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.
