The Perioperative Neonatal and Maternal Glycemic Response and APGAR Score During Elective Cesarean Section: Factors and Anesthetic Management.

Abstract

Background: The type of anesthesia and intensity of pain experienced during surgery are linked to the body's stress response, as reflected in preoperative and postoperative glucose levels.

Objective: This comparative study aims to assess the hyperglycemic stress response to cesarean sections performed under different types of anesthesia.

Methods: This prospective study included 302 participants, divided into two groups: a general anesthesia group and a spinal anesthesia group. Our primary objective was to investigate the effects of general versus spinal anesthesia on pregnant women undergoing cesarean section. Secondarily, we aimed to assess the impact of other factors on the maternal and neonatal stress response during surgery.

Results: Both groups exhibited a significant proportional increase in mean blood glucose levels after surgery. However, this increase was more pronounced in the general anesthesia group than in the spinal anesthesia group. Therefore, spinal anesthesia had a greater effect in attenuating the hyperglycemic response to surgery during cesarean section compared to general anesthesia. Maternal blood glucose levels were significantly associated with steroid injection, type of anesthesia, and gestational age. In contrast, neonatal blood glucose was significantly associated with gestational age, APGAR score, maternal steroid injection, type of anesthesia, maternal age, and both preoperative and postoperative maternal blood glucose levels.

Conclusion: Spinal anesthesia was superior to general anesthesia in attenuating both maternal and neonatal hyperglycemic responses during the cesarean section. This highlights the significant impact of anesthesia type on maternal and neonatal well-being.