scholarly journals Influence of Spinal and General Anesthesia on Newborn’s Status

2015 ◽  
Vol 69 (2) ◽  
pp. 65-70
Author(s):  
Emilija Ivanov ◽  
Dafina Karadzova ◽  
Sotir Nikolovski ◽  
Atanas Sivevski ◽  
Kiro Curlinov ◽  
...  
Keyword(s):  
Caesarean Section ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Apgar Score ◽  
Base Excess ◽  
Rocuronium Bromide ◽  
Apgar Scores ◽  
Ph Values ◽  
Vital Parameters

AbstractIntroduction. The number of caesarean sections has drastically increased and thus arose the idea to examine the effect of the type of anesthesia on the neonates. The objective was to compare vital parameters in the neonates, born under general and spinal anesthesia.Method. A total of 120 patients with need for caesarean section have been divided in two groups of 60, of which the first was lead in general and the second one in spinal anesthesia. The first one was given propophol (2.0-2.5 mg/kg/tt) and succinil colin (1-1.5 mg/kg/tt). The anesthesia was lead with fentanil 0,005 mg/kg/tt and rocuronium bromide 0.4-0.6 mg/kg/tt. O2:N2O was 3:3 l/min. The second group was lead in spinal anesthesia. 2-3 ml Bupivacain 0.5% was spinally applied between L2-L3. Apgar score was defined in the neonates in the first and fifth minutes. The acido-basic status of the neonate was examined through pH values in the blood and the base excess.Results. In the first minute after birth giving with Apgar, 8 newborns 37(61,67%) were born to the group of patients with SA and 29 (48.33%) to the group of patients with GA. In 11 (18.33%) newborns born to the patients led with SA had Apgar score of 9-10, while only 3 (5%) of the newborns born to the patients led with GA had Apgar score of 9-10. Similar ratio was noted in the fifth minute after birth. Ph of the newborns’ blood as well as the base excess (BE) demonstrated significantly lower values in the group of patients led with SA than in the group of patients led with GA. Ph = 7.33 vs 7.37; BE=-4.57±1.8 vs -2.96±2.3.Conclusion. The newborns from the second group had significantly higher Apgar scores than those in the first group. The newborns’ relative acidose (lower SpO2and BE) did not affect the newborns’ Apgar score in the first and fifth minute.

scholarly journals General versus Spinal Anesthesia During Caesarean Section; A Narrative Review

2019 ◽  
Author(s):  
Zahid Hussain Khan ◽  
Negar Eftekhar ◽  
Rafah Sabah Barrak
Keyword(s):  
Family History ◽  
Caesarean Section ◽  
Cesarean Section ◽  
Comparative Study ◽  
General Anesthesia ◽  
Medical History ◽  
Spinal Anesthesia ◽  
Narrative Review ◽  
Included Patient

This research is a method review type, comparative study between the effects of General anesthesia versus those of spinal anesthesia during caesarean section on the newborns and the mother undergoing cesarean section. The variables considered in the study included patient family history, patient medical history, status of patient during pregnancy, age of patient, and emergency or planned cesarean. Both general and spinal methods of anesthesia had differing results in multiple aspects and effects both during and after the surgery. However, pros of spinal anesthesia topped those of general anesthesia and is therefore the more favorable method of anesthesia.

scholarly journals PENGARUH HIPOTENSI IBU TERHADAP APGAR SKOR BAYI YANG LAHIR SECARA SEKSIO SESAREA DENGAN ANESTESIA SPINAL DI RSU. PROF. DR. R. D. KANDOU MANADO PERIODE APRIL-NOVEMBER 2013

e-CliniC ◽  
2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Nia J. M. Lahida
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Apgar Score ◽  
Medical Records ◽  
Systolic Pressure ◽  
Common Complication ◽  
Sympathetic Block ◽  
Apgar Scores ◽  
New Born ◽  
Anesthesia Technique

