Evaluation of anesthesia for obstetric and gynecologic intra-abdominal pelvic surgery in a rural hospital.

From March 1, 1990 to August 31, 1991, there were four hundred and forty eight female patients undergoing major lower abdominal obstetric and gynecologic operations in our hospital. The most frequently performed operation in our series was Cesarean section (80.8%). Besides, there were operations for ectopic pregnancy, ovarian cyst, fallopian tube problems and abdominal total hysterectomy as well as radical hysterectomy for cervical cancer. Most of the operations were done under spinal anesthesia (91.3%). The rest were performed under epidural anesthesia (2.2%), general anesthesia (4.9%) or a combined anesthetic technique (1.3%). On one occasion, a Cesarean section was done during cardio-pulmonary resuscitation in the emergency room. Another parturient developed cardiac arrest during spinal anesthesia for Cesarean section with successful resuscitation. Otherwise, only minor complications such as post dural puncture headache (6.4%), nausea and vomiting (13.51%) and hypotension (38.2%) were found. All complications responded to conservative therapy that no prolonged hospitalization or unacceptable Apgar score in the newborns was noted. In addition, intra-operative blood transfusion was a rare occurrence. Thus, spinal anesthesia is a safe, effective, simple and inexpensive anesthetic method for major obstetric and gynecologic operations particularly in a rural hospital.