Listen Mil, I am not about to criticize your anesthetic. That would be ridiculous on my part.
But, I would like to proved a little info to those out there trying to may sense of all this. I am talking about "Elective Cesareans" here. Hawkin's et al Anesthesiology 1997, found that the case fatality was 32 per million vs 2 per million when Ga was used vs regional. This was based on their feeling that airway management skills were decreasing among American-trained physicians. How many of you in training have actually intubated a c/s? I know I only intubated 1 or 2 in training and the parturient airway is predicted to be 10 times more difficult (but you guys know how some of us in private practice feel about the airway
).
The more interesting studies to me are the ones looking at fetal outcome. There have been a number of retrospective studies evaluating type of anesthetic used in c/s. Roberts et al, Obstet Gynecol, 1995 found that umb artery pH was greater in the neonate delivered with GA, but clinical parameters (ie: Apgars, need for mech. ventilation) was better when regional was used. The acidemia was about 80% respiratory, which does not increase neonatal complications.
2 prospective randomized studies looked at the same thing and found not only that Apgars were better in the regional group but they also found less acidemia.
