Is spinal anesthesia really innocent?

Abstract

Objective: Evaluating the effects of maternal hypotension, a common complication of spinal anesthesia, on fetus. Design: Prospective observational study. Setting: A total of 46 pregnant women at term who previously had a caesarean section(C/S) were scheduled to undergo elective CS for their second CS and participated in this study. Patients: 46 patients were divided into two groups according to hypotension occurrence during spinal anesthesia. Interventions: After all the patients received 1500ml Ringer Lactate solution 15 minutes before induction, the patients whose oxygen saturation became less than 97% received supplemental oxygen. If SBP was 90mm/Hg or less or a decreasing trend was observed during SA, intravenous injections of 2 to 3mg of ephedrine, up to a maximum total dose of 50mg, were administered. Main outcome measures: Age, birth weight, pCo2, bicarbonate, ALT, AST, CK, LDH, Apgar scores, pH and babies requiring pediatric help. Results: pH, HCO3, PCO2, babies requiring pediatric help and Apgar scores were statistically significantly affected by hypotension. Conclusion: In our study, hypotension is the most important factor contributing to acidosis occurrence. Low Apgar scores and increasing rates of pediatrician requirement in patients with hypotension during SA illustrates us that SA has negative impact on short term fetal outcome.