Regional versus general anesthesia for cesarean section delivery
Abstract
Introduction:There is no standard anesthesia technique for cesarean section. General anesthesia has been associated with higher morbidity-mortality; however, recent studies seem to disagree with such statement.
Objective:Based on a search in the literature, to reflect on the comparative results of regional vs. general anesthesia for C-section considering three aspects: mortality, morbidity and neonatal outcomes.
Methods: Article for reflection. A non-systematic search of the literature on the topic was performed in the Medline/Pubmed, Embase, Cochrane and Lilacs databases, using Mesh terms included in the key words.
Results:Although the rates for cesarean sections have been constant, the use of general anesthesia has decreased progressively. Maternal mortality associated to general anesthesia during cesarean section has dropped to practically the same level as regional anesthesia: 1.7 (95% CI, 0.6-4.6). Mortality is lower with regional anesthesia: less bleeding, lower risk of surgical site infection, less post-operative pain. The neonatal outcomes are practically the same.
Conclusion: As long as they are not contraindicated, neuraxial anesthetic techniques are the method of choice for C-section delivery, because they are associated with lower morbidity, though mortality and neonatal outcomes are similar as compared to general anesthesia.
References
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