Objective:

This prospective observational study aimed to investigate the surgical claim that spinal anesthesia in elective cesarean section in educational setting increases operating room time.

Material and Methods:

ASA I-II 120 elective cesarean section parturients were grouped into spinal and general anesthesia groups. Both techniques were performed by residents under consultant supervision. Demographic characteristics of parturients, different time intervals as abbreviated with tready (entry of the patient into operating room-readiness for surgery), tincision (entry of the patient-skin incision), thysterotomy (skin incision-hysterotomy), thysterotomy-delivery (hysterotomy-cord clamping), temergence (end of the operation-entry to the postoperative care unit), toperation (start-end of surgery), toperating room (entry-exit from the operating room), type, and amount of fluid and dosages of ephedrine administered were recorded. Newborn demographic data, Apgar scores and results of the umbilical venous gas analysis were noted.

Results:

Demographics, and parturients’ characteristics were similar in both groups. Spinal anesthesia was associated with longer tready, tincision, thysterotomy, thysterotomy-delivery times whereas general anesthesia resulted in prolonged temergence times. Operating room time were similar (72.9±16.7 vs 70.2±12.9 min for spinal and general anesthesia, respectively). Spinal anesthesia parturients had higher crystalloid and ephedrine requirements. No statistical significance was detected in demographic data of newborns and related PCO2 values. In the general anesthesia group, newborns had higher PO2 (36.7±14.2 vs 28.1±7.8 mmHg; p<0.001) and lower pH values (7.32±0.04 vs 7.34±0.06; p=0.049 compared to the spinal anesthesia group, although not reflected in Apgar scores.

Conclusion:

Contrary to surgical claims, choice of spinal anesthesia as anesthetic technique does not increase operating room time when compared to general anesthesia.

Keywords: Obstetric anesthesia, cesarean section, general anesthesia, spinal anesthesia, operating rooms