Which Should Be Performed; General or Spinal Anesthesia in Elective Cesarean Section?

INTRODUCTION: We aimed to determine the advantages and disadvantages of both techniques by comparing maternal and fetal outcomes in patients who underwent elective cesarean section with general anesthesia or spinal anesthesia.
METHODS: 100 pregnant women who underwent elective cesarean operation due to recurrence history of cesarean section count between 1 and 3 were included. Cases with pregestational or gestational morbidity were excluded. The pregnancies were randomly divided into two equal groups. General anesthesia was performed in cases group I and spinal anesthesia was performed in cases group II. Demographic datas of pregnants, fetal delivery time, duration of operation, preoperative (preop) and postoperative (postop) hemoglobin (hb) and hematocrit (htc) levels, operative blood loss, APGAR (Activity, Pulse, Grimace, Appearance, Respiration) score and umblical artery pH test, which are used in the evaluation of asphyxia and fetal well-being were compared in two groups.
RESULTS: The age, gravida, parity, birth week and the birth weight of newborns were similar in general anesthesia and spinal anesthesia cases (p> 0.05). There was no statistically significant difference between preop and postop hb and htc in groupI and grupII. When the groups were compared in terms of operative blood loss (Preoperative hb- Postoperative hb, Preoperative htc- Postoperative htc), the difference was not significant while the general anesthesia group had more blood loss (p = 013, p = 0.10 respectively). In both groups, the 1st and 5th minute apgar scores and umbilical artery pH values were similar (p=0.88, p=0.43, p=0.11 respectively). However, when 1st and 5th minute apgar scores were evaluated in both groups 5th minute apgar scores were significantly higher than 1st minute apgar (P <0.001, P <0.001).
DISCUSSION AND CONCLUSION: It is found that maternal and fetal outcomes of both anesthesia techniques are similar in elective cesarean section cases. When choosing anesthesia technique in elective cesarean section operation, comorbidity of the pregnancy, urgency of operation, experience of anesthetist, expectancy and preference of mother should be taken into consideration.