A common point reported by some of the patients who were seen by the anesthesiologist arrested for rape last Monday (11) was that they would have been sedated to the point of being unconscious during labor.
In statements given at the Women’s Police Station (Deam), health professionals who worked with Giovanni Quintella Bezerra said that, in fact, the doctor totally sedated his patients.
Such a procedure is uncommon in cases of cesarean section and poses risks for both the mother and the baby.
According to Ana Cristina Pinho, director-general of the National Cancer Institute (Inca) and former president of the Brazilian Society of Anesthesiology (SBA), in the vast majority of cases of cesarean delivery, anesthesia is used that has an effect from the waist down. of the woman.
However, sedation after this procedure occurs only in specific cases and in a light way, and only after umbilical cord ligation.
“Sedation is only authorized after the baby is born and the umbilical cord has been cut. They are two individuals literally linked. When I administer a sedative to the mother, with the umbilical cord present, this sedative crosses the placenta and reaches the baby and exposes him to the risk of being born with respiratory depression. He goes on to not breathe properly and can progress to an oxygen deficit that runs the risk of permanent sequelae,” she explained.
For pregnant women, who have a longer stomach emptying time than non-pregnant women, there are risks of bronchoaspiration, according to experts.
This can lead to serious conditions, such as lung infections and pneumonia and, in more serious cases, it can even result in the patient’s death.
In one of the statements given to the police, the nursing technician Davi de Freitas, who worked with Giovanni, reported that one of the reasons given by the anesthesiologist for using sedatives was that the patient was nauseous and that it was necessary to “turn her off”. .
The technician rightly reported the fear of the risk of bronchoaspiration in case the patient had nausea.
Renato Sá, vice-president of the Association of Gynecology and Obstetrics of the State of Rio de Janeiro (SGORJ), said that using sedatives during cesarean, although not illegal, is not commonplace and, like Ana Pinho, stated that the Doses should be given as lightly as possible.
“There are unusual situations that require sedation. Still, use as little as possible. Sedation can be used within a medical justification. All this depends on medical indications for you to change the standard of anesthesia. Sedating is not prohibited, but it is not the rule,” she explained.
Also according to the doctor, the cases that would justify the use of anesthetics are emergency situations, such as hemorrhage during a cesarean section, or, for example, a blockade failure after anesthesia that paralyzes from the waist down, a procedure normally applied before of a cesarean.
Even so, it is not recommended that the patient lose consciousness.
“The objective of childbirth care is for the mother to participate, to be the protagonist of the birth, even if it is a cesarean. Ideally, she should be awake at all times, so that the baby is born and she is in a position to be in direct contact with the mother, skin-to-skin,” she highlighted.
According to information collected by the Women’s Police Station (Deam), the anesthesiologist arrested for rape used the drugs Propofol and Ketamine to sedate and make the patients unconscious.
Although not illegal, the use of these sedatives is not common in these cases, as Ana Cristina Pinho said.
“Propofol can be used for both sedation and general anesthesia (which requires intubation and muscle relaxation). In sedation, the goal is to maintain spontaneous breathing. In obstetrics, medication is usually used to reduce anxiety rather than sedatives, to take away consciousness”, explained the director general of Inca.
Ketamine, she continued, “is a drug that when used in higher doses causes psychomimetic effects.
When it is used for light sedation, the dose is minimal. This got the team’s attention. The unusual use of high doses of sedative. There is no option for deep sedation,” he added.
Renato Sá followed the same line and stated that “ketamine is another very unusual medication for obstetrical use, and it is one of the heaviest sedatives”.
Institutions take a stand on the case
Brazilian institutions of obstetrics, anesthesiology and medicine took a stand on the rape case that occurred last Sunday (10), at the Maternity Hospital of Women in São João de Meriti.
The Federal Council of Medicine (CFM) stated in a note that the Regional Council of Medicine of the State (Cremerj) has started an investigation and that it is in progress.
“It is up to the Regional Council of Medicine (CRM) of the state where the fact occurred to conduct the investigation through the opening of an inquiry, whose conclusion may lead to the opening of a professional ethical process”, pointed out the CFM in a note of clarification.
A letter was sent to Cremerj on Monday (11) for the anesthesiologist arrested for rape to lose his record.
The Brazilian Society of Anesthesiology (SBA), in an official note, said that it will take the necessary measures, such as the exclusion of the anesthesiologist from the partnership’s department, in addition to carrying out the collection of effective actions by institutions such as Cremerj.
“Our society will not remain inert in the face of facts as obscene and degrading as those that were committed, we will act in a forceful and EXEMPLARY way in order to punish the doctor who starred in this abominable episode”, highlighted the SBA, who has already been temporarily suspended. of membership boards.
The Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) said it does not support any form of violence and prejudice.
“Cases like the ones that, unfortunately, we have been following in the media, escape any medical care premise and, therefore, enter the criminal sphere”, he highlighted in a note.
THE CNN the director general of Inca condemned and regretted the crime committed, and said that it is necessary to send a message of safety to women at this time, and regretted that a professional who is there precisely to provide security, has committed such heinous crimes.
“This feeling of insecurity about the risks one takes in an operating room is understandable. Now, after the case, there is an extra load of anxiety beyond the procedure itself. Anesthetists are highly trained professionals. It is an extremely discerning class in training and intolerant of deviations from medical practice. It is an opportunity to reinforce confidence in the anesthesiologist professional. Our mission, in addition to Socrates’ oath when deciding on anesthesiology, is to commit to ensuring patient safety”, he said.
Source: CNN Brasil
