Evaluation of the effects of different anesthetic techniques on neonatal bilirubin levels

ABSTRACT

The aim of the present study was to determine whether different anesthetic techniques applied for vaginal delivery and cesarean section affect neonatal bilirubin levels in the first 24 hours of life. A total of 511 neonates delivered by vaginal route or cesarean section were included in the study. The neonates were classified according to method of delivery and anesthetic agents as group A [cesarean section / general anesthesia with sevoflurane], group B [cesarean section / spinal anesthesia with bupivacaine hydrochloride], group C [vaginal delivery with episiotomy / local anesthesia with prilocaine hydrochloride] and group D [vaginal delivery/ no anesthesia]. The levels of neonatal serum bilirubin in the groups were compared. There was no difference between group A and group B when compared in terms of neonatal bilirubin levels [p = 0.98]. Depending on the use of prilocaine hydrochloride as local anesthetic agent in the vaginal delivery, there was no significant difference between the groups C and D, who had vaginal delivery, in terms of the neonatal bilirubin levels [p = 0.99]. The serum levels of bilirubin in cesarean section groups were significantly higher than those of the vaginal delivery groups [p < 0.001]. Prilocaine hydrochloride used for episiotomy is not effective on neonatal hyperbilirubinemia. However, sevoflurane and bupivacaine hydrochloride used in cesarean section seem to be increasing bilirubin levels