Spinal versus general anesthesia for elective cesarean delivery: a prospective comparative study

Abstract

Objective: To study the efficacy and safety of spinal anesthesia for elective cesarean section as compared with general anesthesia.

Patients and methods: 175 women undergoing elective cesarean section were studied prospectively. They were allocated into two groups; the first group (n=60) received spinal anesthesia, and the second one (n=115) received general anesthesia for elective cesarean section. Preoperative and intraoperative BP and IV fluids were recorded. Chi-Square and Fisher's exact tests were used to compare differences between the two groups; p < 0.05 was considered significant.

Results: There were no differences between the two groups in terms of demographics, indication for elective cesarean section, operative time, gestational age, 1 and 5-min Apgar scores, and the means of preoperative and postoperative systolic and diastolic BP. A statistically significant increase was observed in terms of hypotension, postoperative analgesia, pre-induction and intraoperative IV fluids in the spinal group as compared to the general anesthesia group (p < 0.001, p < 0.01, and p < 0.01, respectively).

Conclusion: Spinal anesthesia is as effective as a general anesthesia. Maternal and fetal outcome are favorable. Maternal hypotension can be managed successfully with modest doses of ephedrine and IV fluid infusions. It provides sufficient postoperative analgesia allowing the mother to have more vitality and comfort than those who receive general anesthesia.