Assessment of the Optimal Anaesthesia Technique for Caesarean Section and Clinical Effects on Mothers and Newborns

Abstract

Objective: Regional anaesthesia is mostly preferred for elective caesarean delivery. This study aimed to compare general, epidural and spinal anaesthesia techniques in terms of their foetal and maternal effects. Methods: Parturients undergoing elective caesarean delivery were randomly divided into three groups: general anaesthesia (GA), epidural anaesthesia (EA), and spinal anaesthesia (SA). The APGAR score, foetal blood gas level, free O-2 requirement and positive-pressure ventilation, phototherapy requirement, bilirubin level and weight loss were recorded. The time to the first breastfeeding, perioperative bleeding, crystalloid requirement, ephedrine consumption, first analgesic requirement, the time of defaecation and mobilization were also measured. Results: The APGAR scores and SpO(2) were lower in the GA group (p<0.05). Six newborns required O-2 supply and positive-pressure ventilation and one newborn from the GA group was intubated and transferred to the NICU. The time to first breastfeeding was prolonged in the GA group compared with the other groups (p<0.05). Postnatal 48-hour weight loss of the newborns was higher in the EA and SA groups than in the GA group (p<0.05). Peropertive bleeding was higher in the GA group. In the SA group, ephedrine and fluid requirements were higher and the mobilization time was shorter (p<0.05). The first analgesic requirement and defaecation time were shorter in the EA group (p<0.05). Conclusion: With general anaesthesia, there are lower APGAR scores, a requirement for a free O-2 supply and more frequent positive-pressure ventilation and a longer time to the first breastfeeding compared to those with regional anaesthesia. Therefore, regional techniques are preferable for caesarean delivery.