Comparison Of The Effects Of General And Epidural Anesthesia For Cesarean Section On The Fetus

There are some kinds of anesthesia method available for cesarean section. Epidural is regarded as the best anesthesia type in our country. While general anesthesia is used abroad for cesarean section which is urgent or has an absolute contraindication to the use of regional anesthesia techniques or when regional anesthesia fails, local anesthesia technique is adopted in our country because of the consideration of residual effects of general drugs on the neonate at the timeof delivery, although it's obvious disadvantages of inadequate analgesia. There are some reports abroad regarding the comparison of the effects of general and epidural anesthesia for cesarean section on fetus, but there is no study in this field in our country. To determine that the neonate is rarely affected by regular doses of general anesthetics, we have compared the effects of general and epidural anesthesia for cesarean section on fetus.Materials and methodsFrom May 2002 to December 2003, singleton pregnant women with preoperative Hb > 9g/1, ASA class I ~ II for whom elective cesarean sections were planned after 37 gestation weeks were allocated to general anesthesia(P1 50000 / mm3) Or epidural anesthesia (p1 50000 / mm3). Pregnant women with any system medical complications (for example diabetes> heart diseases) were excluded. Our exclusion criteria were also defined for birth weight less than 2500g and the fetal intrauterine distress. No pregnant women use any analgesic or hypnotic agent. 2h. before operation.After preoxygenation, general anesthesia was induced withfentanyl 2. Oug/kg> propofol 1.5 nig / kg and vencuronium 0.08 mg / kg followed by tracheal intubation. 50% oxygen-nitrous oxides was inhaled before delivery.After an infusion of Ringer's lactate was given intravenously, epidural anesthesia was performed at Li~2 or La-3 on the left lateral decubitus position with 1.73% lidocaine carbonate (including 1:20 adrenaline).We studied arterial and venous samples withdrawn from the doubly clamped umbilical cord segment at delivery for the PH, bicarbonate, Pa02, and PaC02. All delivery times, birth weights, and Apgar scores at lmin, 5min were recored.ResultsAll cesarean section in our study were successfully performed. There was no significant difference between the two groups with respect to the surgery duration (skin to skin), (p >0. 05) . During these cesarean sections, the profiles of Bp and HR are stable, none of the women has a fluctuation of Bp or HR exceeding 20% compared with the baseline data.Maternal age, height, weight were similar between the two groups. The mean Apgar scores at 1min for the general anesthesiagroup was 9.53 1.12 and 9.76 0.66 for the epidural anesthesia group, no significant difference was seen (p>0. 05) . The Apgar scores at 5min of all newborns were 10. The mean birth weight, mean gestational weeks between the two groups didn't differ significantly (p>0. 05) .The mean umbilical artery and vein blood PH for the general group were 7. 31 0.06, 7. 31 0. 04 and 7. 28 0. 07, 7. 32 0. 05 for the epidural group respectively. We couldn't find a significant difference between the two groups (p>0.05) .ConclusionOur prospective study suggested that anesthesia type doesn't influence significantly the outcome of the newborn infants for the elective cesarean section. It seems that both general and epidural anesthesia can be used in elective term cesarean sections without any risk.