From January 1967 to April 1975, Chungnam National University Hospital and Ch-ungnam Medical Center has performed 319 cases of cesarean section under general or Local general anesthesia. Statistical analysis was done and results can be summarized as follows.
Total deliveries were 2562 cases, of which 2243 cases were delivered vaginally and
319 cases(12.5%) were delivered by Cesarean section. of the Cesarean section group, 282 cases (88.4%) were performed under general anesthesia and 37 cases(ll. 6°%) were performed under local general anesthesia. The significant difference for this study was that 299 cases (93.7%) were emergency cesarean section.
The major indication for cesarean section was mal-presentation (45. 1 % ), the second was hemorrhage (21.9%), and the others are as following orders ; repeated section (10.0%), fetal distress (2.8%), toxemia (1.6%) and others (4.7%).
In my studies, I adopted four different anesthetic techniques for Cesarean section.
Group I : 182 cases, pentothal sodium-succinylcholine-nitrous oxide-oxygen (67:33 or
50:50) anesthesia or supplemented with halothane, penthrane and ether anest-hesia.
Group 11: 98 cases, epontol-sunccinylcholine-nitrous oxide-oxygen(67:33 or 50:50) ane-sthesia of supplemented with halothane, penthrane and ether anesthesia
Group 111 : 2 cases, ketamine-sunccinylcholine-nitrous oxide -oxygen (50:50) supple-mented with halothane anesthesia
Group IV: 37 cases, local pentothal sodium or epontols uccinylcholine-nitrous oxide oxygen supplemented with halothane and ether anesthesia. All patients were preoxygenated for 4-5 minutes. Anesthesia was induced with pentotial sodium 250mg. or epontol 450-500mg. , followed by succinylcholine chloride 50-60n.g. for intubation and was maintained with N20 and 02 (67:33 or 50:50) suppl-enerd with halothane and penthrane. Muscle relaxation was maintained with 0.2% sunccin, chlorine chloride drip until delivery. Respiration was carefully controlled by manually so as not to producing hyperventilation
Tile clinical condition of newborn infant, under 7 point of one minute Apgar score, in general anesthesia group 282 cases and local general anesthesia group of 37 cases were 83 cases (29.4%) and 5 cases (13.5%) respectively. Of the 328 infants, 16 cases (l.9%) received I. P. P. B. by face mask and other 16 cases (4.9%) received oxygen through endotrachcal tube for the resuscitation. In 61 fetal deaths, only 7 cases (2. 1 %) died due to failure of resuscitaion, and the others were stillbirths. Neonatal dea-th were caused by severe fetal distress associated with hemorrhage, toxemia, malpre-sentation and others of pregnancy. there were two maternal cardiac arrests.
As a results of this study, these general anesthetic techniques were fairly proved to. be safe for mother and child, and showing a wide acceptance of general anesthesia for Cesarean Becton.
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