COMPARISON OF GENERAL ANESTHESIA AND SPINAL ANESTHESIA IN TERMS OF INTRAOPERATIVE HEMODYNAMIC STABILITY IN PATIENTS WITH PLACENTA PREVIA TYPE III UNDERGOING ELECTIVE CESAREAN SECTION

Abstract

Background: Placenta previa type III is associated with an increased risk of significant intraoperative blood loss and hemodynamic instability during cesarean section.

Objective: To compare general anesthesia and spinal anesthesia in terms of intraoperative hemodynamic stability in patients with placenta previa type III undergoing elective cesarean section.

Methods: This randomized controlled trial included 188 patients with placenta previa type III undergoing elective cesarean section at the Department of Anesthesia, Sir Ganga Ram Hospital, Lahore from August 2025 to November 2025. Patients were allocated into two equal groups of 94 patients each. Group A received spinal anesthesia, whereas Group B received general anesthesia.

Results: Mean estimated blood loss was significantly lower in the spinal anesthesia group than in the general anesthesia group (760 ± 510 mL vs. 1030 ± 690 mL, p=0.003). Hemodynamic stability was maintained in 75 (79.8%) patients in the spinal anesthesia group compared with 63 (67.0%) patients in the general anesthesia group (p=0.048). Blood transfusion was required in 19 (20.2%) patients receiving spinal anesthesia and 34 (36.2%) receiving general anesthesia (p=0.015).

Conclusion: Spinal anesthesia was associated with better intraoperative hemodynamic stability, lower estimated blood loss, and reduced blood transfusion requirements compared with general anesthesia in patients with placenta previa type III undergoing elective cesarean section.