Anesth Pain Med.  2021 Jan;16(1):49-55. 10.17085/apm.20072.

Comparison of the effect of general and spinal anesthesia for elective cesarean section on maternal and fetal outcomes: a retrospective cohort study

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
  • 2Myunggok Medical Research Center, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea

Abstract

Background
Anesthesia is needed to ensure both maternal and fetal safety during cesarean sections. This retrospective cohort study compared maternal and fetal outcomes between general and spinal anesthesia for cesarean section based on perioperative hemodynamic parameters (pre- and postoperative systolic blood pressure, heart rate), mean difference of hematocrit and estimated blood loss, and neonatal Apgar scores at 1 and 5 min.
Methods
Data from electronic medical records of 331 singleton pregnancies between January 2016 and December 2018 were analyzed retrospectively; 44 cases were excluded, and 287 cases were assigned to the general group (n = 141) or spinal group (n = 146).
Results
Postoperative hemodynamic parameters were significantly higher in the general group than the spinal group (systolic blood pressure: 136.8 ± 16.7 vs. 119.3 ± 12.7 mmHg, heart rate: 93.2 ± 16.8 vs. 71.0 ± 12.7 beats/min, respectively, P < 0.001). The mean difference between the pre- and postoperative hematocrit was also significantly greater in the general than spinal group (4.8 ± 3.4% vs. 2.3 ± 3.9%, respectively, P < 0.001). The estimated blood loss was significantly lower in the spinal than general group (819.9 ± 81.9 vs. 856.7 ± 117.9 ml, P < 0.001). There was a significantly larger proportion of newborns with 5-min Apgar scores < 7 in the general than spinal group (6/141 [4.3%] vs. 0/146 [0%], respectively, P = 0.012).
Conclusions
General group is associated with more maternal blood loss and a larger proportion of newborns with 5-min Apgar scores < 7 than spinal group during cesarean sections.

Keyword

Cesarean section; General anesthesia; Maternal outcome; Neonatal outcome; Spinal anesthesia

Figure

  • Fig. 1. Flow diagram.

  • Fig. 2. Perioperative hematocrit (%). POD 0: preoperative, POD 1: postoperative 1 day, POD 3: postoperative 3 days. *P < 0.01.


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Association between anesthetic method and postpartum hemorrhage in Korea based on National Health Insurance Service data
Yongho Jee, Hyun Jung Lee, Youn Jin Kim, Dong Yeon Kim, Jae Hee Woo
Anesth Pain Med. 2022;17(2):165-172.    doi: 10.17085/apm.21068.


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