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Elektif sezaryen girişimlerinde genel ve spinal anestezinin anne ve yenidoğan üzerine etkilerinin değerlendirilmesi

Evaluation of the effects of general and spinal anesthesia on the mother and newborn in selective cesarean operations

Journal Name:

  • Selçuk Tıp Dergisi

Publication Year:

  • 2005

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
Our study was performed to compare the effects of general and spinal anesthesia on the hemodynamic values of the mother, APGAR and umbilical vein blood gases of the newborns. 128 term, pregnant volunteer women who were planned for cesarean section and in group ASA l-ll were included in the study. The subjects randomly devided into two groups. In group I (n=60}, induction was performed with iv. propofol per 2 mg kg-l and the maintenance dose was provided with the mixture of 1 % sevofluran, 50 % air and 50 % 02. In group II (n-68j, spinal anestesia was performed in left lateral position, by injecting 7.5 mg /1.5ml} hyperbaric bupivacain intrathecal/y through L3-L4 intervertebral space, with 24 gauce spinal needle. Spinal anesthesia elevated to T6-7 level. Both groups preloaded with 10 mUkg-lh-l % 0.9 NaCI solution. Systolic and diastolic blood pressures, meanterial pressures, pulse rates and peripheric oxygen saturations reponed in all subjects of group I, before the induction and in !., 2., 3., 4., 5., 10., 15. and 30. minutes after endotracheal entubation. In spinal anes¬thesia group it is reported in /., 2., 3., 4., 5 ., 10., 15. and 30. minutes after the anesthesia. When v</e compared the pulse rates and mean arterial pressures of both groups, these values were low in spinal anesthesia group which were found to be statistically significant (p<0.05j. The arterial blood gases (pC02, p02J, pH of the mother and APGAR ( I., 5., 10. minutes) scores of the newborns were better in spinal anesthesia group, and statistically significant (p<0.005). As a result, regarding the undesired effects of the spinal anesthe¬sia on mother's hemodynamic parameters like hypotension and bradycardia; in cesarean section cases it must be used carefully. We can advice its safely use regarding to the results of the arterial blood gases and APGAR scores of the newborns after taking preventive measures especially against deep hypotension.
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Abstract (Original Language): 
Bu çalışmada sezaryen operasyonlarında genel ve spinal anestezinin hemodinami, yenidoğan APGAR skoru ve umbilikal ven kan gazı değerlen üzerine etkilerinin karşılaştırılması amaçlandı. Miyadında ASA 1-1/ grubunda 128 anne adayı çalışmaya dahil edildi ve rastgele seçimle, iki gruba ayrıldı. I. grupta (60} genel anestezi indüksiyonu her intravenöz 2 mg kg-l propofol ile anestezi idamesi ise % I sevofluran, % 50 hava ve % 50 02 karışımı ile sağlandı. II. grupta (68j spinal anestezi sol lateral pozisyonda L3-L4 intervertebral aralığından 24 gauge spinal iğne ile 7,5 mg (1,5 mi} intratekal hiperbarik bupivakain verilerek tek doz spinal anestezi uygulandı. Spinal anestezi seviyesi T6-7 düzeyine kadar yükseltildi. Gene! ve spinal anestezi uygulanan gruba 10 mL kg-lsa-1 % 0.9 NaCI solüsyonu serviste verilerek ön yükleme yapıldı. Tüm olgularda sistolik kan basıncı, diyastolik kan basıncı, ortalama arter basıncı, kalp atım hızları ve periferik oksijen satürasyonları gene! anestezi grubunda indüksiyon öncesi, endotrakeal entübasyonu takiben, spinal anestezi grubunda ise spinal anesteziyi takiben i., 2., 3., 4., 5., 10., 15., 20., 25. ve 30. dk'larda kaydedildi. Kalp atım hızı ve ortalama arter basıncı değerlerinin genel ve spinal anestezi grubu karşılaştırıldığında spinal anestezi grubunda anlamlı olarak düşük olduğu tespit edildi (p< 0.05}. Yenidoğan kan gazı pH, pCOz, pÖ2 değerleri ve APGAR skorları (i., 5., 10. dk) spinal anestezi grubunda daha iyiydi ve istatistik! olarak anlamlı bulundu (p< 0.05}. Sonuç olarak; spinal anestezi, annede hemodinamik para¬metreler üzerindeki hipotansiyon ve bradikardi gibi istenmeyen etkileri nedeniyle sezaryen vakalarında dikkatli uygulanmalıdır. Spinal anesteziyi derin hipotansiyona karşı önlem alındıktan sonra yenidoğan kan gazı ve APGAR skorları sonuçlarına dayanarak güvenle uygulanabilecek bir yöntem olarak öneriyoruz.
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  • 4
98-103
  • Turkish

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