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Anesthetic technique for cesarean delivery and neonatal acid-base status: a retrospective database analysis.

Publication ,  Journal Article
Strouch, ZY; Dakik, CG; White, WD; Habib, AS
Published in: Int J Obstet Anesth
February 2015

INTRODUCTION: A previous meta-analysis reported lower umbilical artery pH with spinal anesthesia for cesarean delivery compared to general or epidural anesthesia. Ephedrine was used in the majority of studies. The objective of this study was to evaluate the effect of anesthetic technique on neonatal acid-base status now that phenylephrine has replaced ephedrine in our institution. METHODS: We retrospectively reviewed our database to identify patients who underwent cesarean delivery and had umbilical artery pH available. We decided a priori to test separately cases where cesarean delivery was performed emergently (category I and II) or non-emergently (category III and IV). Multivariable models were constructed to detect significant predictors of lower umbilical artery pH. RESULTS: One thousand sixty-four cases were included (647 emergent, 417 non emergent). In emergent cesarean delivery, anesthesia type was a significant predictor of lower umbilical artery pH (P <0.0001) with the pairwise comparisons showing lower neonatal umbilical artery pH [mean (95% CI)] with general anesthesia [7.16 (7.13, 7.19)] compared with spinal anesthesia [7.24 (7.22, 7.25)] and epidural anesthesia [7.23 (7.21, 7.24)], with no difference between spinal and epidural anesthesia. When excluding cases where general anesthesia was chosen due to insufficient time to place a neuraxial block or dose an existing epidural catheter, anesthesia type was not a predictor of lower umbilical artery pH. Anesthetic technique was not a predictor of lower umbilical artery pH in non-emergent cases. CONCLUSIONS: Spinal anesthesia was not associated with lower umbilical artery pH compared to other types of anesthesia. This might be due to the use of phenylephrine in our practice.

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Published In

Int J Obstet Anesth

DOI

EISSN

1532-3374

Publication Date

February 2015

Volume

24

Issue

1

Start / End Page

22 / 29

Location

Netherlands

Related Subject Headings

  • Umbilical Arteries
  • Retrospective Studies
  • Infant, Newborn
  • Hydrogen-Ion Concentration
  • Humans
  • Fetal Blood
  • Female
  • Databases, Factual
  • Cesarean Section
  • Anesthesiology
 

Citation

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Strouch, Z. Y., Dakik, C. G., White, W. D., & Habib, A. S. (2015). Anesthetic technique for cesarean delivery and neonatal acid-base status: a retrospective database analysis. Int J Obstet Anesth, 24(1), 22–29. https://doi.org/10.1016/j.ijoa.2014.11.002
Strouch, Z. Y., C. G. Dakik, W. D. White, and A. S. Habib. “Anesthetic technique for cesarean delivery and neonatal acid-base status: a retrospective database analysis.Int J Obstet Anesth 24, no. 1 (February 2015): 22–29. https://doi.org/10.1016/j.ijoa.2014.11.002.
Strouch ZY, Dakik CG, White WD, Habib AS. Anesthetic technique for cesarean delivery and neonatal acid-base status: a retrospective database analysis. Int J Obstet Anesth. 2015 Feb;24(1):22–9.
Strouch, Z. Y., et al. “Anesthetic technique for cesarean delivery and neonatal acid-base status: a retrospective database analysis.Int J Obstet Anesth, vol. 24, no. 1, Feb. 2015, pp. 22–29. Pubmed, doi:10.1016/j.ijoa.2014.11.002.
Strouch ZY, Dakik CG, White WD, Habib AS. Anesthetic technique for cesarean delivery and neonatal acid-base status: a retrospective database analysis. Int J Obstet Anesth. 2015 Feb;24(1):22–29.
Journal cover image

Published In

Int J Obstet Anesth

DOI

EISSN

1532-3374

Publication Date

February 2015

Volume

24

Issue

1

Start / End Page

22 / 29

Location

Netherlands

Related Subject Headings

  • Umbilical Arteries
  • Retrospective Studies
  • Infant, Newborn
  • Hydrogen-Ion Concentration
  • Humans
  • Fetal Blood
  • Female
  • Databases, Factual
  • Cesarean Section
  • Anesthesiology