Anesthesia Type in C-Sections: Preterm Outcomes Unaffected


WASHINGTON — No significant differences in neonatal outcomes were found among premature infants of women who had spinal anesthesia versus general anesthesia for cesarean delivery, based on the results of a study of 78 deliveries.

Most data on anesthesia and elective C-sections come from studies of term infants, said Dr. Robin Russell and colleagues at the John Radcliffe Hospital in Oxford, England. Data from one recent review of premature infants suggested that neonatal mortality risk was greater with spinal anesthesia than with general anesthesia, the researchers noted.

In this study, Dr. Russell and associates reviewed information from 78 women who were delivered at less than 33 weeks' gestation at a single hospital (69 singleton and 9 twin deliveries); the average age of the women was 31 years. The results were presented in a poster at the annual meeting of the Society for Obstetric Anesthesia and Perinatology.

Spinal anesthesia (SA) was used in 58 cases, general anesthesia (GA) in 18 cases, and an epidural in 2 cases. The researchers compared the outcomes for the SA and GA cases based on Apgar scores and umbilical blood gas levels.

Overall, Apgar scores were not significantly different between the spinal and general anesthesia groups. The median 1-minute Apgar score was 8 in the SA group (range, 2-10) and 7 in the GA group (range, 3-9), and the median 5-minute Apgar scores were 8 in the SA group and 9 in the GA group.

Measures of umbilical venous gases were available for 49 SA deliveries and 15 GA deliveries, and measures of umbilical arterial gases were available for 51 SA deliveries and 13 GA deliveries. Based on these measures, there were no significant differences between the groups.

In addition, the birth weights were similar between the two groups, and no significant differences were observed in the health of the infants at 28 days or 3 months of age.

The results contrast with findings from previous research, but the study was limited by its small size and retrospective design, the researchers said. “Further work is needed to determine the optimal mode of anesthesia for cesarean section in premature infants,” they wrote. The investigators reported that they had no financial conflicts to disclose.

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