• Sao Paulo Med J · May 2015

    Randomized Controlled Trial

    Comparison of maternal and fetal outcomes among patients undergoing cesarean section under general and spinal anesthesia: a randomized clinical trial.

    • Anıl İçel Saygı, Özkan Özdamar, İsmet Gün, Hakan Emirkadı, Ercüment Müngen, and Yaşam Kemal Akpak.
    • Department of Obstetrics and Gynecology, Ankara Military Hospital, Ankara, Turkey.
    • Sao Paulo Med J. 2015 May 1; 133 (3): 227234227-34.

    Context And ObjectiveAs the rates of cesarean births have increased, the type of cesarean anesthesia has gained importance. Here, we aimed to compare the effects of general and spinal anesthesia on maternal and fetal outcomes in term singleton cases undergoing elective cesarean section.Design And SettingProspective randomized controlled clinical trial in a tertiary-level public hospital.MethodsOur study was conducted on 100 patients who underwent cesarean section due to elective indications. The patients were randomly divided into general anesthesia (n = 50) and spinal anesthesia (n = 50) groups. The maternal pre and postoperative hematological results, intra and postoperative hemodynamic parameters and perinatal results were compared between the groups.ResultsMean bowel sounds (P = 0.036) and gas discharge time (P = 0.049) were significantly greater and 24th hour hemoglobin difference values (P = 0.001) were higher in the general anesthesia group. The mean hematocrit and hemoglobin values at the 24th hour (P = 0.004 and P < 0.001, respectively), urine volume at the first postoperative hour (P < 0.001) and median Apgar score at the first minute (P < 0.0005) were significantly higher, and the time that elapsed until the first requirement for analgesia was significantly longer (P = 0.042), in the spinal anesthesia group.ConclusionIn elective cases, spinal anesthesia is superior to general anesthesia in terms of postoperative comfort. In pregnancies with a risk of fetal distress, it would be appropriate to prefer spinal anesthesia by taking the first minute Apgar score into account.

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