Eugene Oreshnikov, MD, PhD
Associate Professor
Chuvash State University
Cheboksary, Russia
Disclosure information not submitted.
Svetlana Oreshnikova, n/a
Associate Professor
Chuvash State University
Cheboksary, Russia
Disclosure information not submitted.
Elvira Vinokur, n/a
Associate Professor
Chuvash State University
Cheboksary, Russia
Disclosure information not submitted.
Tamara Denisova
Professor
Chuvash State University
Cheboksary, Russia
Disclosure information not submitted.
Title: Specific features of spinal anesthesia during cesarean section with severe coronavirus pneumonia
Introduction: Spinal anesthesia is the main type of anesthesia for cesarean section. Severe coronavirus pneumonia, which complicates the course of pregnancy, requires some adjuncts to provide spinal anesthesia.
Methods: The safe conduct of spinal anesthesia was ensured by the temporary discontinuation of the use of heparin or low molecular weight heparins in the perioperative period. Spinal anesthesia was performed exclusively in the sitting position, then the patient was transferred to the horizontal position with the head end elevated by 30-45-60 degrees (depending on the needs). Respiratory support was used at all stages of preparation, performance, and administration of anesthesia: insuflation of humidied oxygen, high-fow oxygenation through nasal cannula or face mask, and noninvasive mechanical lung ventilation through the
face mask. Maintenance of normotension was provided by intravenous boluses of 50 μg phenylephrine.
Results and Conclusions: The above-described features of spinal anesthesia were used by us during cesarian section in 30 women in labor with severe coronavirus pneumonia. Compliance with the characteristics of spinal anesthesia caused by coronavirus pneumonia was expressed in the following:
1) sitting position - half sitting at all stages of the perioperative period;
2) constant respiratory support, mainly high-fow oxygenation;
3) early transfer to the pron-position in the postoperative period, accompanied by effective postoperative anesthesia for its provision;
4) a quick return to heparin therapy in therapeutic doses.
This approach ensured that there was no need to use general anesthesia with tracheal intubation for cesarian section. Supplemented with high-flow oxygenation, half-sitting spinal anesthesia is the method of choice for providing cesarian section in labor with severe coronavirus pneumonia.