Comparison of the Effects of Induction before and after Surgical Preparation on Neonatal Well-being in General Anesthesia for Elective Cesarean Section

Kim, Dong Yeon; Seo, Yun Pyo; Chung, Mi Hwa; Lee, Sung Woo; Won, Rim Soo

Abstract

BACKGROUND: Generally, in order to decrease the fetal exposure time from anesthetic drugs, anesthetic induction is conducted after the completion of surgical preparation in general anesthesia for cesarean section. However, this method, in decreasing the fetal exposure time from anesthetic drugs, has been regarded as also aggravating the feeling of anxiety and fear of the patients. The purpose of this research is to compare the result of anesthetic induction conducted before and after surgical preparation in relation to the well-being of the newborn.
METHODS
Fifty healthy women scheduled for elective cesarean section, not in labor, with no signs of fetal distress were randomly divided into 2 groups. Group A (n = 25) started anesthetic induction after surgical preparation and group B (n = 25) started before surgical preparation. Induction to delivery (I-D) interval and uterine incision to delivery (U-D) interval were measured and for the evaluation of the neonatal outcome, blood gas analysis at umbilical vein and artery, 1 and 5 min Apgar scores, and neurobehavioral test at 15 min, 2 hr and 24 hr of age, respectively, were performed.
RESULTS
There was a significant difference in the I-D interval (P < 0.05) but no significant difference in the U-D interval between the two groups. Blood gas analysis, acid-base status, Apgar score and neurologic and adaptive capacity score (NACS) all did not differ significantly between the two groups.
CONCLUSIONS
From our results, the induction before surgical preparation did not seem to affect neonatal well-being significantly. Therefore, when patients without fetal distress are very anxious, anesthetic induction before surgical preparation would reduce the patient's anxiety and fear without neonatal depression in general anesthesia for cesarean section.