بررسي مقايسه اي بيهوشي عمومي و روش بيحسي ناحيه اي بر مقدار خونريزي در حين عمل جراحي سزارين الكتيو بوسيله مقايسه HEMATOCRIT قبل و بعد از عمل در سه ماه اول سال 1379 در بيمارستان رويين تن آرش

Assessment effect of general anaesthesia and regional anaesthesia on blood loss at elective cesareans section by preoperative and postoperative haematocrit in Roointan Arash hospital, in 1379 (2000)

It has recently been reported that the use of halogenated agents during balanced general anaesthesia may result in an increase in blood loss associated with cesarean section. This report has been criticized for failure to control for a variety of other factors that may have contributed to the increased blood loss, particularly the indication for and type of cesarean section. The present study was designed in attempt to resolve this criticism. Blood loss was evaluated in uncomplicated patients undergoing elective repeat cesarean section under either general anaesthesia using a halogenated agent (Halotane) or regional anaesthesia (spinal). All 130 singleton term, nonlaboring women underwent repeat low transverse cesarean section performed through a transverse abdominal incision. Exclusion criteria were maternal medical complications, abnormal placentation, polyhydramnios, presence of uterine leiomyomas, and intraoperative complications. Sixty - five patienst (50%) received regional and 65 (50%) received general anaesthesia. A greater proportion of women undergoing general anaesthesia experienced a postoperatvie hematocrit decrease of 5 vol % or more compared with patients receiving regional anaesthesia of 65 versus 4 of 65, P = 0.003 Thus, we conclude that women undergoing uncomplicated elective repeat cesarean section under general anaesthesia supplemented with a halogenated agent are at risk for increased blood loss compared with those women receiving regional anaesthesia. However, the incresed blood loss was not clinically significant in this study, since none of the patients required trasfusion.