Abstract
Objective The aim of the study was to know which type of anesthesia, general or spinal, causes less amount of blood loss in elective cesarean section. Study design This was a randomized controlled trial conducted in Ain Shams University Maternity Hospital on 155 women. Seventy-seven women were allocated (after computer-generated randomization) to group G (general anesthesia), and 78 women to group S (spinal anesthesia). All patients underwent elective lower segment cesarean section following the same operative steps and by the same surgeon and their anesthesia, whether general or spinal, was standardized. Amount of intraoperative blood loss was estimated by the acute normovolemic hemodilution technique. Results On using hemoglobin level changes to estimate blood loss, it was seen that group S had significantly less blood loss than group G with a difference of 152.760 ml (P=0.003). On using hematocrit values, it was seen that group S had statistically significant less blood loss than group G, with a difference of 174.2 ml (P=0.001). Headache attacks were higher in group S (29.49%) than in group G (12.99%) (P=0.010). Group S started breast feeding 54.3 min earlier than group G (P=0.013). Group S started postoperative ambulation 69.36 min earlier than group G (P=0.014). Group G requested analgesia 17.6 min earlier than group S (P=0.035). No statistically significant differences were observed between the two groups with respect to postoperative pulse, blood pressure, urinary output, and fainting attacks. Conclusion Spinal anesthesia shows definite advantages over general anesthesia in terms of higher postoperative hemoglobin and hematocrit values, less intraoperative blood loss, less postoperative pain, less need for analgesia, earlier ambulation, and faster initiation of breast feeding.
Published Version
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