Summary
Background. In obstetric emergencies, the time required for preparation of the patient and surgical team for cesarean section may determine survival of the foetus. There is no general agreement regarding the choice of anaesthesia in this regard. Methods. We have retrospectively compared the time required to be ready for emergency cesarean section, when performed under either spinal (SA) or general anaesthesia (GA). The following time periods were analyzed: the time from entering the operating room to successful SA or to induction of GA (b-z); the time from entering the operating room to skin incision (b-s); the time from entering the operating room to umbilical cord clamping (b-w); the time from skin incision to umbilical cord clamping (incision delivery time – IDT), or the time from injection of intravenous anaesthetic to umbilical cord clamping (induction delivery time – IDT); the time from uterine incision to umbilical cord clamping (uterine delivery time – UDT). Results. Of 2702 cesarean sections, 831 (75.06%) were performed under spinal and 276 (24.9%) were performed under GA. The mean time b-s was 12.0±8.1 min for SA versus 6.1±3.38 min for GA; the b-w times were 18.9±10.17 min for SA versus 7.09±3.37 min for GA. The mean IDT was 290.5±150.05 sec for SA versus 197.4±76.52 sec for GA; the mean UDT was 52.61±35.42 sec for SA versus 37.4±23.4 sec for GA. All differences were highly statistically significant (p<0.01). Conclusions. Because of significant time difference, general anaesthesia should be recommended for selected obstetric emergencies (NICE category I only). Spinal anaesthesia should be regarded as a method of choice in all other cases, also in patients with foetal distress.