The effect of type of anesthesia on intra-and postoperative blood loss at elective cesarean section

In cesarean section (c-sec) it is known that women receiving spinal anesthesia have decreased intraoperative blood loss compared to women receiving general anesthesia. However, we should always consider postoperative bleeding (postpartum bleeding) that may follow. The amount of postpartum bleeding can be substantial. Therefore, we sought to evaluate the effect of type of anesthesia retrospectively on intra- and postoperative blood loss by comparing the changes of postoperative Hb, Hct at c-sec.

We retrospectively compared the medical records of 287 elective c-sec patients. We excluded medical and obstetric conditions that may predispose such patients to increased blood loss. Subsequent detailed record analysis included 152 patients that received spinal anesthesia (group S), and 135 patients that received sevoflurane for general anesthesia (group G).

In comparison with the preoperative Hb, rates of Hb in the 1(st) postoperative day in group S significantly decreased compared to group G, but there was no significant difference in decreasing rates of Hb in the 3(rd) postoperative day between groups S and G. Estimated blood loss (EBL) of the intraoperative and operative day in group S was significantly lower compared to group G, but there was no significant difference in EBL of 1(st) and 2(nd) postoperative day between groups S and G.

We conclude that group S had a decrease in blood loss between the intraoperative and operative day and there was no significant differences in postoperative blood loss compared with group G.