Neonatal wellbeing after elective caesarean delivery with general, spinal, and epidural anaesthesia.
A comparison was made of the acid-base and Apgar status of neonates following general (n = 34), spinal (n = 28) and epidural (n = 23) anaesthesia for elective caesarean section. Neonates delivered following spinal anaesthesia were more acidaemic (pH = 7.249) (P < 0.05) than those delivered following epidural (pH = 7.291) or general anaesthesia (pH = 7.296) despite measures taken to minimize hypotension. The percentage of neonates with a 1 min Apgar score > or = 7 was 96% after epidural anaesthesia, 93% after spinal anaesthesia and 75% after general anaesthesia. The difference between epidural and general anaesthesia was significant (P < 0.05). Using these two measures of neonatal wellbeing, epidural anaesthesia provided the most favourable outcome.
Nuffield Department of Anaesthetics, John Radcliffe Hospital, Headington, Oxford, UK.
F M
FM
Ratcliffe
J M
JM
Evans
D000136:Acid-Base Equilibrium / Q000502:physiology*; D000138:Acidosis / Q000097:blood; D000328:Adult; D000767:Anesthesia, Epidural / Q000379:methods; D000768:Anesthesia, General / Q000379:methods; D000773:Anesthesia, Obstetrical / Q000379:methods; D000775:Anesthesia, Spinal / Q000379:methods; D001034:Apgar Score; D001794:Blood Pressure / Q000502:physiology; D002245:Carbon Dioxide / Q000097:blood; D002585:Cesarean Section; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007022:Hypotension / Q000517:prevention & control; D007231:Infant, Newborn / Q000502:physiology*; D010100:Oxygen / Q000097:blood; D011247:Pregnancy; D011446:Prospective Studies; D014469:Umbilical Arteries; D014471:Umbilical Veins
D002245:Carbon Dioxide; D010100:Oxygen