Comparıson of epıdural and general anesthesıa for electıve cesarean delıvery accordıng to the effects on apgar score and acıd-base status of the newborn

Cesarean section rates have been steadily increasing in recent years and regional anesthesia has become the preferred technique. The objective of this study was to determine the effects of lumbar epidural anesthesia on the Apgar score and acid-base status of the newborn. Umbilical artery blood gases were obtained in 85 singleton, term, uncomplicated pregnancies delivered by elective cesarean section. The umbilical artery blood pH, PaCO2, PaO2 and HCO3 values and Apgar scores (1 and 5 minutes) were compared between lumbar epidural and general anesthesia groups. General anesthesia was used in 45 (52.9%) women and lumbar epidural anesthesia in 40 (47.1%). Only two of the newborns exposed to epidural anesthesia had umbilical artery blood pH values 7.19 or less. The mean umbilical artery blood pH was found to be significantly lower in the newborns exposed to lumbar epidural anesthesia (P=0.011). No newborns in the both groups were severely depressed (Apgar scores less than fıve). The mean umbilical artery blood PaCO2, PaO2 and HCO3 values did not show any significant difference between the groups. İn conclusion, lumbar epidural anesthesia is associated with lower umbilical artery blood pH values, occasionalty with severe fetal acidemia.

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