Minimally invasive spinal anesthesia for cesarean section in maternal anticoagulation therapy: a randomized controlled trial.

ABSTRACT: BACKGROUND:Anticoagulant therapy during pregnancy is widely used due to the increasing awareness of maternal hypercoagulability. Few studies have reported the use of minimally invasive spinal anesthesia in these parturients. The objective of this study was to evaluate the safety and feasibility of minimally invasive spinal anesthesia in parturients with anticoagulation therapy undergoing cesarean section. METHODS:This was a randomized, controlled study conducted in 239 parturients using anticoagulants and undergoing selective cesarean section. 37 parturients withdrew, and finally parturients received spinal anesthesia using 27gauge pen type fine spinal needles (experimental group, n?=?110) and 22gauge traditional spinal needles (control group, n?=?92). The primary efficacy outcomes included low back pain (LBP) and postdural puncture headache (PDPH) after delivery. Secondary efficacy outcomes included visual analogue scale during subarachnoid puncture (VASdural), difference between visual analogue scale (VAS) during peripheral venipuncture and VASdural (?VAS), VAS of back puncture point 24, 48 and 72?h after operation (VASdural-24?h, VASdural-48?h and VASdural-72?h, respectively), maternal satisfaction and hospitalization stay. RESULTS:No parturient had PDPH and was suspected with spinal or intracranial haematoma in two groups. There was no significant difference in VASlbp-24?h, VASlbp-48?h and VASlbp-72?h (P?=?0.056; P?=?0.813; P?=?0.189, respectively) between two groups. In experimental group, VASdural (P?=?0.017), ?VAS (P?=?0.001) and VASdural-24?h (P?

SUBMITTER: Huang D 

PROVIDER: S-EPMC6330402 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature