A Comparison of Lumbar Epidural Anesthesia Using Bupivacaine-Fentanyl-Epinephrine-Sodium Bicarbonate Mixture with General Anesthesia for Cesarean Section

Conftroversy 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-fen-tanyl-epinephrine-sodium bicarbonate mixture on mother and neonate with general anesthesia.

The induction-to-delivery time(IDT), uterine incision-to-delivery time(UDT), Apgar scoresat 1 and 5 minute. maternal arterial, umbilical arterial and venous blood gas analysis, degreeof uterine contraction. and preoperative, postoperative hemoglobin and hematocrit level weremeasured in 28 pregnant women underwent Cesarean section(15 under epidural anesthesia,13 under general anesthesia).

The results were as follows :

1) The mean IDT was much longer(p<0.001) with epidural anesthesia group comparedwith general anesthesia group, but the average UDT were similar. The Apgar scores at 1 and5 minute were generally satisfactory with no significant differences between groups.

2) Mean maternal arterial PH, PCO₂ and BE were simitar between two groups. but meanmaternal PO₂ and O₂ saturation were less in the epidural anesthesia group. reflecting thesmaller 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 lowerin the epidural anesthesia group than in the general anesthesia group respectively, but remainedwithin normal ranges.

4) No significant differences in the degree of uterine contraction was noted between twogroups.

5) A decrease in the homoglobin 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-sodiumbicarbonate mixture in patients undergoing Cesarean section may be safe without significantmaternal or neonatal side effect.