Comparison of Spinal and General Anesthesia in Patients Undergoing Elective Cesarean Section: A Cross-Sectional Comparative Study at Lady Reading Hospital Peshawar

Abstract

Background: Cesarean section is one of the most frequently performed obstetric surgical procedures, and the choice of anesthesia can influence maternal hemodynamic stability, postoperative pain, recovery, and maternal satisfaction. Spinal anesthesia is increasingly preferred for elective cesarean delivery because it provides effective surgical anesthesia while allowing the mother to remain conscious and may reduce several postoperative complications. To compare the maternal outcomes, postoperative recovery, complications, and satisfaction associated with spinal and general anesthesia among patients undergoing elective cesarean section. Methods: This cross-sectional comparative study was conducted at the Department of Anaesthesiology, Lady Reading Hospital, Peshawar, from 1st January to 30th April 2026. A total of 384 women undergoing elective cesarean section were enrolled and divided into two equal groups (n=192 each) according to the anesthesia technique received: spinal anesthesia and general anesthesia. Data were collected on a structured proforma covering demographic characteristics, intraoperative complications, postoperative pain, nausea and vomiting, recovery time, analgesic requirements, and maternal satisfaction. Data were analyzed using SPSS version 25.0, and a p-value <0.05 was considered statistically significant. Results: The spinal anesthesia group demonstrated more favorable postoperative outcomes than the general anesthesia group. Maternal satisfaction was higher with spinal anesthesia (87.5%) than with general anesthesia (68.2%). Postoperative nausea and vomiting occurred in 12.0% of the spinal group versus 25.5% of the general anesthesia group. Mean recovery time was shorter in the spinal group (38.6 ± 8.4 minutes) than in the general anesthesia group (51.3 ± 10.2 minutes). Intraoperative hypotension was more frequent with spinal anesthesia, while respiratory complications and postoperative nausea and vomiting were more common with general anesthesia (p<0.05). Conclusion: Spinal anesthesia was associated with better postoperative comfort, higher maternal satisfaction, fewer adverse effects, and faster recovery compared with general anesthesia in women undergoing elective cesarean section. Spinal anesthesia is recommended as the preferred technique when no contraindications exist.

Keywords: Spinal anesthesia; General anesthesia; Elective cesarean section; Maternal satisfaction; Postoperative recovery; Postoperative nausea and vomiting.