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Elektif Sezaryenlerde Intratekal Bupivakaine ilave Edilen Fentanil ve Morfinin Efedrin Gereksinimi ve Fetusa Etkisi

The Effects of Intrathecal Bupivacaine-Fentanyl and Bupivacaine-Morphine on Ephedrine Requirements and Health Status of Fetus in Elective Cesarean Section

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2005

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objectives: In this study, we aimed to compare the effects of intrathecal bupivacaine-fentanyl and bupivacaine-morphine on ephedrine requirements and on health status of fetus. Methods: We enrolled 54 cases undergoing elective cesarean section in this study. Ringer's lactate was infused to all patients at a rate of 10-12 mL kg-1 preoperatively and 8-10 mL kg hr-1 during operation. Spinal anesthesia was achieved with 2 mL of bupivacaine %0.5 in Group I (n=18), with 1.5 mL of bupivacaine %0.5 + 0.5 mL fentanyl, 25 [i.g, in Group II (n=18) and with 1.5 mL of bupivacaine %0.5 + 0.5 mL morphine, 0.1 mg, in Group III (n=18). After spinal anesthesia, ephedrine infusion was given following a bolus dose of 5 mg ephedrine, to maintain arterial pressure during the operation at the level of 80-110% of the basal value. Results: We found that total ephedrine requirements during operation was 58.4+25.4 mg in Group I, 46.3+22.3 mg in Group II and 38.6+16.3 mg in Group III. The total amount of ephedrine administered in Group III was found to be significantly lower than that in Group I (p<0.05). Umblical blood pH in Group I was detected lower than that in Group III (p<0.05). Conclusion: We concluded that; combination of bupivacaine+morphine with lower doses of ephedrine achieved the same hemodynamic states than bupivacaine alone in elective cesarean sections.
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Abstract (Original Language): 
Amaç: Bu çalışmada elektif sezaryenlerde intratekal bupivakaine ilave edilen fentanil ve morfinin, efedrin gereksinimine ve fetus üzerine etkilerini karşılaştırmayı amaçladık. Gereç ve Yöntem: Elektif sezaryen planlanan 54 olgu çalışmaya alındı ve tüm olgulara laktatlı ringer; anestezi öncesi 10-12 mL kg-1 ve operasyon süresince 8-10 mL kg sa-1 verildi. Grup I (n=18)'de 2 mL %0.5 bupivakain, Grup II (n=18)'de 1.5 mL %0.5 bupivakain + 0.5 mL'de 25 fentanil ve Grup III (n=18)'te 1.5 mL %0.5 bupivakain + 0.5 mL'de 0.1 mg morfin kullanılarak spinal anestezi uygulandı. Spinal anestezi sonrası 5 mg bolus efedrini takiben operasyon süresince kan basıncı, giriş sistolik arter basıncı değerinin %80-110'ları olacak şekilde efedrin infüzyonu uygulandı. Bulgular: Operasyon süresince grupların total efedrin ihtiyacı Grup I'de 58.4±25.4 mg, Grup II'de 46.3±22.3 mg ve Grup III'te 38.6+16.3 mg idi. Kullanılan total efedrin miktarı Grup III'te Grup I'e göre anlamlı olarak düşük bulundu (p<0.05). Fetal umblikal pH, Grup I'de Grup III'e göre daha düşük tespit edildi (p<0.05). Sonuç: Spinal anestezi uygulanmış elektif sezaryenlerde, bupivakain ile morfin kombinasyonunun, bupivakainin tek başına kullanımına göre daha az dozda efedrin ile aynı hemodinamik koşulları sağladığı kanısına varıldı.
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  • 1
5-9
  • Turkish

REFERENCES

References: 

1. Kee WD, Khaw KS, Lee BB, Lau TK, Gin T. A dose-response study of prophylactic
intravenous ephedrine for the prevention of hypotension during spinal anesthesia for
cesarean delivery. Anesth Analg 2000; 90:1390-1395.
2. Mercier FJ, Riley ET, Frederickson WL, et al. Phenylephrine added to prophylactic
ephedrine infusion during spinal anesthesia for elective cesarean section.
Anesthesiology 2001; 95:668-674.
3. Vercauteren MP, Coppejans HC, Hoffmann VH, Mertens E, Adriaensen HA
Prevention of hypotension by a single 5-mg dose of ephedrine during small-dose
spinal anesthesia in prehydrated cesarean delivery patients. Anesth Analg 2000;
90:324-327.
4. Ayorinde BT, Buczkowski P, Brown J, Shah J, Buggy DJ. Evaluation of pre-emptive
intramuscular phenylephrine and ephedrine for reduction of spinal anaesthesiainduced
hypotension during caesarean section. Br J Anaesth 2001; 86:372-376.
5. Ngan Kee WD, Lau TK, Khaw KS, Lee BB. Comparison of metaraminol and
ephedrine infusions for maintaining arterial pressure during spinal anesthesia for
elective cesarean section. Anesthesiology 2001; 95:307-313.
6. Hawkins JL, Koonin LM, Palmer SK, Gibbs CP. Anesthesia-related deaths during
obstetric delivery in the United States, 1979-1990. Anesthesiology 1997; 86:277-284.
7. Pan PH, Moore C. Intraoperative antiemetic efficacy of prophylactic ondansetron
versus droperidol for Cesarean section patients under epidural anesthesia. Anesth
Analg 1996; 83:982-986.
8. Rout CC, Rocke DA, Levin J, Gouws E, Reddy D. A re-evaluation of the role of
crystalloid preload in the prevention of hypotension associated with spinal anesthesia
for elective Cesarean section. Anesthesiology 1993; 79:262-269.
9. Critchley LA, Stuart JC, Conway F, Short TG. Hypotension during subarachnoid
anaesthesia: haemodynamic effects of ephedrine. Br J Anaesth 1995; 74:373-378.
10. Vincent RD, Werhan CF, Norman PF, et al. Prophylactic angiotensin I I infusion
during spinal anesthesia for elective cesarean delivery. Anesthesiology 1998; 88:1475¬
1479.
11. Datta S, Alper MH, Ostheimer GW, Weiss JB. Method of ephedrine administration
and nausea and hypotension during spinal anesthesia for cesarean section.
Anesthesiology 1982; 56:68-70.
12. Bakan N, Özpolat S, Ayas A, Ersoy MÖ. Sezaryen ameliyatlarında intratekal
uygulanan fentanilin etkileri. Türk Anest Rean Cem Mecmuası 2000; 28:430-436.
13. Morgan P: The role of vasopressors in the management of hypotension induced by
spinal and epidural anaesthesia. Can J Anaesth 1994; 41:404-413.

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