Comparison of Effects of General Anesthesia and Combined Spinal/Epidural Anesthesia for Cesarean Delivery on Umbilical Cord Blood Gas Values: A Double-Blind, Randomized, Controlled Study

Abstract

Background The objective of this study was to analyze the effects of general anesthesia in cesarean section on the umbilical cord blood gas values and intraoperative hemodynamics of parturient women. Material/Methods A total of 112 parturient women who received cesarean section were eventually randomized into 2 groups, GA (general anesthesia) group (n=56), and SE (combined spinal and epidural anesthesia) group (n=56). The umbilical cord blood gas values, postpartum Apgar score, intraoperative blood loss, mean arterial pressure, heart rate, total operative time, time intervals from anesthesia to delivery and from skin incision to delivery, the incidences of adverse reactions and neonatal asphyxia, and the postoperative patient satisfaction were compared between the 2 groups. Results There were no significant differences between the 2 groups in total operative time, Apgar score, neonatal asphyxia rate, umbilical arterial and venous cord blood gas values, intraoperative blood loss, and time interval from skin incision to delivery (all P >0.05). The GA group was significantly shorter in the time interval from anesthesia to delivery than the SE group ( P <0.05). The incidences of nausea, vomiting, and chills in the GA group were significantly lower than those in the SE group (all P <0.05). The GA group was significantly higher in postoperative patient satisfaction than the SE group ( P <0.05). Conclusions General anesthesia has little impact on the umbilical cord blood gas values and Apgar score, and ensures better hemodynamic stability in cesarean section. Moreover, general anesthesia is characterized by rapid induction and is therefore valuable for use in clinical procedures.

How does the obstetric anesthesia in cesarean section affect the wellbeing of the newborn?

“…The median APGAR score atthe 1st and 5th minutes after birth was 9 (4, 9), 10 (6, 10), respectively, in both groups. Similar to our finding, some studies also revealed that there was no difference between the two anesthetic methods in terms of APGAR score [6,12,13]. The arterial cord blood gas is currently known as an important indicator of neonatal oxygenation, acid-base status and it accurately reveals the effect of anesthesia on the fetus like APGAR score [14].…”

“…In the literature, RA was associated with significantly lower umbilical arterial pH than GA. This may be because of hypotension following RA that can decrease uteroplacental perfusion and produce fetal acidosis [6,15,16], although in some studies, GA was associated with lower pH values [17,18]. Edipoglu et al [19] found that umbilical blood pH with GA is associated with lower pH values (7.20 for GA versus 7.29 for RA), although this difference was not statistically significant (p > 0.05).…”

“…The cord blood gas analysis shows oxygenation of the newborns and acid-base status. Both the cord blood gas analysis and APGAR score can accurately show the effect of anesthesia for the newborns [6]. Different anesthesia methods may also affect the timing of onset of lactation.…”

Anesthesia for Cesarean Section: Retrospective Comparative Study

“…Chen et al 22 found that, compared with SA, the GA group was significantly higher in post-operative patient satisfaction. However, Ghaffari et al 23 found that SA, compared with GA, was the technique of choice for cesarean section because, in addition to other benefits, it provided effective pain control, mobility and fast return back to daily activities for new mothers and increased their quality of life.…”

Fetal and Maternal Responses to Dexmedetomidine Intrathecal Application During Cesarean Section: A Meta-Analysis

“…General anesthesia has been shown to reduce neonatal Apgar scores as early as the 1970s [6]. With the advancement of anesthesia techniques and the development of anesthetics, recent studies have shown that general anesthesia has little effect on cord blood gas parameters and neonatal Apgar scores [7]. However, more high-quality clinical studies are needed to confirm whether general anesthesia can replace spinal anesthesia as the preferred anesthesia for cesarean section in the future.…”