Effects of general and regional anesthesia on the neonate (a prospective, randomized trial)

Abstract

Anesthetic methods used during cesarean section have advantages and disadvantages to both mothers and infants and may result in short and long term neonatal effects. Objective : To determine the effects of general and regional anesthesia on the infants, a prospective, randomized trial was performed in Siriraj Hospital, Mahidol University. Material and Method : 341 uncomplicated pregnant women who were to be delivered at term by Cesarean section were recruited and randomized to receive general anesthesia, GA (103); epidural anesthesia, EA (120) and spinal anesthesia, SA (118). The immediate fetal and neonatal effects were assessed by cord blood gas analysis and the infant's Apgar scores. The Neurologic and Adaptive Capacity Scores (NACS) was performed within 4 hours after birth by two pediatricians who were blind to the anesthetic method. Result : Maternal age, weight, height, duration of the operation and infants' birth weight were not different among the study groups. In the EA and SA group, maternal systolic blood pressure decreased more than 20 per cent from the baseline in more than half. The infants' Apgar scores at 1 and 5 minutes were 8.3±1.9; 8.2±1.6; 6.7±2.8, and 9.7±0.9; 9.8±0.7; 9.2±1.6 in EA, SA and GA group respectively. The adaptive capacity, active tone, passive tone, general assessment and primary reflexes of the NACS were not statistically different. Conclusion: Apgar scores of the infants whose mothers received general anesthesia were lower than infants whose mothers received regional anesthesia but the NACS were not statistically different among the three study groups.