Anesthesia for cesarean delivery: general or regional anesthesia—a systematic review

Background
General anesthesia and regional anesthesia are the anesthetic techniques of choice for cesarean delivery. These anesthetic techniques have their effects on both the fetus and mother. The choice of anesthetic techniques for cesarean delivery depends on several factors including physiological presentation of the patient, experience level of the practitioner, availability of drugs, and equipment, among others. However, whichever technique is used is chosen because of its safety profile and benefit to both mother and fetus. Therefore, this study aimed to compare the effects of general anesthesia against regional anesthesia on fetal and maternal outcomes for cesarean delivery.
Main body
Search methods were conducted on PubMed, Scopus, Embase, and Cochrane library to identify eligible studies using the keywords, MeSH terms, and filters. Two review authors independently assessed the included studies for quality, bias, and accuracy. A total of fourteen (14) studies (1924 women) contributed data for this review. Findings showed that the 1st and 5th minute Apgar scores were higher in regional anesthesia than in general anesthesia while the 1st minute Apgar scores < 7 were more in general anesthesia. On the other hand, fetal umbilical arterial blood pH was lower in regional anesthesia. Also, intraoperative hypotension was more in regional anesthesia while heart rate and estimated blood loss significantly higher in general anesthesia.
Conclusion
In conclusion, regional anesthesia emerges as a better option evidenced by its better fetal and maternal outcomes. However, both regional anesthesia and general anesthesia are still used for cesarean delivery.