Anaesthetic managment and clinical outcomes of parturients with COVID-19: a multicentre, retrospective, propensity score matched cohort study

Yuan Zhang; Rong Chen; Jie Wang; Yuan Gong; Qin Zhou; Hui-hui Cheng; Zhong-yuan Xia; Xiangdong Chen; Qing-tao Meng; Daqing Ma

In this study, we comparatively analyzed the epidemiological data, anaesthetic techniques and management, complications and outcomes of maternal patients with and without COVID-19 in the 3 hospitals in Hubei Province. The results indicated that the high rates of emergency and general anaesthesia use were likely due to the high risk for parturients and newborn. Consisting with previous reports 9 , the clinical manifestation of parturients with COVID-19 had mild symptoms and none severe phenotype if the disease was in our study. Thus, the intrathecal anaesthesia was the first choice for parturients with COVID-19 in order to reduce medical staff exposing to virus via patient's airway. Spinal anaesthesia is a safe and quick technique for cesarean delivery due to its quality of sensory blockade and reliability. However, the risk of high level of sensory blockade and the high incidence and degree of hypotension may be the disadvantages when compared with epidural anaesthesia. Although none of the mothers who received intrathecal anaesthesia for delivery had any complications in this study, considering that SARS-CoV-2 virus may also invade the central nervous system 10 , epidural anaesthesia seems to be superior for patients with COVID-19. Due to the limited tactile sensation of PPE, it is necessary to use ultrasound guide epidural procedure for avoiding unintentional dural puncture and subarachnoid catheterization.