[The use of spinal anaesthesia for cesarean section (author's transl)]

In analysing our own material of 139 cases of cesarean section a clinical report is given concerning the method of anaesthesia, the maternal haemodynamics during anaesthesia and the Apgar score of the newborn. Primarily hyperbaric spinal anaesthesia was always chosen, only 28.3% of the cases were performed under general anaesthesia because of missing maternal consent or general objection of the obstetrician. The rationale for choosing spinal anaesthesia was the safe prevention of acid aspiration of the mother and in the minimal fetal depression. The only disadvantage of spinal anaesthesia, namely a marked blood pressure fall leading to placental hypoperfusion, can be safely prevented by counteracting the sympathetic blockade by volume therapy in time. The two groups of newborns should no show significant differences in Apgar scores. 10 lively babies in a group of 12 cases of severe haemolytic disease of the newborn (Rh) however, all delivered under spinal anaesthesia, confirm our ideas about spinal anaesthesia being less depressant to the fetus than general anaesthesia. Regional anaesthesia therefore is stated as the method of choice especially for the fetus at risk. Differences in favour of spinal anaesthesia in our series were not statistically relevant in the normal case; studies of neurobehavioral function, however, are not included.