Korean J Anesthesiol.  2003 Nov;45(5):622-626. 10.4097/kjae.2003.45.5.622.

Comparison of Neonatal Effects during General Anesthesia Using Sevoflurane and Spinal Anesthesia for Elective Cesarean Section

• Kim KU
• Lee JH
• Ban JS
• Min BW

• KMID: 1935952
• DOI: http://doi.org/10.4097/kjae.2003.45.5.622

Abstract

BACKGROUND: The study was designed to compare neonatal outcome biochemically and clinically. We examined the administration of sevoflurane below 1.0% with 50% oxygen and 50% nitrous oxide and spinal anesthesia during elective cesarean section.
METHODS
The study examined 60 parturients, who were planned after 36 weeks gestation, ASA I-II, at term undergoing elective cesarean section, and who were allocated to receive 1.0% sevoflurane with 50% oxygen and 50% nitrous oxide (n = 30), and spinal anesthesia (n = 30). General anesthesia was induced with thiopental 5 mg/kg followed by succinylcholine 1.0 mg/kg to facilitate tracheal intubation. Parturients received sevoflurane given in a 50 : 50 oxygen and nitrous oxide mixture, using 0.5-1.0% progressive incremental dosing up to 1.5-2.0 MAC. Spinal anesthesia involving a spinal injection of 8 mg hyperbaric (plain) bupivacaine 0.5% with 20microgram fentanyl was added. A systolic blood pressure of less than 90 mmHg or a reduction in the systolic pressure of greater than 20% from baseline was considered as hypotension and treated with a bolus of 5 mg of intravenous ephedrine. We studied neonatal data including umbilical artery gas analysis results and Apgar scores at 1 and 5 min.
RESULTS
Comparing the general and the spinal anesthetic groups, no significant differences could be detected in neonatal outcome biochemically or clinically.
CONCLUSIONS
Anesthesia type does not seem to influence the biochemical or clinical results of the neonates delivered by elective cesarean section. We believe that both general anesthesia with sevoflurane and spinal anesthesia could be performed in elective term cesarean sections without risk to neonates.

Keyword

cesarean section; neonate; sevoflurane; spinal

MeSH Terms

Anesthesia
Anesthesia, General*
Anesthesia, Spinal*
Blood Pressure
Bupivacaine
Cesarean Section*
Ephedrine
Female
Fentanyl
Humans
Hypotension
Infant, Newborn
Injections, Spinal
Intubation
Nitrous Oxide
Oxygen
Pregnancy
Succinylcholine
Thiopental
Umbilical Arteries
Bupivacaine
Ephedrine
Fentanyl
Nitrous Oxide
Oxygen
Succinylcholine
Thiopental