A Clinical & Statistical Study on the General Anesthesia and Epidural Anesthesia for Elective Cesarean Section

Lee, M S; Kim, J D; Lee, D G; Yoon, B C; Kim, J G

Abstract

This study was undertaken to evaluate the effects of general and epidural anesthesia for cesarean section. Controversy exsists concerning the choice anesthetic technic for elective cesarean section. Several maternal and newborn parameters were compared during general anesthesia and epidural anesthesia. One hundred thirteen paturients for elective cesarean section was divided into two groups. One group (56) of paturients was anesthetized with general anesthesia. The other group (57) was anesthetized with epidural anesthesia. The results were as follows; 1) There was no significant difference in age, weight, height, blood pressure, pulse rate, hemoglobin and gravidity of paturients, weight of newborn except gestational age of paturients between two groups before cesarean section. 2) There was no significant difference in total surgical time between two groups but induction of anesthesia-delivery time is prolonged in epidural anesthesia. 3) For elective cesarean section under general anesthesia, prolongation of induction-delivery time was not related to lowering of Apgar scores. 4) For elective cesarean section under epidural anesthesia, there was no more neonatal depression accompanied by prolongation of local analgesic injection-delivery time. 5) There was no significant difference in one minute Apgar score and five minute Apgar score between two groups. 6) Maternal PaO2 at the time of uterine incision was significantly higher in the epidural group. But the pH of both umbilical artery and vein was significantly lower in the epidural group. There was a greater (but not significantly greater)base deficit in the umbilical-cord samples of the general anesthesia group. Transplacental difference were statistically significant for O2 alone. 7) In contrast to epidural group, general anesthesia patients developed an impressive degree of hypertension. But hypotension did not develop during epidural anesthesia. 8) There was no significant difference in mean blood loss during operation and lowering of hemoglobin after 24 hours between two groups. 9) Urinary retention, which occured in 26.3% of patients during epidural anesthesia, is only statistically significant difference complication. 10) Forty patient experienced no pain or discomfort during epidural anesthesia. On the basis of this study, neither technique can be vigorously recommended over the other from the standpoint of the newborn condition and maternal status. But we wish to evaluate the study of epidural anesthesia for cesarean section.