Bani Hani Diab A, Altal Omar F, Bataineh Adel, Al Athamneh Mahmoud, Altarawneh Mohammad, Alshawaqfeh Moath, Haddouchane Hajar, Al-Zyoud Sultan M, Hamarsheh Musa'b, Alhowary Ala A A
Department of Anesthesia and Recovery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 21110, Jordan.
Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 21110, Jordan.
Ann Med Surg (Lond). 2021 Mar 4;64:102209. doi: 10.1016/j.amsu.2021.102209. eCollection 2021 Apr.
It has been known that the type of anesthesia can affect the stress response to surgery in form of hyperglycemia. This study aims to evaluate and compare the influence of general anesthesia (GA) and spinal anesthesia (SA) on pregnant women who are scheduled to undergo cesarean section (CS) and to understand the impact of obstetrical factors on the maternal hyperglycemic-stress response during CS.
Prospectively, we identified, assessed and followed those pregnant women who were scheduled to undergo elective CS surgery. The included group comprises any women who was scheduled to undergo an elective CS. The preoperative and postoperative blood glucose levels were measured and compared between both groups (GA and SA groups).
The study included 302 patients who satisfied the inclusion and exclusion criteria of the study. GA was more commonly utilized in cesarean sections (56.6%) compared with SA (43.4%). The average gestational age at time of delivery was 37.4 weeks. The post-operative readings were significantly higher in the GA group with a mean sugar level of 110.1 mg/dL and a mean sugar level in the SA group of 87.7 mg/dL (P = 0.00). After performing multiple regression analysis, it was revealed that the type of anesthesia is the most independent factor affecting the postoperative sugar level.
GA causes higher blood glucose concentrations than SA, which indicates that the impact of GA on hormonal stress response and metabolic hemostasis is greater than in SA.
已知麻醉类型可通过高血糖的形式影响手术应激反应。本研究旨在评估和比较全身麻醉（GA）和脊髓麻醉（SA）对计划行剖宫产术（CS）的孕妇的影响，并了解产科因素对剖宫产术中母体高血糖应激反应的影响。
前瞻性地，我们识别、评估并随访了计划行择期剖宫产手术的孕妇。纳入组包括任何计划行择期剖宫产的女性。测量并比较两组（GA组和SA组）术前和术后的血糖水平。
该研究纳入了302例符合研究纳入和排除标准的患者。与SA（43.4%）相比，GA在剖宫产中更常用（56.6%）。分娩时的平均孕周为37.4周。GA组术后读数显著更高，平均血糖水平为110.1mg/dL，SA组平均血糖水平为87.7mg/dL（P = 0.00）。进行多元回归分析后发现，麻醉类型是影响术后血糖水平的最独立因素。
GA导致的血糖浓度高于SA，这表明GA对激素应激反应和代谢止血的影响大于SA。
