Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Spinal and general anesthesia are commonly used for caesarean section and both have their advantages and disadvantages. Spinal anesthesia is the most common mode of anesthesia used in cesarean section because it offers awakeness of the mother during the procedure and proper interaction with the baby. It is also safer for the mother than general anesthesia. General anesthesia has so rapid and reliable onset, good control of airway patency and ventilation and potentially less lowering of maternal blood pressure.The major adverse fetal effect of spinal anesthesia and its sympathetic blockade is uteroplacental hypoperfusion which leads to an acute fall in intervillous blood flow with the potential for fetal acidaemia. In our study we compared between effect of spinal versus general anesthesia at cesarean section on fetal acid-base status, neonatal bilirubin and breast feeding establishment. We recruited 200 neonates immediately after birth by cesarean section at obstetric department Kasr Al Aini Hospital and divided them into 2 groups - 100 neonates delivered by cesarean section by spinal anesthesia. - 100 neonates delivered by cesarean section by general anesthesia. In our study as regard acid base balance of the new born we found that there is a significantly better result with spinal anesthesia group than general anesthesia group. As regard Apgar score, it was significantly higher at 5 minute in spinal anesthesia group than general anesthesia group As regard neonatal bilirubin there was no significant difference between 2 groups with slightly higher levels of bilirubin in general anesthesia group. As regard breastfeeding establishment there was no significant difference between 2 groups with slightly better results in spinal anesthesia group

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