Comparison of maternal and fetal outcomes among patients undergoing cesarean section under general and spinal anesthesia: a randomized clinical trial.

Anıl İçel Saygı,İsmet Gün,Hakan Emirkadı,Yaşam Kemal Akpak,Ercüment Müngen,Özkan Özdamar

doi:10.1590/1516-3180.2014.8901012

Anıl İçel Saygı, İsmet Gün + Show 4 more

Open Access

https://doi.org/10.1590/1516-3180.2014.8901012

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Abstract

As the rates of cesarean births have increased, the type of cesarean anesthesia has gained importance. Here, we aimed to compare the effects of general and spinal anesthesia on maternal and fetal outcomes in term singleton cases undergoing elective cesarean section. Prospective randomized controlled clinical trial in a tertiary-level public hospital. Our study was conducted on 100 patients who underwent cesarean section due to elective indications. The patients were randomly divided into general anesthesia (n = 50) and spinal anesthesia (n = 50) groups. The maternal pre and postoperative hematological results, intra and postoperative hemodynamic parameters and perinatal results were compared between the groups. Mean bowel sounds (P = 0.036) and gas discharge time (P = 0.049) were significantly greater and 24th hour hemoglobin difference values (P = 0.001) were higher in the general anesthesia group. The mean hematocrit and hemoglobin values at the 24th hour (P = 0.004 and P < 0.001, respectively), urine volume at the first postoperative hour (P < 0.001) and median Apgar score at the first minute (P < 0.0005) were significantly higher, and the time that elapsed until the first requirement for analgesia was significantly longer (P = 0.042), in the spinal anesthesia group. In elective cases, spinal anesthesia is superior to general anesthesia in terms of postoperative comfort. In pregnancies with a risk of fetal distress, it would be appropriate to prefer spinal anesthesia by taking the first minute Apgar score into account.

Highlights

The frequency of cesarean section births continues to steadily rise worldwide.[1]
The patients were divided into two groups of 50 each, named the general anesthesia and spinal anesthesia groups, according to the route of administration of anesthesia
Regarding the first minute APGAR scores of the newborns, after adjustments were made by taking confounders into account, the difference between two groups continued to exist (P = 0.005)

Summary

Introduction

The frequency of cesarean section births continues to steadily rise worldwide.[1]. Even though the cesarean procedure has become very safe over the years, it is still associated with high rates of maternal and perinatal mortality and morbidity.[2]. The higher mortality and morbidity rates might be attributable to the surgical procedure and to the anesthetic technique preferred. General anesthesia was the preferred type for use in cesarean procedures.[4] it has many advantages, such as faster induction, better cardiovascular stability with lower incidence of hypotension, and good control over ventilation, use of anesthetic drugs that cross the placental barrier can produce neonatal depression.[4] complications such as maternal aspiration syndrome and intubation failure, which may occur during general anesthesia and contribute towards maternal mortality, have been reported.[5,6]

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