-students)& Alhosein hosp(female-student). In babel-shareah (Male-students), there are 20-30,000 deliveries/year& 15,000/year in Alhosein hosp. Rate of Cs is 30%. All elective cases receive spinal anesthesia with Spinal needles G22 or 25. Epidural analgesia is given for selected cases of vaginal deliveries for medically compromised parturients or for teaching purpose.However the obstetric anesthesia practice differs in private sector. In one of the famous maternity private hospital in Cairo, they have around 4000 Deliveries/year.Rate of Cs is about 30%. Spinal anesthesia is given to only 20% of cases according to surgeon's preference & patient's request. While the majority receive G.A as patients are refined& just want to sleep . On the contrary parturients going for normal vaginal delivery require (Painless Labor) by epidural analgesia with both L.A (Bupivacaine 0.125-0.25% & narcotics (fentanil or sufentanil).After the visit of Kybele group to Egypt in April 2008,the anesthetists showed interest in decreasing PDPH by using pencil-point needles G25 & G26.Phenylephrine will soon be available in market to replace ephedrine.