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Effects of types of Anesthesthesia on Neurobehavioral Response and Apgar score in Neonates Delivered with Cesarean Section at CMCH Bhopal

Dawar Shailendra L., Associate Professor, Deparment of Anaethesiology, Chirayu Medical College and Hospital, Bhopal, Madhya Pradesh 462030, India. , Chavan Gajanan N.1 , Dawar Shailendra L.2

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Indian Journal of Anesthesia and Analgesia 4(4):p 951-956, October-December 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.6

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Abstract

Context: As the Frequency of cesarean section birth continuous to steadily rises worldwide the type of anaesthesia provided has gained importance. Though the anaesthesia has become very safe over the years some studies showed adverse Neonatal outcome in the babies delivered by cesarean section under general anaesthesia however this outlook needs to be further studied hence we aimed to compare the effect of general anaesthesia and spinal anaesthesia on foetal outcome delivered by cesarean section by monitoring APGAR & NACS scores. Aims: Settings and Design: Prospective Randomized Controlled clinical trail in tertiary level institute. Methods and Material: Our study was conducted in 100 patients with elective indications patients was randomly divided into general anaesthesia (in 50 patients) and spinal anaesthesia (50 patients). The APGAR score and neonatal neurological adaptive capacity score (NACS) were noted and the results were compared with the groups. The maternal age, height, weight, time taken for delivery of baby after induction & NICU admission were also noted and compared with groups. Statistical Analysis Used: Mean and standard deviation, unpaired t test. Results: There was no significant difference in spinal versus general anaesthesia group regarding age (26.34±3.61 vs 26.26±3.43), weight (75.36±6.33 vs 71.03±8.20) and height (5.21±0.16 vs 5.18±0.14) time taken for delivery of baby was statistically insignificant in both the groups percentage of NICU admission in the babies delivered under general anaesthesia group was high (28%) as compare to babies delivered under spinal anaesthesia group (10%) babies born to mothers underwent spinal anaesthesia had significantly better APGAR score after delivery (7.18±1.00 vs 6.1±0.70 P<0.001, 1 minute (8.30±1.00 vs6.82±0.89 P<0.001) and 5 minute (8.56±1.07 vs 7.54±0.76 P< 0.001) APGAR score. Neonate Neurological adaptive capacity score (NACS) at 15 minutes and 2 hours were better in spinal anaesthesia group compare to general anaesthesia group. Conclusions: NACS score and APGAR score were better preserved in neonates born to mother under spinal anaesthesia for elective cesarean section so this could be a base to recommend the spinal anaesthesia as a standard anaesthesia technique for cesarean section, though should be further evaluated.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.6

Keywords

Neonatal Neurological Adaptive Capacity Score; APGAR Score; Caesarean Section; Spinal Anaesthesia; General Anaesthesia. 

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