Effect of General Anesthesia Compared to Regional Anesthesia on the Apgar Score of Neonates

Omar S Almomani

doi:10.52981/sjms.v7i3.837

Omar S Almomani

DOI: https://doi.org/10.52981/sjms.v7i3.837

Keywords: Apgar score, Cesarean section, General Anesthesia, Regional anesthesia.

Abstract

Background: cesarean section (CS) is one of the common operations performed in obstetric practice worldwide; it can be conducted as elective or emergency operation.
Objective: to assess the effect of different types of anesthesia used during conducting elective cesarean sections (CS) on the health of neonates by using the Apgar score.
Method: a prospective study conducted in Royal medical Services hospitals in Jordan between Jan. 2011 and May 2012.All pregnant women planned for elective CS were included in this study. Women of eventful pregnancy or intra uterine fetal growth retardation or malformation were excluded from the study. 161 healthy pregnant women underwent elective CS were included in this study. The patients were divided into 3 groups; the 1st one received general anaesthesia (GA) (group A) and consists of 104 patients, group B consists of patients who received spinal anesthesia (42 patients) and group C consists of patients who received epidural anesthesia (15 patients).

Results: at one minute 62.5% of patients in group A had normal Apgar score while in group B and C about 80% had normal scores. At five minutes 87.5% of patients in group A had normal Apgar score while in group B and C about 93% had normal scores. There was no statically difference between the three groups in regard to Apgar score at 10 minutes.
Conclusion: General anesthesia adversely influences the short term outcome of infants born to mothers by elective cesarean section. Regional anesthesia is safe and well tolerated for the mother and the neonate and should be considered when there is a choice during cesarean section.

References

1.Tekin I, Laçin S, Arýca I et al. Factors influencing patient preferences of anesthesia type for caesarean section. Türkiye Klinikleri J Anest Reanim 2005; 3: 1- 6.
2. Hawkins JL, Gibbs CP, Orleans M et al. Obstetric anesthesia work force survey, 1981 versus 1992. Anesthesiology 1997; 87: 135-143.
3. Apgar, Virginia. A proposal for a new method of evaluation of the newborn infant.Curr. Res. Anesth. Analg.1953;32 (4): 260–267.
4. Judith Littleford.Effects on the fetus and newborn of maternal analgesia and anesthesia: a review. CAN J ANESTH 2004; 51 (6): 586–609.
5. GoriF., PasqualucciA., CorradettiF.. Maternal and neonatal outcome after cesarean section: The impact of anesthesia. 2007; 20, (1): 53-57.
6. Fox GS, Smith JB, Namba Y et al. Anesthesia for cesarean section: further studies. Am J Obstet Gynecol 1979;133:15-9.
7. Crawford JS, Davies P. Status of neonates delivered by elective caesarean section. Br J Anaesth 1982;54:1015-22.
8. OngB. Y., CohenM M, PalahniukR J. Anesthesia for Cesarean Section-Effects on Neonates. Anesth Analg 1989;68:270-5.
9. AbboudT K., NagappalaS, MurakawaK et al. Comparison of the Effects of General and Regional Anesthesia for Cesarean Section on Neonatal Neurologic and Adaptive Capacity Scores. Anesth. Analg.1985;64:996-1000.
10. Kolatat T, Somboonnanonda A, Lertakyamanee J,et al. Effects of general and regional anesthesia on the neonate (a prospective, randomized trial). J Med Assoc Thai. 1999;82(1):40-5.