Comparison of Effects of General Anesthesia and Combined Spinal/Epidural Anesthesia for Cesarean Delivery on Umbilical Cord Blood Gas Values: A Double-Blind, Randomized, Controlled Study

Abstract

BACKGROUND The objective of this study was to analyze the effects of general anesthesia in cesarean section on the umbilical cord blood gas values and intraoperative hemodynamics of parturient women. MATERIAL AND METHODS A total of 112 parturient women who received cesarean section were eventually randomized into 2 groups, GA (general anesthesia) group (n=56), and SE (combined spinal and epidural anesthesia) group (n=56). The umbilical cord blood gas values, postpartum Apgar score, intraoperative blood loss, mean arterial pressure, heart rate, total operative time, time intervals from anesthesia to delivery and from skin incision to delivery, the incidences of adverse reactions and neonatal asphyxia, and the postoperative patient satisfaction were compared between the 2 groups. RESULTS There were no significant differences between the 2 groups in total operative time, Apgar score, neonatal asphyxia rate, umbilical arterial and venous cord blood gas values, intraoperative blood loss, and time interval from skin incision to delivery (all P˃0.05). The GA group was significantly shorter in the time interval from anesthesia to delivery than the SE group (P˂0.05). The incidences of nausea, vomiting, and chills in the GA group were significantly lower than those in the SE group (all P˂0.05). The GA group was significantly higher in postoperative patient satisfaction than the SE group (P˂0.05). CONCLUSIONS General anesthesia has little impact on the umbilical cord blood gas values and Apgar score, and ensures better hemodynamic stability in cesarean section. Moreover, general anesthesia is characterized by rapid induction and is therefore valuable for use in clinical procedures.

Figure 1

CONSORT flow chart.

Figure 2

Comparison of surgical data. (A) Comparison of total operative time (minutes). (B) Comparison of intraoperative blood loss (mL). (C) Comparison of time interval from anesthesia to delivery (minute). (D) Comparison of time interval from skin incision to delivery (minute). *** P<0.001. GA group – general anesthesia group; SE group – combined spinal and epidural anesthesia group.

Figure 3

Comparison of hemodynamics. (A) Comparison of HR between 2 groups. (B) Comparison of MAP between 2 groups. *** P<0.001. GA group – general anesthesia group; SE group – combined spinal and epidural anesthesia group; HR – heart rates; MAP – mean arterial pressure.