Comparing the effects of general and spinal anesthesia on the postoperative pain intensity in patients undergoing emergent or elective cesarean section

Abstract

Objective:The aim of this study is to compare the effects of general and spinal anesthesia on postoperative pain intensity and analgesic agent requirements in patients scheduled for emergent or elective cesarean sections.Patients and Methods: This was a prospective, observational study conducted in patients who underwent emergent or elective cesarean delivery under spinal or general anesthesia. Postoperative pain intensity and analgesic agent requirements, postoperative complications and patients' satisfactions were evaluated during the first 48 h postoperatively.Results: A total of 212 parturients were enrolled; 104 (53 elective, 51 emergent) patients received general and 108 (54 elective, 54 emergent) patients received spinal anesthesia. Preoperatively, patients who underwent emergent cesarean section under spinal or general anesthesia had higher Numeric Rating Scale (NRS) scores than the patients who underwent elective cesarean delivery (p<0.001). In the first postoperative 48 h, NRS pain scores were similar in patients who underwent emergent or elective cesarean sections under spinal or general anesthesia. Postoperative analgesic agent requirements and patients' satisfactions were not statistically significant between groups.Conclusion: The effects of general and spinal anesthesia on postoperative pain were similar in emergent and elective cesarean sections. Therefore, postoperative analgesic effect should not be a determining factor in choosing the anesthesia method in cesarean sections.

Comparison of the median effective concentration (EC50) and effect of sevoflurane with or without remifentanil in cesarean section with supreme laryngeal mask under narcotrend monitoring: a randomized trial

“…Although cesarean delivery (CD) has shown a decline in recent decades (1,2), the rate of CD remains high worldwide (3): 32.2% in United States in 2014 (4), 34.9% in China in 2014 (5), highly 56% in Brazil in 2015 (6). Compared with neuraxial anesthesia (NA), general anesthesia (GA) is not the first choice for most CDs with disadvantage of higher risks for anesthesiarelated complications, surgical site infection, venous thromboembolic events, and postoperative pain (7)(8)(9), but it is still used in the condition of patients preference (10), emergency CD or patients contraindications to NA, such as severe placental abruption, ruptured uterus, or severe hemorrhage (7,8). The estimated current GA rate for CD is 5.5% (11,12).…”