Retrospective Analysis of Anesthesia Techniques Applied in Cesarean Section and Factors Effective on Neonatal Apgar Score: Case of District State Hospital

Abstract

Objective: The choice of anesthesia technique to be applied in cesarean section is made according to the patient’s clinic, preference, or anesthesiologist’s experience. In this study, evaluation of the anesthesia techniques applied in cesarean sections in our hospital in the last 5 years (2015-2019) was aimed. Our secondary aim was to determine the factors associated with intraoperative hemodynamic parametres, and newborn Apgar scores. Method: After the approval of the ethics committee was obtained, 691 cases who underwent cesarean section in our hospital between 2015 and 2019 were included in the study. Information such as demographic data of patients, anesthesia techniques applied in cesarean sections, spinal anesthesia success rates, intraoperative hemodynamic complications, drug doses, maternal hemoglobin level and neonatal Apgar scores (1st and 5th min.) were obtained from the hospital information system and patient files. The data obtained were evaluated retrospectively. Results: A total of 535 (77.42%) of cesarean sections were performed under general anesthesia and 156 (22.58%) of them under spinal anesthesia, and spinal anesthesia rates were very low. General anesthesia rates were found to be 72.5% and 77.7% in emergency and elective conditions, respectively. The incidence of hypotension (p<0.001) and bradycardia (p<0.001) were significantly higher in spinal anesthesia applications than in general anesthesia. Apgar scores were significantly higher in patients undergoing spinal anesthesia (p<0.001 and p=0.009). Conclusion: Spinal anesthesia rates in our district hospital were found to be quite low compared to the results of the studies conducted in our country and abroad. Although hemodynamic instability was more frequently experienced in spinal anesthesia compared to general anesthesia, newborn Apgar scores were significantly higher in infants of mothers who underwent spinal anesthesia. Further and comprehensive studies are needed to evaluate the general situation in cesarean sections in second level hospitals and to determine what can be done to increase the rates of spinal anesthesia.