[Comparison between the effects of epidural and spinal anesthesia for selective cesarean section]

Abstract

This study is proposed to compare the analgesic and side effects of different types of anesthesia used for Cesarean section (CS). Based on the use of CS inpatients, of whom 27 were without and 20 with previous CS experience, 47 cases were randomized into two groups: 21 epidural and 26 spinal anesthesia. Visual analogue scale was used to measure the pain score in seven stages (p1-p7): skin incision, peritoneum incision, abdominal wall retraction, delivering neonate, uterus exteriorization, checking bleeding and suturing skin, respectively. Significantly higher pain scores were found in epidural than spinal anesthesia during p1 to p4. However no significant differences were found during p5 to p7. This may be due to post-delivery intravenous injection of other analgesics and sedatives. No significant differences in hypotensive rate were found between epidural and spinal anesthesia (RR = 1.04, 95% C.I. = 0.93-1.17). There were also no significant differences in occurrence of tachycardia either according to definition (PR > or = 100 beats/min or 120% of baseline pulse rate) or clinical judgement (tachycardia resulted from hypotension). (According to definition:RR = 1.08, 95% C.I. = 0.91-1.27; clinical judgement:RR = 0.83, 95% C.I. = 0.35-1.95). If clinical judgement is used as the gold standard, sensitivity and specificity were 100% and 12.5% respectively. The rate of nausea and vomiting in the epidural group was only half of that of spinal group, but was not statistically significant (RR = 0.5, 95% C.I. = 0.18-1.36). Based on the above, no significantly better effects on blood pressure and pulse rate in epidural, rather than spinal, anesthesia were found.(ABSTRACT TRUNCATED AT 250 WORDS)