Anestesia regional versus general para parto por cesárea.

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Bibliographic Details
Title:	Anestesia regional versus general para parto por cesárea.
Alternate Title:	Regional versus general anesthesia for cesarean section delivery.
Authors:	Páez, L. John Jairo¹, Navarro, V. J. Ricardo² jrnavarrov@unal.edu.co
Source:	Colombian Journal of Anesthesiology / Revista Colombiana de Anestesiología. ago-oct2012, Vol. 40 Issue 3, p203-206. 4p.
Subjects:	GENERAL anesthesia, CONDUCTION anesthesia, CESAREAN section, COMPARATIVE studies, MATERNAL mortality, OBSTETRICS surgery complications
Abstract (English):	Introduction: There is no standard anesthesia technique for cesarean section. General anesthesia has been associated with higher morbidity-mortality; however, recent studies seem to disagree with such statement. Objective: Based on a search in the literature, to reflect on the comparative results of regional vs. general anesthesia for C-section considering three aspects: mortality, morbidity and neonatal outcomes. Methods: Article for reflection. A non-systematic search of the literature on the topic was performed in the Medline/Pubmed, Embase, Cochrane and Lilacs databases, using Mesh terms included in the key words. Results: Although the rates for cesarean sections have been constant, the use of general anesthesia has decreased progressively. Maternal mortality associated to general anesthesia during cesarean section has dropped to practically the same level as regional anesthesia: 1.7 (95% CI, 0.6-4.6). Mortality is lower with regional anesthesia: less bleeding, lower risk of surgical site infection, less post-operative pain. The neonatal outcomes are practically the same. Conclusion: As long as they are not contraindicated, neuraxial anesthetic techniques are the method of choice for C-section delivery, because they are associated with lower morbidity, though mortality and neonatal outcomes are similar as compared to general anesthesia. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	Introducción: No existe una técnica estándar de anestesia para el parto por cesárea. La anestesia general ha sido asociada con mayor morbimortalidad; sin embargo, estudios recientes parecen no estar de acuerdo con esta afirmación. Objetivo: Hacer una reflexión a través de los resultados de estudios que comparan anestesia regional y general para cesárea desde 3 aspectos: mortalidad, morbilidad y desenlaces neonatales, a partir de una búsqueda de la literatura Métodos: Artículo de reflexión. Se realizó una búsqueda no sistemática de la literatura referente a este tema en las bases de datos Medline/Pubmed, Embase, Cochrane y Lilacs usando términos Mesh incluidos en las palabras clave. Resultados: Aunque la tasa de cesáreas se ha mantenido constante, el uso de anestesia general ha disminuido progresivamente. La mortalidad materna asociada a anestesia general durante cesárea ha descendido hasta prácticamente ser igual a la de anestesia regional 1,7 (IC 95%, 0,6-4,6). La morbilidad es menor con anestesia regional: menor sangrado, menor riesgo de infección del sitio operatorio y menor dolor posoperatorio. Los desenlaces neonatales son prácticamente iguales. Conclusión: Las técnicas de anestesia neuroaxial son la elección para parto por cesárea siempre que no esté contraindicada, porque se asocia con menor morbilidad, aunque la mortalidad y los desenlaces neonatales son similares cuando se compara con anestesia general. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	Introduction: There is no standard anesthesia technique for cesarean section. General anesthesia has been associated with higher morbidity-mortality; however, recent studies seem to disagree with such statement. Objective: Based on a search in the literature, to reflect on the comparative results of regional vs. general anesthesia for C-section considering three aspects: mortality, morbidity and neonatal outcomes. Methods: Article for reflection. A non-systematic search of the literature on the topic was performed in the Medline/Pubmed, Embase, Cochrane and Lilacs databases, using Mesh terms included in the key words. Results: Although the rates for cesarean sections have been constant, the use of general anesthesia has decreased progressively. Maternal mortality associated to general anesthesia during cesarean section has dropped to practically the same level as regional anesthesia: 1.7 (95% CI, 0.6-4.6). Mortality is lower with regional anesthesia: less bleeding, lower risk of surgical site infection, less post-operative pain. The neonatal outcomes are practically the same. Conclusion: As long as they are not contraindicated, neuraxial anesthetic techniques are the method of choice for C-section delivery, because they are associated with lower morbidity, though mortality and neonatal outcomes are similar as compared to general anesthesia. [ABSTRACT FROM AUTHOR]
ISSN:	01203347
DOI:	10.1016/j.rca.2012.05.008