Key result
Spinal anesthesia yielded better Neonatal Neurologic Adaptive capacity scores at 15 minutes and 2 hours compared to general anesthesia, despite lower maternal intraoperative systolic blood pressure (P<0.05).
Why the study?
Does spinal anesthesia improve neonatal neurobehavioral response and Apgar score compared to general anesthesia in neonates delivered by cesarean section?
RCT (n=200)
Lottery method
No
Does spinal anesthesia improve neonatal neurobehavioral response and Apgar score compared to general anesthesia in neonates delivered by cesarean section?
Spinal anesthesia is associated with better early neonatal neurobehavioral outcomes compared to general anesthesia for cesarean sections.
Favors spinal over general anesthesia for cesarean delivery to optimize early neonatal neurobehavior; extends RCT evidence guiding obstetric anesthesia choice.
Background: Neonatal outcomes are affected by types of anesthesia and perioperative patient cares. Studies showed that neonatal neurobehavioral response and Apgar score were better in mothers who gave birth under spinal anesthesia than general anesthesia. But studies were inadequate locally and this study compared neonatal neurobehavioral response and Apgar score in mothers who undergo caesarean section. Objective: The main objective of the study was to compare Neonatal neurobehavioral response and Apgar score in neonates delivered with caesarean section under spinal vs. General anesthesia. Methods and materials: After approval from institutional review Board (IRB) of Dilla University, we studied 200 consecutive babies delivered with caesarean section under spinal and General Anesthesia from ASA I&II term pregnant mother in Dilla University Teaching and referral Hospital. Prospective effectiveness study design was employed. Mothers were randomly allocated in two equal groups 60 patients each by lottery method after informed consent. Result: There was a significant mean difference between the two groups on mean Intraoperative systolic blood pressure. More women who received spinal anesthesia had lower intraoperative systolic blood pressure as compared to women who received general anesthesia (P<0.05). Neonatal Neurologic Adaptive capacity score at 15 minutes were better in spinal as compared to General Anesthesia. There were significant association between types of Anesthesia with the majority of the tests in 15 minute and 2 hrs period. But Neonatal Neurologic Adaptive capacity score at 24 hrs didn’t show significant Association. Conclusion: Spinal Anesthesia is associated with good neonatal outcomes even in emergency caesarean section with non-touching rapid sequence spinal anesthesia technique. General anesthesia should be preserved for cases contra indicated with spinal anesthesia.
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Semagn Mekonnen (2016) conducted an RCT in Cesarean section (n=200). Spinal anesthesia vs. General anesthesia was evaluated on Neonatal neurobehavioral response (Neonatal Neurologic Adaptive capacity score) and Apgar score. Spinal anesthesia yielded better Neonatal Neurologic Adaptive capacity scores at 15 minutes and 2 hours compared to general anesthesia, despite lower maternal intraoperative systolic blood pressure (P<0.05).
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