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KMID : 0374019930160010085
Ewha Medical Journal
1993 Volume.16 No. 1 p.85 ~ p.94
A Comparison of Lumbar Epidural Anesthesia Using Bupivacaine-Fentanyl-Epinephrine-Sodium Bicarbonate Mixture with General Anesthesisa for Cesarean Section


Abstract
Controversy has existed concerning the choice of anesthetic technique for Cesarean section.
The aim of this study was to compare the effects of epidural anesthesia using bupivacaine-fentanyl-epinephrine-sodium bicarbonate mixture on mother and neonate with general anesthesia.
The induction-to delivery time (IDT). Uterine incisicn-to-delivery time (UDT), Apgar scores at 1 and 5 minute, maternal arterial, umbilical arterial and venous blood gas analysis, degree of uterine contraction, and preoperative, postoperative
hemoglobin
and hematocrit level were measured in 28 pregnant women underwent Cesarean section (15 under epidural anesthesia. 13 under gereral anesthesia).
@ES The results were as follows :
@EN 1) The mean IDT was much longer(p<0.001) with epidural anesthesia group compared with general anesthesia group. but the average UDT were similar. The Apgar scores at l and 5 minute were generally satisfactory with no significant differences
between
groups.
2) Mean maternal arterial PH. PCO2 and BE were similar between two groups but mean maternal PO2 and O2 saturation were less in the epidural anesthesia group, reflecting the smaller FI02 inhaled by the mother in the epidural anesthesia group.
3) The PH, BE and O2 saturation in both umbilical vein and artery was significantly lower in the epidural anesthesia group than in the general anesthesia group respectively, but remained within normal ranges.
4) No significant differences in the degree of uterine contraction was noted between two groups.
5) A decrease in the hemoglobin level 72 hour after Cesarean section is significantly less in epidural anesthesia group than in general anesthesia group.
These data suggest that epidural anesthesia using bupivacaine-fentanyl-ephinephrine-sodium bicarbonate mixture in patients undergoing Cesarean section may be safe without significant maternal or neonatal side effect.
KEYWORD
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