Abstract: Spinal anesthesia is a regional anesthesia technique that is widely used in cesarean section surgery . The most common complication in spinal anesthesia is hypotension that occurs due to sympathetic block. It caused maternal hypotension and decreased uteroplacental perfusion and intervillous perfusion affecting the transfer of oxygen and nutrients to the fetus, causing fetal intrauterine stress which can lower baby’s Apgar score. Low Apgar scores can be found in women who experienced a decrease in systolic pressure reaches 90-100 mmHg for 15 minutes. The duration of hypotension has greater effect on apgar score than the severity of the hypotension. Objective: To analyze the effect of maternal hypotension to Apgar score of babies born with spinal anesthesia by cesarean section in RSU Prof. . R. D. Kandou Manado. Hypothesis: Hypotension has effect on Apgar score of new born babies with spinal anesthesia by cesarean section. Duration of hypotension has greater influence than the severity of the hypotension. Methods: Collecting data from medical records of patients who experienced maternal hypotension. The criteria of hypotension is  when there is a decrease of systolic hypotension ≤ 100 mmHg. Noting the decreased systole, duration of hypotension, and Apgar scores. Results: Out of 32 samples, most babies which is 23 cases of them ( 72 % ) has decreased Apgar scores which were categorized into mild asphyxia , and 16 of them experienced interval of hypotension in 10 minutes. The longer the hypotension that occurs decrease the Apgar scores. Conclusion: Hypotension have an effect to Apgar score of the new born babies with spinal anesthesia by cesarean section. The duration of hypotension has greater effect on apgar score than the severity of the hypotension. Keywords: spinal anesthesia, Apgar scores, hypotension.   Abstrak: Anestesia spinal merupakan salah satu teknik anestesia regional yang banyak digunakan dalam operasi seksio sesarea. Komplikasi yang tersering pada anestesia spinal adalah hipotensi yang terjadi karena blok simpatis. Hipotensi maternal menyebabkan hipoperfusi dari uteroplasental dan penurunan perfusi intervillous yang mempengaruhi transfer oksigen dan nutrisi janin sehingga menyebabkan stress janin intra uterin yang dapat mempengaruhi kondisi bayi lair dengan apgar skor yang rendah. Apgar skor rendah dapat ditemukan pada ibu yang mengalami penurunan tekanan sistolik yang mencapai 90 - 100 mmHg selama 15 menit. Faktor lamanya hipotensi lebih besar pengaruhnya daripada besarnya hipotensi. Tujuan: Menganalisis pengaruh kejadian hipotensi ibu terhadap apgar skor bayi yang lahir secara seksio sesarea dengan anestesia spinal di RSU Prof. R. D. Kandou Manado. Hipotesis: Hipotensi berpengaruh terhadap apgar skor bayi yang lahir secara seksio sesarea dengan anestesia spinal. Lamanya hipotensi lebih besar pengaruhnya daripada besarnya hipotensi. Metode: Mengumpulkan data dari rekam medik dari pasien yang mengalami hipotensi maternal. Dikatakan hipotensi bila terjadi penurunan sistol ≤100 mmHg. Mencatat tekanan darah, lama hipotensi dan apgar skor. Hasil: Dari 32 sampel yang ada, sebagian besar bayi yang lahir yaitu sebanyak 23 kasus (72%) mengalami penurunan apgar skor dan dikategorikan dalam asfiksia ringan sedang, dan 16 diantaranya mengalami interval lama hipotensi 10 menit. Semakin lama hipotensi yang terjadi semakin menurun apgar skor. Simpulan: Hipotensi berpegaruh terhadap apgar skor bayi yang lahir secara seksio sesarea dengan anestesia spinal. Faktor lamanya hipotensi besar pengaruhnya terhadap apgar skor.Kata Kunci: anestesia spinal, apgar skor, hipotensi.

scholarly journals To the question about the influence of regional anesthesia on the contractile function of the uterus

2013 ◽  
Vol 62 (2) ◽  
pp. 144-150
Author(s):  
Vladimir Anatolyevich Pervak
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Blood Cells ◽  
Artificial Ventilation ◽  
Contractile Function ◽  
Qualitative Composition ◽  
Ventilation Of The Lungs

Was held a retrospective analysis of 215 histories parturient women undergoing caesarean section under spinal anesthesia and under general anesthesia in combination with artificial ventilation of the lungs. For both methods of anesthesia maintenance was held compared signs, who indirectly characterizing the contractile function of the uterus ( the amount of blood loss, the amount and the quality of uterotonic therapy, the dynamics of the preoperative and postoperative indicators of hemoglobin, hematocrit, and erythrocytes). As a result of the conducted research it was shown that the amount of blood loss, the amount of and qualitative composition of uterotonic therapy, the dynamics of the preoperative and postoperative indicators of hemoglobin, hematocrit, red blood cells in caesarean sections performed under spinal anesthesia and under General anesthesia in combination with artificial ventilation of the lungs authentically did not differ.

scholarly journals COMPARISON OF NEONATAL APGAR SCORES AND PATIENT SATISFACTION LEVELS IN SPINAL VERSUS GENERAL ANESTHESIA IN ELECTIVE CESAREAN SECTIONS

