Effects of General and Spinal Anesthesia With Marcaine on Maternal Hemodynamic and Newborns’ Apgar Score

2005 
Background: Several investigations on safe anesthesia in preeclamptic parturients show that general anesthesia has greater risk than spinal anesthesia. This study was conducted on preeclamptic parturients to show spinal anesthesia with slow acting drugs not only accompanying stable maternal hemodynamic but also can bypass difficult intubation and consecutive hypoxia. Materials and Methods: It was a randomized clinical trial study (RCT). After we received institutional ethics committee approval and informed patient consent, all preeclamptic parturients aged 18-40 yr and scheduled to undergo elective cesarean section, were randomly divided in two groups: general anesthesia with sodium thiopental 5 mg/kg and succinylcholine 1.5 mg/kg IV, and spinal anesthesia with marcaine 2mg plus epinephrine 0.2 mg CSF. Blood pressure was measured at 1 st , 5 th , 10 th & 15 th minutes and Apgar scores of 1 st and 5 th minutes were recorded. Data analysis was achieved using chi-square test and SPSS soft ware. Results: There was no significant difference regarding the age and body weight prior to study. IV fluid intake was greater in spinal than general anesthesia (P=0.026). There was no significant difference between desirable and undesirable apgar score of 5 th minute (P>0.05). Undesirable apgar score of first minute was greater in general than spinal anesthesia (P=0.004). At the first minute of anesthesia all blood pressures in the spinal anesthesia were desirable but 68.8% of them were desirable in general anesthesia. (P=0.0002). At 15 th minute in the spinal anesthesia only 85.4% of blood pressures were desirable but in general anesthesia all blood pressures were desirable. (P=0.0123) Conclusion: In preeclamptic parturients undergoing cesarean section spinal anesthesia with marcaine is safer than general anesthesia.
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