Anesthesia and the HIV infected parturient: a retrospective study

We wished to determine whether immunosuppression and/or acceleration of human immunodeficiency virus (HIV)-associated disease is related to the mode of anesthesia in the HIV infected parturient. Ninety-six known HIV-infected asymptomatic parturients who delivered between January 1990 and January 1992 at Grady Memorial Hospital were reviewed for pre-delivery health status, mode of anesthesia and peripartum/post-partum complications. Statistics used chi2 analysis. There were 36 regional anesthetics (28 epidural, 8 spinal), 11 general anesthetics, 22 local anesthesia/intravenous sedation and 27 patients who did not receive anesthesia. There were no differences in the 24-48 h and 4-6 week complication rates. None of the women studied developed neurologic sequelae for 2 years after anesthesia. Thirty-one of the 96 women had CD4/CD8 T-cell lymphocyte data at second trimester and 24-48 h post partum which showed no worsening of maternal immune status in women receiving regional anesthesia, local anesthesia/intravenous sedation or no anesthesia. We believe that both regional and general anesthesia can be performed safely on the asymptomatic HIV-infected parturient. The choice of anesthesia should be based on the usual obstetric and clinical considerations.