Comparison of Spinal and General Anesthesia on Hemodynamic Responses and Perioperative Blood Glucose Levels in Patients Undergoing Cesarean Section

Abstract

Background: The choice of anaesthetic technique during caesarean section may influence maternal haemodynamic stability and the metabolic response to surgical stress. Spinal and general anaesthesia differ in their effects on cardiovascular regulation and perioperative blood glucose levels. However, evidence regarding their combined effects on haemodynamic parameters and glycaemic responses in non-diabetic patients undergoing caesarean section remains limited, warranting further investigation. Aims: To compare spinal and general anaesthesia in relation to perioperative haemodynamic responses and blood glucose levels in non-diabetic patients undergoing caesarean section. Study Design: Prospective controlled clinical study. Place and Duration of Study: Al-Zahraa Teaching Hospital, Middle Al-Furat Teaching Hospital, Al-Hakim General Hospital, and Najaf Al-Ashraf Teaching Hospital, Najaf, Iraq, from November 2025 to February 2026. Methodology: Forty non-diabetic patients undergoing caesarean section were included and divided into two equal groups according to the anaesthetic technique received: general anaesthesia (n = 20) or spinal anaesthesia (n = 20). Blood glucose, heart rate, systolic blood pressure, and diastolic blood pressure were recorded preoperatively, intraoperatively, and postoperatively. Data were analysed using GraphPad Prism and two-way repeated-measures analysis of variance (ANOVA). Results: Baseline measurements did not differ significantly between groups. Intraoperative blood glucose was significantly higher with general anaesthesia than with spinal anaesthesia (119.13 vs 105.80 mg/dL, P < 0.001), and the difference remained significant postoperatively (125.13 vs 113.93 mg/dL, P < 0.05). Intraoperative heart rate was significantly higher with general anaesthesia than with spinal anaesthesia (97.00 vs 78.27 beats/min, P < 0.001). Spinal anaesthesia was also associated with significantly lower intraoperative systolic blood pressure (93.00 vs 125.67 mmHg, P < 0.0001) and diastolic blood pressure (59.47 vs 82.60 mmHg, P < 0.0001). Conclusion: Spinal and general anaesthesia produced different metabolic and haemodynamic profiles during caesarean section. Spinal anaesthesia was associated with a smaller perioperative increase in blood glucose and a lower heart rate, but it also produced a greater reduction in blood pressure. These findings support careful haemodynamic monitoring when spinal anaesthesia is used.