General versus neuraxial anaesthesia for caesarean section: Impact on the duration of hospital stay

Summary We investigated retrospectively the duration of hospital stay of 1,619 women who received general (GA) (n = 582) or neuraxial anaesthesia (combined spinal-epidural [CSEA] (n = 614), epidural [EA] (n = 423)) for caesarean delivery over the years 2002–2005. Hospital stay was also analysed for the different obstetricians involved. Overall duration of hospital stay differed between 2002 and 2005 (p < 0.0001) but not between CSEA and EA (p = 0.460). Overall duration of hospital stay differed between neuraxial and GA group (p < 0.001). Duration of hospital stay of the GA group showed a progressive decrease between 2002 and 2005 (p = 0.002). Duration of hospital stay after neuraxial anaesthesia differed between 2002 and 2005 (p = 0.013) and among different surgeons (p < 0.001). Discharge rates from the hospital were shorter after neuraxial anaesthesia versus GA for the 3rd and 4th postoperative days (p < 0.001 and p < 0.001, respectively). Neuraxial anaesthesia for caesarean section seems to be associated with shorter duration of hospital stay than GA.

[1]  P. Seed,et al.  Anaesthesia for Caesarean section and neonatal acid‐base status: a meta‐analysis * , 2005, Anaesthesia.

[2]  F. Bonnet,et al.  Influence of anaesthetic and analgesic techniques on outcome after surgery. , 2005, British journal of anaesthesia.

[3]  Henrik Kehlet,et al.  Anaesthesia, surgery, and challenges in postoperative recovery , 2003, The Lancet.

[4]  C. Whitty,et al.  Caesarean section in Malawi: prospective study of early maternal and perinatal mortality , 2003, BMJ : British Medical Journal.

[5]  R. Dyer,et al.  Prospective, Randomized Trial Comparing General with Spinal Anesthesia for Cesarean Delivery in Preeclamptic Patients with a Nonreassuring Fetal Heart Trace , 2003, Anesthesiology.

[6]  H. Kehlet,et al.  Multimodal strategies to improve surgical outcome. , 2002, American journal of surgery.

[7]  P. Myles,et al.  Epidural anaesthesia and analgesia and outcome of major surgery: a randomised trial , 2002, The Lancet.

[8]  H. Vaghadia,et al.  Selective Spinal Anesthesia Versus Desflurane Anesthesia in Short Duration Outpatient Gynecological Laparoscopy: A Pharmacoeconomic Comparison , 2002, Anesthesia and analgesia.

[9]  Anthony Rodgers,et al.  Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials , 2000, BMJ : British Medical Journal.

[10]  A. C. Primavesi.  Comparison of Combined Spinal Epidural Anesthesia and Epidural Anesthesia for Cesarean Section , 2000 .

[11]  C. Gevirtz,et al.  Anesthesia-related deaths during obstetric delivery in the United States. 1979-1990. , 1997, Anesthesiology.

[12]  L. Koonin,et al.  Anesthesia‐related Deaths during Obstetric Delivery in the United States, 1979–1990 , 1997, Anesthesiology.

[13]  K. Leveno,et al.  Randomized Comparison of General and Regional Anesthesia for Cesarean Delivery in Pregnancies Complicated by Severe Preeclampsia , 1995, Obstetrics and gynecology.