Isoflurane or halothane for cesarean section: comparative maternal and neonatal effects.

Area of Science:

• Anesthesiology
• Obstetric Anesthesia

Background:

• Cesarean sections require safe anesthetic agents for both mother and neonate.
• Isoflurane and halothane are volatile anesthetics used in combination with nitrous oxide.
• Evaluating anesthetic safety in obstetric patients is crucial.

Purpose of the Study:

• To compare the maternal and neonatal effects of isoflurane versus halothane during cesarean section.
• To assess the safety of isoflurane as an alternative to halothane in obstetric anesthesia.

Main Methods:

• 60 healthy parturients undergoing cesarean section were randomly assigned to receive anesthesia with isoflurane (0.5% or 1%) or halothane (0.5%) combined with 50% N2O-50% O2.
• Maternal blood loss, intraoperative awareness, plasma epinephrine levels, and serum fluoride concentrations were monitored.
• Neonatal status was evaluated using Apgar scores, cord acid-base status, and Neurologic and Adaptive Capacity Scores (NACS).

Main Results:

• No significant differences in maternal blood loss or intraoperative awareness were observed among groups.
• Maternal plasma epinephrine levels increased in the 0.5% isoflurane group but not in others.
• Neonatal outcomes (Apgar, acid-base, NACS) were similar across all anesthetic groups.
• No maternal renal toxicity or significant increases in maternal/neonatal fluoride levels were detected.

Conclusions:

• Isoflurane is a safe anesthetic supplement to N2O-O2 for cesarean sections.
• Isoflurane is a safer alternative to halothane for cesarean sections in patients on beta-adrenergic therapy due to reduced risk of arrhythmias.