Effect of type of anaesthesia in lower segment caesarean section on apgar score of new born babies: A comparative study

Background: To compare the effects of general anaesthesia and spinal anaesthesia on Apgar score in full term neonates born to elective caesarean section. Methods: The study was conducted on 90 healthy full term patients of ASA 1 and 2 category presenting for elective lower segment caesarean section (LSCS). 45 patients were given general anaesthesia and other 45 received spinal anaesthesia. The Apgar score was recorded at 1 minute and 5 minutes after birth. Results: Out of 45 mothers who received general anaesthesia, 38 (84.4%) gave birth to neonates having Apgar score less than or equal to 6 at 1 minute after birth and the remaining 7 neonates (15.6%) had Apgar score of more than 7. Out of 38 babies only one baby continued to have Apgar score of less than or equal to 6 at 5 minutes. On the other hand, out of 45 mothers who received spinal anaesthesia, only 15 mothers gave birth to babies having Apgar score less than or equal to 6 at 1 minute after birth out of which 14 improved at 5 minutes with Apgar score of more than or equal to 7. Conclusion: We conclude based on the study results that babies born by LSCS under general anaesthesia are at higher risk of having low Apgar score (Less than or equal to 6) at 1 minute after birth. Key Word: Caesarean Section, General Anaesthesia, Spinal Anaesthesia, Apgar score *Address for Correspondence: Dr. Neerupam Gupta, Department of Pediatrics, Govt. Hospital Sarwal, Directorate of Health services, Jammu, J and K -180015, INDIA. Email: neroped@gmail.com Received Date: 20/01/2019 Revised Date: 27/02/2019 Accepted Date: 07/04/2019 DOI: https://doi.org/10.26611/10141018 INTRODUCTION The choice of anaesthesia for obstetric cases has been traditionally influenced by patient and physician preferences. It can be performed under general or regional anaesthesia like spinal or epidural technique. The obstetric anaesthetist requires special training and skills to provide safe anaesthesia. The anaesthetic techniques and agents chosen should provide good anaesthesia and analgesia with minimal effects on fetomaternal well being. Although most patients undergoing caesarean section are young and healthy, they represent a high risk group of patients. Either of general and spinal anaesthesia is not ideal for caesarean section because each has advantages and risk to both mother and foetus. However the aim of anaesthetist is to choose the method which is safest and most comfortable for the mother, least depressive to the new born and which provides optimal working conditions for obstetrician1. Apgar score is the best parameter to assess the immediate condition of the baby.2,3 It is the first non invasive test done to the new born after birth. It is a bedside clinical method to assess the health of the new born immediately after birth and to determine the need of any resuscitative measures. The scores are taken at 1 and 5 minutes after birth. Of the two scores, the 5 minutes score is regarded as the better predictor of survival whereas 1 minute score has the value in assessing the effects of different drugs given to the mother during caesarean section. We conducted a randomized prospective comparative study to see the effects of general versus spinal anaesthesia in elective caesarean sections on Apgar score at 1 and 5 minutes. Access this article online Quick Response Code: Website: