Comparative Study of General Anaesthesia and Spinal Anaesthesia in Pre-Eclampsia Patients Undergoing Emergency Caesarean Section

Deepak Kumar Sinha, Sumit Kumar Verma, Hirday Kumar

Abstract: Background: Preeclampsia is a multisystem disorder characterized by hypertension and proteinuria after 20 weeks of gestation. It remains a major contributor to maternal and neonatal morbidity and mortality worldwide. Anaesthetic management during emergency caesarean section in pre-eclamptic patients is challenging, with general anaesthesia (GA) and spinal anaesthesia (SA) being the two primary options. While GA is associated with increased risks of hypertensive responses and airway complications, SA is linked to hemodynamic instability and hypotension. This study aims to compare maternal and neonatal outcomes between GA and SA in pre-eclamptic patients undergoing emergency caesarean section. Objectives: The primary objective of this study was to evaluate and compare the maternal and neonatal outcomes in pre-eclampsia patients undergoing emergency caesarean section under spinal anaesthesia versus general anaesthesia. Secondary objectives included assessing maternal hemodynamic stability, anaesthesia-related complications, neonatal Apgar scores, NICU admissions, maternal satisfaction, postoperative pain management effectiveness, and hospital stay duration. Methods: A prospective comparative study was conducted at NMCH, Sasaram, over 24 months, including 100 pre-eclamptic pregnant women scheduled for emergency caesarean section. Patients were randomly assigned to two groups. Group S: Received spinal anaesthesia with 10 mg of 0.5% hyperbaric bupivacaine. Group G: Received general anaesthesia with thiopentone, succinylcholine, and maintenance with nitrous oxide and sevoflurane. Hemodynamic parameters, postoperative complications, neonatal Apgar scores, and duration of hospital stay were recorded and analyzed. Statistical comparisons were made using t-tests and chi-square tests. Results: General anaesthesia was associated with significantly higher cardiovascular stress post-induction, with elevated heart rate (103.22 vs. 92.85 bpm, p < 0.0001), systolic blood pressure (145.54 vs. 133.68 mmHg, p < 0.0001), and mean arterial pressure (103 vs. 96.62 mmHg, p = 0.0059). Spinal anaesthesia required more vasopressor use (62% vs. 30%, p = 0.0024) due to hypotension. GA patients had a higher incidence of acute kidney injury (10% vs. 0%, p = 0.0563), congestive heart failure (8% vs. 0%, p = 0.1175), and pulmonary edema (16% vs. 8%). Neonatal Apgar scores were higher in GA patients at 1, 5, and 10 minutes (p < 0.05), though NICU admissions were similar (6% vs. 10%, p = 0.7150). Hospital stay was significantly shorter in the SA group (4.68 vs. 5.94 days, p < 0.0001). Conclusion: Spinal anaesthesia, despite its association with procedural complications, exhibited superior maternal hemodynamic stability and faster recovery, with fewer systemic complications compared to general anaesthesia. General anaesthesia was linked to increased cardiovascular stress but demonstrated better neonatal adaptation immediately post-delivery. Individualized anaesthesia selection, based on patient haemodynamic, severity of pre-eclampsia, and surgical urgency, remains crucial for optimizing maternal and neonatal outcomes.

Keywords: Preeclampsia, spinal anaesthesia, general anaesthesia, caesarean section, maternal outcomes, neonatal outcomes, hemodynamic stability, anaesthesia complications, Apgar score, NICU admission, postoperative recovery

How to Cite?: Deepak Kumar Sinha, Sumit Kumar Verma, Hirday Kumar, "Comparative Study of General Anaesthesia and Spinal Anaesthesia in Pre-Eclampsia Patients Undergoing Emergency Caesarean Section", Volume 14 Issue 9, September 2025, International Journal of Science and Research (IJSR), Pages: 494-502, https://www.ijsr.net/getabstract.php?paperid=SR25909225033, DOI: https://dx.doi.org/10.21275/SR25909225033