2021 ◽  
Vol 71 (4) ◽  
pp. 1183-87
Author(s):  
Syed Khurram Naseer ◽  
Aijaz Ali ◽  
Shizan Hamid Feroz ◽  
Dr Danish ◽  
Amir Sohail
Keyword(s):  
Patient Satisfaction ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Elective Cesarean Section ◽  
Military Hospital ◽  
P Value ◽  
Apgar Scores ◽  
Significant Difference ◽  
Elective Cesarean

Objective: To compare patients undergoing cesarean section under spinal and general anesthesia in terms of neonatal APGAR scores and patient satisfaction. Study Design: Comparative cross-sectional study. Place and Duration of Study: Departments of Anesthesia and Gynecology and Obstetrics, Combined Military Hospital Peshawar, for six months from Mar to Aug 2019. Methodology: In this study, 120 females with a singleton pregnancy of 36-40 weeks, and requiring a non-emergency elective cesarean section were enrolled through consecutive sampling in the study. The patients were randomly allocated into two equal groups of 60 women each through random table numbers. Group A received spinal anesthesia and group B general anesthesia. APGAR score was assessed at 5 minutes after delivery, and score of ≥7 was taken as satisfactory. Patient's satisfaction level regarding anesthesia was recorded on a visual analogue scale of 0 (extremely unsatisfied) to 10 (completely satisfied), and score of ≥7 was taken as satisfactory. Results: Women receiving general anesthesia were more satisfied as compared to receiving spinal anesthesia (95% vs. 78.3%; p-value 0.007). There was no significant difference in terms of APGAR scores in general anesthesia and spinal anesthesia (83.33% versus 90%; p-value 0.283). Conclusion: After an elective caesarean section, more mothers were satisfied after receiving general anesthesia as compared to spinal anesthesia. However, both types of anaesthesia were found to be equally safe for babies born in terms of APGAR scores at 5 minutes.

scholarly journals Comparison of maternal and fetal outcomes among patients undergoing cesarean section under general and spinal anesthesia: a randomized clinical trial

2015 ◽  
Vol 133 (3) ◽  
pp. 227-234 ◽  
Author(s):  
Anıl İçel Saygı ◽  
Özkan Özdamar ◽  
İsmet Gün ◽  
Hakan Emirkadı ◽  
Ercüment Müngen ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Apgar Score ◽  
Urine Volume ◽  
Fetal Distress ◽  
Controlled Clinical Trial ◽  
Fetal Outcomes ◽  
General Anesthesia Group

CONTEXT AND OBJECTIVE: As the rates of cesarean births have increased, the type of cesarean anesthesia has gained importance. Here, we aimed to compare the effects of general and spinal anesthesia on maternal and fetal outcomes in term singleton cases undergoing elective cesarean section.DESIGN AND SETTING: Prospective randomized controlled clinical trial in a tertiary-level public hospital.METHODS: Our study was conducted on 100 patients who underwent cesarean section due to elective indications. The patients were randomly divided into general anesthesia (n = 50) and spinal anesthesia (n = 50) groups. The maternal pre and postoperative hematological results, intra and postoperative hemodynamic parameters and perinatal results were compared between the groups.RESULTS: Mean bowel sounds (P = 0.036) and gas discharge time (P = 0.049) were significantly greater and 24th hour hemoglobin difference values (P = 0.001) were higher in the general anesthesia group. The mean hematocrit and hemoglobin values at the 24th hour (P = 0.004 and P < 0.001, respectively), urine volume at the first postoperative hour (P < 0.001) and median Apgar score at the first minute (P < 0.0005) were significantly higher, and the time that elapsed until the first requirement for analgesia was significantly longer (P = 0.042), in the spinal anesthesia group.CONCLUSION: In elective cases, spinal anesthesia is superior to general anesthesia in terms of postoperative comfort. In pregnancies with a risk of fetal distress, it would be appropriate to prefer spinal anesthesia by taking the first minute Apgar score into account.

scholarly journals Puppy Apgar scores after vaginal delivery and caesarean section

2017 ◽  
Vol 62 (No. 9) ◽  
pp. 488-492 ◽  
Author(s):  
R. Titkova ◽  
M. Fialkovicova ◽  
M. Karasova ◽  
J. Hajurka
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Apgar Score ◽  
Evaluation Criteria ◽  
Vital Signs ◽  
Term Survival ◽  
Apgar Scores ◽  
Spontaneous Vaginal Delivery ◽  
Modified Method ◽  
Type Of Delivery

