General versus spinal anesthesia during elective cesarean section in term low-risk pregnancy as regards maternal and neonatal outcomes: a prospective, controlled clinical trial

Objective The objective of this study was to compare general and spinal anesthesia as regards its maternal and neonatal outcomes in low-risk pregnancies undergoing elective cesarean section (C-section) at term. Patients and methods In a prospective, controlled clinical trial, 64 low-risk pregnant women underwent elective C-section for the first time for variant indications. The included women were randomly divided into two groups; group I (n=32) received spinal anesthesia and group II (n=32) received general anesthesia. The distinction between preoperative and postoperative maternal hematological indices, intraoperative and postoperative maternal hemodynamic parameters, the maternal requirement for analgesia, return of bowel function, and neonatal outcomes were compared between the two groups. Results The mean time for bowel to be open (9.7±1.3 vs. 6.8±1.6 h, P=0.001), and the first analgesia requirement was significantly (5.33±4 vs. 2.91±2.16 h, P=0.004) longer, and the hemoglobin and hematocrit difference values at 24 h postoperative were significantly (P=0.03, and 0.02, respectively) larger in group II. Urine output at the first postoperative hour was more (P=0.002) in the spinal group. The median Apgar scores at the first minute and at fifth minute were significantly higher (P=0.001, and 0.005, respectively) in the spinal group. Conclusion As long as it is not contraindicated, spinal anesthesia during elective C-section was safer for both neonates (higher Apgar scores), and mother (less bleeding, less postoperative pain) than general anesthesia and can be the ideal anesthesia and method of choice during elective C-section.