The Maternal and Neonatal Effects of the Volatile Anaesthetic Agents Desflurane and Sevoflurane in Caesarean Section: A Prospective, Randomized Clinical Study

Abstract

This study compared maternal and neonatal outcomes in women undergoing elective caesarean section under general anaesthesia with desflurane or sevoflurane; the neonatal effects were also compared with those in women undergoing epidural anaesthesia. Fifty women requesting general anaesthesia were randomly assigned to receive either 3% desflurane or 1% sevoflurane. Twenty-five women requesting regional anaesthesia received epidural anaesthesia with ropivacaine. Comparing desflurane sevoflurane with respect to their maternal haemodynamic effects, maternal blood pressure levels were higher and tachycardia was more frequent in the desflurane group. Comparing general and epidural anaesthesia, no significant differences were detected in terms of neonatal Apgar scores or neurological adaptive capacity scores. In conclusion, 3% desflurane or 1% sevoflurane for general anaesthesia and ropivacaine for epidural anaesthesia for elective caesarean section had similar effects on neonatal outcomes. In women who received desflurane, blood pressure and heart rate elevation were significantly higher than in the sevoflurane group, though this difference did not have any clinical importance.

The effect of labor and delivery mode on electrocortical and brainstem autonomic function during neonatal transition

“…It is not well established how maternal general anesthesia affects ANS tone in the newborn. In a study comparing maternal and neonatal outcome of general anesthesia versus epidural anesthesia for caesarean section, no difference was seen in Apgar scores or neurological adaptive capacity scores at two and 24 hours after delivery 22 . In a different study to evaluate ANS function in the term newborn following non-reassuring fetal heart rate tones in labor, Sheen and colleagues compared newborns born via vaginal delivery versus caesarean section 23 .…”

Incidence and Management of Umbilical Artery Flow Abnormalities during Open Fetal Surgery

“…Birth weight and gestational age at birth were not different between these anesthetic groups. The difference in total dose of vasoactive agents in the univariate analysis, with a greater mean phenylephrine administration rate in the desflurane group is likely a reflection of the fact that (1) efforts were made to bring both blood pressure and heart rate to baseline conditions during potential fetal compromise, and (2) desflurane is associated with higher maternal heart rates compared to sevoflurane [27].…”

Gastrosquisis: Experiencia del Hospital Carlos van Buren en el manejo anestésico del Símil-EXIT. Un estudio de cohorte retrospectiva

“…En cuanto a los halogenados, el bajo coeficiente de partición sangre:gas para el sevofluorano (0,69), permite un incremento rápido en la sangre materna, un fácil traspaso a través de la barrera placentaria y una rápida eliminación al suspender su administración [21]. Este fármaco cumple dos importantes objetivos.…”