Document Detail

Comparison of general anaesthesia and spinal anaesthesia for caesarean section in Antigua and Barbuda.
MedLine Citation:
PMID:  18198737     Owner:  NLM     Status:  MEDLINE    
Regional anaesthesia has become the anaesthetic of choice for Caesarean section (CS) in developed countries, with use extended to smaller, less developed countries in the past decade. This study is a comparison of maternal and neonatal outcomes comparing general anaesthesia (GA) and the early experience with spinal anaesthesia (SA) for CS in Antigua and Barbuda. Data obtained included maternal age, gravidity, parity, indication for operation, emergent versus routine operation and type of anaesthesia used. Outcome data comprised estimated blood loss, transfusion requirement, length of stay, postoperative wound infection for mothers. Data obtained for babies included birthweight, one and five minute Apgar scores, neonatal special care unit admission or perinatal death. The sample population included 103 CS patients who underwent GA and 45 who underwent SA. There was no difference in age (mean 29.3 vs 29.4 years), gravidity (mean 3.25 vs 3.27), parity (mean 1.74 vs 1.56) or emergency vs routine CS (44.4% vs 49.5%). Mothers who underwent GA had significantly greater estimated blood loss (mean 787 vs 632 mL, p < 0. 02) and rate of transfusion (13.6% vs 2.2%, p < 0. 05). There was a trend toward longer hospital stay (mean 6.86 vs 6.42 days, p = 0. 16) but a lower rate of postoperative wound infection (8.7% vs 20%, p < 0. 10) for mothers who underwent GA. There were no maternal deaths. Babies demonstrated no difference in birthweight (mean 3238 vs 3258 g) but those born to mothers who underwent GA had significantly lower one minute (mean 6.84 vs 8.17, p < 0.0001) and five minute (mean 8.13 vs 8.91, p < 0.001) Apgar scores, with a trend toward more frequent neonatal special care unit admission (26.2% vs 17.7%, p < 0.20) and perinatal death (3.9 vs 0%, p < 0.30). GA and SA appear equally safe, but SA was associated with significantly better outcome for both mothers and babies.
T C Martin; P Bell; O Ogunbiyi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The West Indian medical journal     Volume:  56     ISSN:  0043-3144     ISO Abbreviation:  West Indian Med J     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2008-01-17     Completed Date:  2008-02-08     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0417410     Medline TA:  West Indian Med J     Country:  Jamaica    
Other Details:
Languages:  eng     Pagination:  330-3     Citation Subset:  IM    
The Paediatric Service, Obstetrical Service and Anaesthesia Service, Holberton Hospital, Antigua.
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MeSH Terms
Anesthesia, General*
Anesthesia, Spinal*
Antigua and Barbuda
Cesarean Section / methods*
Length of Stay
Postoperative Complications
Pregnancy Outcome

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