title: Maternal and umbilical cord oxygen content and acid-base balance in relation to general, epidural or subarachnoid anesthesia for term elective cesarean section.
abstract: OBJECTIVE
  To compare maternal and neonatal oxygenation and acid-base status after elective cesarean section (CS) under different anesthetic techniques.
  
  
  METHODS
  Three hundred and eighty parturients undergoing elective cesarean section were randomly assigned to receive general (GA, n =140), epidural (EA, n = 117) or subarachnoid anesthesia (SA, n =123). Blood gases, oxygen content, and acid-base status parameters were measured in maternal artery and umbilical cord vessels. Neonatal Apgar scores were also recorded.
  
  
  RESULTS
  Umbilical artery pH, HCO3-, and actual base excess (ABE) were significantly higher in the GA compared to SA group (p < 0.001, p < 0.05, andp < 0.05, respectively). Umbilical vein ABE was lower in the SA compared to GA and EA groups (p < 0.05). Oxygen content in maternal artery was higher in the GA and EA groups compared to the SA group (p < 0.05). Neonatal oxygen content in both cord vessels was higher in the GA group compared to EA and SA groups (p < 0.05). Umbilical venous-arterial difference of PO2, oxygen content, and Apgar scores did not differ significantly among groups.
  
  
  CONCLUSIONS
  Neonatal oxygenation and acid-base status values were better preserved when GA was administered for elective CS compared to regional modalities. Apgar scores and neonatal outcomes were not affected by the anesthetic technique.
authors.affiliation: 1st Department of Anesthesiology, Aretaieio Hospital, Medical School, University of Athens, Athens, Greece. c_staikou@yahoo.gr
authors.forename: C
authors.initials: C
authors.lastname: Staikou
authors.forename: A
authors.initials: A
authors.lastname: Tsaroucha
authors.forename: P
authors.initials: P
authors.lastname: Vakas
authors.forename: N
authors.initials: N
authors.lastname: Salakos
authors.forename: D
authors.initials: D
authors.lastname: Hasiakos
authors.forename: K
authors.initials: K
authors.lastname: Panoulis
authors.forename: G
authors.initials: G
authors.lastname: Petropoulos
mesh_terms: D000136:Acid-Base Equilibrium / Q000502:physiology*; D000328:Adult; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D001034:Apgar Score; D002585:Cesarean Section; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010100:Oxygen / Q000378:metabolism*; D013346:Subarachnoid Space; D014470:Umbilical Cord / Q000378:metabolism*
chemical_list: D010100:Oxygen