Publication:
Cesarean Section under General Anesthesia over 10 Years at Tertiary Care Center: A Descriptive Cross-sectional Study

Date

2024

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Nepal Medical Association

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Abstract

Abstract Introduction: The global surge in cesarean deliveries necessitates safe anesthetic practices to optimize outcomes. While the neuraxial block is the preferred method, specific conditions warrant general anesthesia. This study is aimed to determine the prevalence of cesarean sections under general anesthesia at a tertiary care center. Methods: A descriptive cross-sectional study was conducted on cesarean sections performed between April 14, 2013, and April 13, 2023, at a tertiary care center. Ethical approval was obtained from the Institutional Review Committee (Reference number: 20092023/01). Total sampling was done. Data for the past ten years were manually collected from hospital records using a self-structured proforma and analyzed using Microsoft Excel 2018 and IBM SPSS version 26. The point estimate and 95% confidence interval were calculated for the study. Results: In this study, there were 216 (2.98%) (95% CI: 2.59-3.38%) cesarean sections under general anesthesia in 10 years. Notably, among them, there were 103 (47.69%) primigravida, nullipara 130 (60.19%), 135 (62.50%) with no living children, and 161 (74.54%) without any past abortions. In most cases, 182 (84.26%) were emergency procedures and 34 (15.74%) were elective. Fetal bradycardia with distress was the primary indication observed in 121 (56.02%) cases, followed by 32 (14.81%) maternal requests. Additionally, twenty-one cases were found initially planned as cesarean sections under subarachnoid block but were converted to general anesthesia. The prevalence in this study was found within the recommended limits. Conclusions: The findings highlight that the majority of these procedures were emergency cases, predominantly due to fetal distress, with a notable proportion involving primigravida and nulliparous women.

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Smriti Basnet Kathmandu Medical College and Teaching Hospital Prabineshwor Prasad Lekhak Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal. Prabin Subedi Department of Anesthesia and Intensive Care, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal. Sushila Lama Moktan Department of Anesthesia and Intensive Care, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal.

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