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Effect of Anesthesia Methods on Recovery of Patients Undergoing Cervical Cerclage
Abstract Number: T210-546
Abstract Type: Original Research
Cervical cerclage operation is an important procedure to prevent or treat cervical incompetence or insufficiency. The procedure usually lasts no more than 30 minutes and is traditionally performed under spinal anesthesia. With the increased demand for enhanced recovery, the application of deep sedation or intravenous general anesthesia (IVGA) has emerged. The purpose of this study is to review the cervical cerclage cases performed under different anesthesia methods.
A retrospective review of all the patients who underwent cervical cerclage procedure at the Partners HealthCare Systems from July 2015 to January 2019 was conducted. Data including demographic information, anesthesia method, surgical duration, complications, and recovery time were collected. Three groups of parturients were identified based on the anesthesia methods of spinal (Group SP), IVGA (Group IVGA) and spinal plus IVGA (Group SP+IVGA). Statistical analysis was performed using SPSS version 20.0 software.
A total of 365 parturients were included in this study, among which 336 patients received spinal anesthesia, 18 received IVGA, and 11 received spinal + IVGA. Demographic characterizations of the 3 groups were similar (p > 0.05). The recovery time of the IVGA group was significantly (p = 0.000) shorter than the Group SP. In all three groups, prophylactic drugs (Ondansetron or metoclopramide) were used to minimize the risk of postoperative nausea and vomiting (PONV). In this study, no patients suffered from the PONV, and no complications were observed. Though no significant difference was found between the duration of surgery of IVGA and SP (p > 0.05), the induction time was significantly decreased in Group IVGA compare to Group SP.
Previous studies indicated that cervical vaginal cerclage is often performed under spinal anesthesia. Our results indicated that IVGA in cervical cerclage could be advantageous due to improved recovery time with no increased risk. However, we have not explored the effect of different IV drugs, dose concentrations, and their potential effects on the fetus.
1 Bolla D, et al. Arch Gynecol Obstet 2017; 295(4):885-890.
2 Berghella V, et al. Am J Clin Exp Obstet Gynecol 2013; 209(3):181-192.
3 Moore D, et al. Anesth Analg 1980: 59: 743-750.