The aim of this study was to evaluate the vital signs of newborn puppies using the modified Apgar score after spontaneous delivery and caesarean section. The survival of puppies was monitored for up to 24 hours after birth. The experiment consisted of ten deliveries of bitches with dystocia terminated by caesarean section (C-section group) and ten bitches with spontaneous vaginal delivery (SVD group). Vital signs of neonates were evaluated using a modified method of the Apgar score 5, 10 and 15 min after birth. Five evaluation criteria (colour of mucous membranes, reflex irritability, motility, heart rate and respiration) were used with puppies classified into three scoring groups: “severe distress” (0–3 points), “moderate distress” (4–6 points) and “no distress” (7–10 points). In the SVD group, 57 puppies were evaluated; 98.2% of puppies were born alive, all survived their first 24 hours of life. At the time of birth, 1.8% of puppies were dead (1/57). The Apgar scores of all foetuses were in the “no distress” category. In the C-section group (n = 37), 13.5% of puppies (5/37) were stillborn, two puppies (6.3%) died within 24 hours of delivery. The “no distress” group included 51.4% (19/37) of puppies, while 5.4% (2/37) of puppies were classified into “moderate distress” and 43.2% of puppies (16/37; P &lt; 0.001 at 5 min, P &lt; 0.005 at 10 min and P &lt; 0.005 at 15 min after delivery) were classified into “severe distress”. These results confirm the influence of type of delivery on the Apgar score immediately after parturition and on the short-term survival rate of puppies after parturition.

scholarly journals Effect of General and Spinal Anesthesia on Hepatic and Renal functions and Hemodynamic parameters of Iraqi Women Undergo Cesarean Section: Comparative Study

2018 ◽  
pp. 78-90
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Liver Enzymes ◽  
Hemodynamic Parameters ◽  
Operative Blood Loss ◽  
Beneficial Effects ◽  
Renal Functions ◽  
Iraqi Women

Both general and spinal anesthesia can be use during caesarean section. Spinal anesthesia is preferred by anesthesiologists and gynecologists because of its beneficial effects for both mothers and their fetuses. They were not affecting the creatinine level but affecting only on elevation of liver enzymes. Spinal anesthesia effect on hemodynamic parameters more than general anesthesia, and it causes less operative blood loss than general anesthesia.

scholarly journals Umbilical Cord Blood Gas Parameters and Apgar Scoring in Assessment of New-Born Dogs Delivered by Cesarean Section

Animals ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 685
Author(s):  
Agnieszka Antończyk ◽  
Małgorzata Ochota ◽  
Wojciech Niżański
Keyword(s):  
Carbon Dioxide ◽  
Partial Pressure ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Apgar Score ◽  
Base Excess ◽  
Blood Gas ◽  
Apgar Scores ◽  
Risk Of Death

The article presents the results of the clinical evaluation (Apgar scores, AS) and umbilical cord blood gas analysis (UCBGA) obtained from clamped umbilical cords of newborn pups delivered by the elective Caesarean section. The study was planned as a controlled clinical study, the newborns were allocated into one of the groups, I—critical neonates (severe distress, AS ≤ 3), II—weak neonates (moderate distress, AS 4–6) and III—healthy neonates (no distress, AS ≥ 7). The following parameters were evaluated: pH (pH units), carbon dioxide partial pressure (pCO2; mmHg), oxygen partial pressure (pO2; mmHg), actual bicarbonate (cHCO3-; mmol/L), total carbon dioxide (cTCO2; mmol/L), base excess of extracellular fluid (BE(ecf); mmol/L), base excess of blood (BE(b); mmol/L), oxygen saturation (csO2; %), lactate (Lac; mg/dl), hematocrit (Hct; %PCV), hemoglobin (cHgb; g/dl), glucose (Glu; mg/dl), ions (Na, K, Ca, Cl). The majority of puppies had low AS at birth (AS 4–6 in 38.1% and AS ≤ 3 in 57.1% of the neonates), but most of them (85.7%) improved by the 20th min. reaching AS of 7 and more. Moreover, puppies with lower AS (≤ 3) were at higher risk of death within the first 24h (20.8% did not survive). The positive correlation was found between Apgar score measured at 0 minute and pH (r = 0.46, p = 0.01), and between Apgar score (at 0 min) and base excess in whole blood measured [BE(b)] r = 0.36, p = 0.03). Whereas, a negative correlation was detected between Apgar score at 0 and 5th minute and glycemia (r = −0.42, p = 0.05, r = −0.34, p = 0.02 respectively. Overall, the puppies with higher glucose levels had lower Apgar scores and were at higher risk of death. Furthermore, in our study, the newborn puppies had mild acidemia with elevated pCO2 levels and the HCO3 at the lower range of normal limits, suggesting the mixed component in the acidemic state. Adaptation to extra-uterine life is crucial and any practical improvement in neonatal diagnostics and care would be beneficial for newborn puppy survival.

