ALTHOUGH GREAT STRIDES have been made in the reduction of perinatal mortality and morbidity, this problem occurs daily in delivery rooms throughout North America. In 1965, Care and Nelson, 1 in reviewing 965 caesarean sections found double the neonatal mortality after operative delivery, compared to vaginal delivery (3.4 per cent vs 1.7 per cent). A study published by the Ontario Department of Health, 2 revealed a perinatal mortality rate of 47.8 per 1,000 elective caesarean sections. This is more than double the rate for cephalic vaginal delivery. Further, this study revealed that during all caesarean sections the perinatal mortality during general anaesthesia was 57.9 per 1,000 births while this number was 26.0 with conduction anaesthesia, The incidence of infant depression per 100 live births was 22.9 and 9.5 during general and conduction anaesthesia respectively.A great many investigators have been interested in the effects of general and conduction anaesthesia on maternal and foetal acid-base parameters. Low, 3 compared the acid-base status of the newborn infant delivered by elective caesarean section during epidural and general anaesthesia. Other authors 4 have compared spinal versus epidura] anaesthesia. Observations on the use of nitrous oxide, oxygen and suecinylcholine anaesthesia, n,6 and epiduraF anaesthesia have been published. We present observations on three groups of thirteen parturients and neonates at delivery during elective caesarean section. One group received thiopentone, nitrous oxide:oxygen and suceinyleholine. The other 26 patients received epidural anaesthesia. Results of acid-base and metabolic studies of both mother and infant are discussed, and conclusions are drawn regarding which of these commonly used techniques is preferred. METHODSThirty-nine women who received anaesthesia for caesarean section were studied. Thirteen patients received general anaesthesia while twenty-six were given epidural analgesia. One half of the patients who received epidural anaesthesia breathed 100 per cent oxygen via a Magill circuit and face mask for at least ten minutes before delivery.Premedication consisted of atropine sulphate 0.4 mg intramuscularly one hour prior to operation. Epidural anaesthesiaWith the patient in the sitting position a No. 16 gauge Tuohy needle was inserted into the epidural space between the third and fourth lumbar vertebrae

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ALTHOUGH GREAT STRIDES have been made in the reduction of perinatal mortality and morbidity, this problem occurs daily in delivery rooms throughout North America. In 1965, Care and Nelson, 1 in reviewing 965 caesarean sections found double the neonatal mortality after operative delivery, compared to vaginal delivery (3.4 per cent vs 1.7 per cent). A study published by the Ontario Department of Health, 2 revealed a perinatal mortality rate of 47.8 per 1,000 elective caesarean sections. This is more than double the rate for cephalic vaginal delivery. Further, this study revealed that during all caesarean sections the perinatal mortality during general anaesthesia was 57.9 per 1,000 births while this number was 26.0 with conduction anaesthesia, The incidence of infant depression per 100 live births was 22.9 and 9.5 during general and conduction anaesthesia respectively. A great many investigators have been interested in the effects of general and conduction anaesthesia on maternal and foetal acid-base parameters. Low, 3 compared the acid-base status of the newborn infant delivered by elective caesarean section during epidural and general anaesthesia. Other authors 4 have compared spinal versus epidura] anaesthesia. Observations on the use of nitrous oxide, oxygen and suecinylcholine anaesthesia, n,6 and epiduraF anaesthesia have been published. We present observations on three groups of thirteen parturients and neonates at delivery during elective caesarean section. One group received thiopentone, nitrous oxide:oxygen and suceinyleholine. The other 26 patients received epidural anaesthesia. Results of acid-base and metabolic studies of both mother and infant are discussed, and conclusions are drawn regarding which of these commonly used techniques is preferred. METHODS Thirty-nine women who received anaesthesia for caesarean section were studied. Thirteen patients received general anaesthesia while twenty-six were given epidural analgesia. One half of the patients who received epidural anaesthesia breathed 100 per cent oxygen via a Magill circuit and face mask for at least ten minutes before delivery. Premedication consisted of atropine sulphate 0.4 mg intramuscularly one hour prior to operation. Epidural anaesthesia With the patient in the sitting position a No. 16 gauge Tuohy needle was inserted into the epidural space between the third and fourth lumbar vertebrae