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Regional anesthesia—typically with a spinal or epidural block—has long been favored for cesarean births due in part to concerns about the effects that general anesthesia may have on newborns during labor and delivery. Powerful societal pressures also push the idea that mothers need to be awake during delivery to witness the first cry and capture the “perfect” birth moment. But for some women who undergo a cesarean birth, the pain can become excruciating, even after they received a spinal or epidural block. Now, new research from a team at the Perelman School of Medicine finds that general anesthesia may be a reasonable alternative for many patients. The findings are published in Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists.
“No patient should have to experience pain during cesarean section; as an anesthesiologist, I never want someone to feel forced to choose between their baby’s health and not having to experience the pain of surgery,” says Mark Neuman, the Horatio C. Wood Professor of Anesthesiology and senior author of the study. “Since regional anesthesia is so widely used, it’s common for patients to feel that a spinal or epidural block is the only safe option for cesarean section. But as our study shows, anesthesia type during pregnancy does not need to be one-size-fits-all.”
The research analyzed 30 years’ worth of data from multiple clinical trials, comparing outcomes between general anesthesia versus spinal or epidural anesthesia for cesarean sections. The Penn study finds that, while babies born under spinal or epidural anesthesia had slightly higher Apgar scores—a measure of newborn health—than those born under general anesthesia, the differences were small and not likely to be clinically meaningful.
While the majority of patients experience good outcomes with spinal or epidural block for cesarean delivery, recent studies show that up to one in six patients who receive an epidural or spinal block may feel pain during their cesarean section. These experiences can be traumatic and have lasting emotional impacts.
Read more at Penn Medicine News.
Matt Toal
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