Anesthesia for Cesarean Section: Retrospective Comparative Study

Abstract

Background Cesarean section is a widely performed surgery. Objective To compare anesthetic types regarding feto-maternal outcomes. Materials and Methods Retrospective comparative study of 3599 cesarean sections (emergency and elective categories). Results Mean APGAR score was statistically higher in the spinal than general anesthesia among the emergency category, P = 0.000 and 0.026, respectively, with no significant difference in the elective category. Estimated blood loss among the elective category was statistically significantly higher in the spinal than general anesthesia, P = 0.001. However, among the emergency category, it was significantly higher in the general than in spinal or epidural anesthesia, P = 0.000. Diclofenac sodium was used more after spinal than general anesthesia (P = 0.000), with no significant difference between epidural and general or between epidural and spinal anesthesia. Pethidine hydrochloride (HCL) was used more after general than after spinal anesthesia (P = 0.000). However, pethidine HCL use was not statistically significantly different between spinal and epidural anesthesia. In the elective category, paracetamol was requested more after spinal than epidural or general anesthesia, P = 0.000. No significant difference was seen between epidural and general anesthesia, P = 1.000. No statistically significant difference was found among the anesthetic types in both categories regarding tramadol HCL. Length of hospital stay, operative time and neonatal intensive care unit admission were not statistically different between anesthetic modes. In the emergency category, significantly higher percentage of patients were satisfied with and would recommend epidural anesthesia. Conclusion There was no statistically significant difference among the three types of anesthesia regarding neonatal intensive care admission and length of hospital stay for emergency and elective categories. APGAR score was higher with spinal than with general anesthesia in the emergency category with no significant difference in the elective category. More diclofenac sodium and paracetamol and less opioids were used after regional than after general anesthesia. Satisfaction was higher with epidural anesthesia. Limitations Retrospective and single centered.

A critical appraisal of tools for delivery room assessment of the newborn infant

“…Furthermore, muscular hypotonia is often associated with cardiac, neuromuscular and other genetic syndromes, 50,54 other causes of neonatal encephalopathy than HIE, 50,55 birth trauma, 56 hypoglycemia, hypocalcemia and infections. 55 Finally, maternal anesthesia 3,57,58 and delivery mode 49,59 may also affect neonatal muscle tone.…”

Intraoperative Awareness During Cesarean Delivery Under General Anesthesia

“…Studies using the isolated forearm technique reported incidence of AGA 40% [11]. Interestingly, none of these cases could recall any intraoperative events.…”

“…The risk of pulmonary aspiration, failed intubation, increased blood loss, higher degrees of postoperative pain, chronic pain, increased risk of postpartum depression, and oxygen toxicity are GA-related risks in CS [8][9][10]. However, in emergencies or any contraindication to SA, GA should be considered [11].…”

Comparison of the Hypotension in Lateral Verses Sitting Positions during Induction of Spinal Anaesthesia for Caesarean Section

“…Use of the spinal anaesthesia is usually due to the rapid onset of action in cesarean sections. In the spinal cord there is a rapid action, sensory and motor blockade, as well as a reduction in the risk of toxicity of local anesthesia [1,2].…”