OBJECTIVE To determine the safety of general anesthesia during cesarean section for neonates. METHODS Singleton pregnant women for whom elective cesarean sections were planned after 37 gestation weeks were allocated to general anesthesia or epidural anesthesia. After preoxygenation, general anesthesia was induced with fentanyl (2.0 microg/kg), propofol (1.5 mg/kg) and vencuronium (0.08 mg/kg) followed by tracheal intubation. Oxygen-nitrous oxides (50%) was inhaled before delivery. Epidural anesthesia was performed at L(1 - 2) or L(2 - 3) on the left lateral decubitus position with 1.73% lidocaine carbonate (including 1:200 000 adrenaline). We studied arterial samples withdrawn from the infants 30 min after birth for the pH, PaO(2), PaCO(2), SPO(2) and Hct. Neonatal behavioral neurological assessments (NBNA) 3 - 5 days after birth were recorded. RESULTS (1) The pH, PaO(2), PaCO(2), SPO(2) and Hct in the general anesthesia group were 7.34 +/- 0.08, (40 +/- 11) mm Hg, (73 +/- 17) mm Hg, (96.8 +/- 1.0)%, and (53 +/- 5)%, while in the epidural anesthesia group were 7.35 +/- 0.05, (41 +/- 8) mm Hg, (71 +/- 17) mm Hg, (96.6 +/- 1.0)%, and (54 +/- 6)%. (2) NBNA scores: In the general anesthesia group, neonatal adaptive capacity, passive tone, active tone, primary reflexes and general status were 12.6 +/- 0.7, 7.2 +/- 0.7, 7.4 +/- 0.6, 5.6 +/- 0.8, and 5.9 +/- 0.3 respectively. While in the epidural anesthesia group they were 13.4 +/- 0.8, 7.3 +/- 0.5, 7.3 +/- 0.8, 5.6 +/- 0.6, and 5.9 +/- 0.3 respectively. No significant difference was seen (P > 0.05) between the general anesthesia group and the epidural anesthesia group in NBNA scores, mean pH, PaO(2), PaCO(2), SPO(2) and Hct of newborn infants. CONCLUSIONS It study suggests that general anesthesia for the elective cesarean section does not influence significantly the outcome of the newborn infants.