General versus spinal anaesthesia for elective caesarean sections: effects on neonatal short-term outcome. A prospective randomised study.
OBJECTIVE
To compare neonatal short-term outcome in patients who underwent spinal, general anaesthesia and conversion from spinal to general anaesthesia.


METHODS
One hundred seventy-nine pregnant women undergoing elective caesarean section were allocated randomly to general (n=89) or spinal anaesthesia (n=90) and compared with 63 patients who required conversion to general anaesthesia. Umbilical cord artery pH, Apgar score as well as its individual parameter and need for assisted ventilation were evaluated.


RESULTS
No differences were found in pH values (p=0.35), while the need for assisted ventilation differed significantly (p=0.001). The rate of depressed newborns was 1.1% in the spinal group, 25.9% in the general group and 12.7% in the conversion group with a significant difference for all comparisons. At 5-min, all newborns were vigorous. At 1 min, a higher score for each parameter was found in spinal group with respect to general group, while 'activity', 'grimace' and 'respiration' showed a higher score in conversion group than in general group. At 5 min, a difference was found only for 'activity'.


CONCLUSIONS
All kinds of anaesthesia seem to be safe, but loco-regional blockade shows more advantages on the neonatal outcome also when a conversion is necessary.
Mancuso
Alfredo
A
Department of Gynaecological, Obstetrical Sciences and Reproductive Medicine, University of Messina, Messina, Italy.
De Vivo
Antonio
A
Giacobbe
Annamaria
A
Priola
Valentina
V
Maggio Savasta
Laura
L
Guzzo
Marianna
M
De Vivo
Dominique
D
Mancuso
Alba
A
D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects / Q000379:methods; D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects / Q000379:methods*; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods*; D001034:Apgar Score; D001784:Blood Gas Analysis; D002585:Cesarean Section; D005260:Female; D005312:Fetal Blood; D006801:Humans; D007231:Infant, Newborn; D057240:Patient Preference; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome