The influence of anesthesia type on perioperative maternal glycemic-stress response during elective cesarean section: A prospective cohort study

BACKGROUND: 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. METHODS: 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). RESULTS: 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. CONCLUSION: 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.