Abstract
Objective: To compare the effects of general and spinal anesthesia in patients undergoing elective Cesarean section in terms of neonatal outcome.
Study design: Randomized control trial.
Setting: This study was conducted in the department of anesthesiology, surgical intensive care and pain management and department of Gynecology and Obstetrics, Peoples Medical College Hospital Nawabshah.
Duration of study: June 2009 to December 2009.
Subjects and methods: Patients in this study were admitted through obstetric OPD for lower segment Cesarean section. Patients were selected by simple random envelop draw method. Sample size were 160 patients, they divided in to two equal groups. Group A (N=80) patients underwent spinal anesthesia and Group B patients underwent general anesthesia. Immediately after delivery of the neonate, umbilical artery blood sample was taken for assessment of blood pH. Apgar score was assessed at 01 and 05 minutes and recorded on proforma. Anesthesia was labeled as effective i-c satisfactory if the Apgar score was 7 and above and blood pH 7.2 and above.
Results: An Apgar score > 7 was observed at 01 and 05 minutes in 78(97.5%) and 80 (100%) neonates respectively in group A while it was 60(75%) and 74 (92.5%) in group B neonates. Apgar score > 7 was observed in significantly more neonates in group A as compare to group B (p = 0.028). Average Apgar score at 01 and 05 minutes was also significantly higher in group A than group B; 8.04 +/- 0.82 vs 7.10 +/- 0.92 (p=0.0001) and 9.89 +/- 0.32 vs 9.34 +/- 1.07 respectively (p=0.0001).Umbilical artery blood pH>7.2 was observed significantly high in group A93.8% as compared to group B 83.8% (p=0.045). Also average pH was significantly high in group A than group B e.g. 7.38 +/- 0.15 vs 7.21 +/- 0.16 (p=0.017).
Conclusion: Spinal anesthesia is associated with better neonatal out come as compared to general anesthesia in elective Cesarean sections.