Impact of General Versus Spinal Anaesthesia in Caesarean Section on Maternal Blood Loss: A Randomized Controlled Trial
Mohamed Magdy Badie El-sum;
Abstract
Cesarean section is considered the most common surgical procedure in the world. The number of operations performed annually worldwide is estimated by about one million cases.
The type of anesthesia used and the way by which it is managed by are considered important elements in determining the outcome of cesarean section as both general and spinal anesthesia used in cesarean section have advantages and disadvantages, so there is no completely perfect way of anesthesia to perform.
The most important factors that determine the type of anesthesia include; complications associated with pregnancy, parental choice, urgency of the operation, the experience of the anesthesiologist, medical history of the mother and the choice of the obstetrician.
Some studies demonstrated that the amount of blood loss in women who receive spinal anesthesia in cesarean sections is less when compared to women who receive general anesthesia, as well as post-operative pain. Also the ability to move and walk in women who receive spinal anesthesia is faster than women who receive general anesthesia.
However, these results should not be taken into consideration without further studies and researches to compare between spinal anesthesia and general anesthesia. Accordingly, the objective of conducting this research was to evaluate the use of both general and spinal anesthesia in cesarean section to determine which one was associated with less blood loss.
This research was conducted on one hundred and fifty-five pregnant women carrying single full term infant, between 25 and 35 years old, and did not undergo any previous operations in the lower abdomen except cesarean sections and did not have any bleeding tendency, then undergone a cesarean section after random distribution into the two studied groups, one with general anesthesia and one with spinal anesthesia.
The first group who had undergone general anesthesia included seventy-seven pregnant women, while the second group who had undergone spinal anesthesia included seventy eight pregnant women.
All circumstances were united in both groups regarding intravenous fluids and medications used; together with measuring of blood pressure and other vital data of the women. Basic data of the study has been recorded including: age, parity, hemoglobin and hematocrit before, and on third day after CS. Amount of blood loss has been calculated and recorded using the acute normovolemic hemodilution equation. Secondary outcomes has also been recorded including: vital signs, urine output, the number of fainting and headache attacks, need for blood transfusion and the elapsed time from the end of the operation till lactation ,mobilization , passing flatus and ability to eat and drink.
The type of anesthesia used and the way by which it is managed by are considered important elements in determining the outcome of cesarean section as both general and spinal anesthesia used in cesarean section have advantages and disadvantages, so there is no completely perfect way of anesthesia to perform.
The most important factors that determine the type of anesthesia include; complications associated with pregnancy, parental choice, urgency of the operation, the experience of the anesthesiologist, medical history of the mother and the choice of the obstetrician.
Some studies demonstrated that the amount of blood loss in women who receive spinal anesthesia in cesarean sections is less when compared to women who receive general anesthesia, as well as post-operative pain. Also the ability to move and walk in women who receive spinal anesthesia is faster than women who receive general anesthesia.
However, these results should not be taken into consideration without further studies and researches to compare between spinal anesthesia and general anesthesia. Accordingly, the objective of conducting this research was to evaluate the use of both general and spinal anesthesia in cesarean section to determine which one was associated with less blood loss.
This research was conducted on one hundred and fifty-five pregnant women carrying single full term infant, between 25 and 35 years old, and did not undergo any previous operations in the lower abdomen except cesarean sections and did not have any bleeding tendency, then undergone a cesarean section after random distribution into the two studied groups, one with general anesthesia and one with spinal anesthesia.
The first group who had undergone general anesthesia included seventy-seven pregnant women, while the second group who had undergone spinal anesthesia included seventy eight pregnant women.
All circumstances were united in both groups regarding intravenous fluids and medications used; together with measuring of blood pressure and other vital data of the women. Basic data of the study has been recorded including: age, parity, hemoglobin and hematocrit before, and on third day after CS. Amount of blood loss has been calculated and recorded using the acute normovolemic hemodilution equation. Secondary outcomes has also been recorded including: vital signs, urine output, the number of fainting and headache attacks, need for blood transfusion and the elapsed time from the end of the operation till lactation ,mobilization , passing flatus and ability to eat and drink.
Other data
| Title | Impact of General Versus Spinal Anaesthesia in Caesarean Section on Maternal Blood Loss: A Randomized Controlled Trial | Other Titles | تأثير التخدير العام مقارنةً بالتخدير النصفى في الولادة القيصرية علي كمية الدم المفقودة من الأم أثناء العملية | Authors | Mohamed Magdy Badie El-sum | Issue Date | 2014 |
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