Prospective, Randomized Trial Comparing General with Spinal Anesthesia for Cesarean Delivery in Preeclamptic Patients with a Nonreassuring Fetal Heart Trace

2003 ◽  
Vol 99 (3) ◽  
pp. 561-569 ◽  
Author(s):  
Robert A. Dyer ◽  
Ilse Els ◽  
Josef Farbas ◽  
Gregory J. Torr ◽  
Leann K. Schoeman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Fetal Heart ◽  
Base Deficit ◽  
Apgar Scores ◽  
Anesthesia Group ◽  
Arterial Ph ◽  
Umbilical Arterial Ph

Background There are no randomized studies on neonatal outcome after spinal versus general anesthesia for cesarean delivery in preeclamptic patients with a nonreassuring fetal heart trace. This study examined both markers of neonatal hypoxia and maternal hemodynamics. Methods Seventy patients were randomized to general (n = 35) or spinal anesthesia (n = 35). The general anesthesia group received thiopentone, magnesium sulfate, and suxamethonium intravenously before intubation, followed by 50% nitrous oxide in oxygen, 0.75-1.5% isoflurane, and morphine after delivery. The target end-tidal partial pressure of carbon dioxide (Pco2) was 30-34 mmHg. The spinal anesthesia group received 1.8 ml hyperbaric bupivacaine plus 10 microg fentanyl at the L3-L4 interspace. Heart rate and blood pressure were measured at specific time points. Hypotension was treated with ephedrine. Maternal arterial and neonatal umbilical arterial blood gas samples were taken at delivery. Resuscitation requirements were recorded. Results In both groups, hemodynamic measures remained within acceptable limits. Spinal anesthesia patients required more ephedrine (13.7 vs. 2.7 mg). Maternal Paco2 was lower in the spinal group (28.9 vs. 32.4 mmHg). One-minute Apgar scores were lower after general anesthesia. Base deficit was greater (7.13 vs. 4.68 mEq/l) and neonatal umbilical arterial pH was lower (7.20 vs. 7.23) after spinal anesthesia. Post hoc analysis showed that if maternal diastolic blood pressure on admission was greater than 110 mmHg, neonatal umbilical arterial base deficit was greater after spinal anesthesia. There was no difference in the number of patients with Apgar scores less than 7 at 1 or 5 min or umbilical arterial pH less than 7.2 or in the requirements for resuscitation. Conclusions In preeclamptic patients with a nonreassuring fetal heart trace, spinal anesthesia for cesarean delivery was associated with a greater mean neonatal umbilical arterial base deficit and a lower median umbilical arterial pH. The clinical significance remains to be established. Maternal hemodynamics were similar and acceptable with either anesthetic technique.

scholarly journals Comparison of The Effects of General and Spinal on Apgar Scores of Babies Born Through Caesarean Section in RSUP Haji Adam Malik Medan from 2018 to 2019

2021 ◽  
Vol 3 (4) ◽  
pp. 132-138
Author(s):  
Aldo Putra Rambe ◽  
Akhyar Hamonangan Nasution ◽  
Cut Meliza Zainumi ◽  
Nova Zairina Lubis
Keyword(s):  
Cesarean Section ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Apgar Score ◽  
Newborn Infants ◽  
Secondary Data ◽  
Cross Sectional ◽  
Advantages And Disadvantages ◽  
Analytic Design ◽  
Minute Apgar Score

Background. General anesthesia and spinal anesthesia in cesarean section both have advantages and disadvantages. The scoring system of APGAR is a standardized tool that can inform the condition of newborn infants, which might be influenced by gestational age, medication, resuscitation, cardiorespiratory and neurological conditions of the mother. This study aimed to compare the effect of general and spinal anesthesia usage to the APGAR score of newborn infants at Haji Adam Malik General Hospital Medan. Methode. This study uses an observational-analytic design with a cross-sectional approach,  conducted using secondary data through the medical records of mothers who gave birth through cesarean section and obtained at the Medical Record Installation at the Haji Adam Malik Hospital Medan from 2018 to 2019. Result. In spinal anesthesia, there are 52 samples for a score of 8-10. Whereas in general anesthesia, there are 52 samples to score 8-10. The APGAR score of 1 minute in infants born through cesarean section under spinal anesthesia had an average of 8.63, with general anesthesia of 8.00 (p=0.001). The 5-minute APGAR score in infants born through cesarean section under spinal anesthesia had an average of 9.85, and with general anesthesia of 8.67 (p=1.000). Conclusion: The 1-minute APGAR score for infants using spinal anesthesia showed a statistically better effect than the 1-minute APGAR score for infants using general anesthesia.

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