Research Article
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COMPARISON OF THE EFFECTS OF ANESTHESIA METHOD APPLIED IN ELECTIVE CESAREAN SECTION ON NEONATAL BILIRUBIN LEVEL

Year 2023, Volume: 30 Issue: 4, 644 - 650, 30.12.2023
https://doi.org/10.17343/sdutfd.1338003

Abstract

Objective
General and regional anesthesia techniques are used
in cesarean section operations, which are frequently
applied today. The aim of this study was to examine
the effect of general anesthesia on newborn bilirubin
and to compare it with the level of bilirubin in babies
born with regional anesthesia.
Material and Method
Between March 2022 and September 2022, 154
patients over 18 years of age with term pregnancy
and elective cesarean section planned without
complications were randomly included in the study.
Cases diagnosed with liver and biliary tract disease,
systemic liver and biliary tract effective drug use,
direct coombs test (Dcoombs) (+) and Covid 19 (+)
clinics were excluded.
Results
General anesthesia was applied to 75 (48.8%) of the
patients included in our study, and spinal anesthesia
was applied to 79 (51.2%) patients, who underwent
cesarean section. It was determined that the first hour
bilirubin and the fourth hour bilirubin values were
significantly higher (p <0.05) in the general anesthesia
group than the spinal anesthesia group. APGAR 1st
min and APGAR 5th min scores were found to be
significantly higher (p <0.05) in the spinal anesthesia
group than in the general anesthesia group. Neonatal
weight, head circumference and infant height did not
differ significantly between general anesthesia and
spinal anesthesia groups (p> 0.05).
Conclusion
General anesthesia and spinal anesthesia applied;
Bilirubin value measured among babies born by
cesarean section differs in favor of spinal anesthesia.
It seems that it is more beneficial to avoid systemic
effective applications as much as possible. However,
it is an important issue that regional anesthesia
practices become more prevalent in clinical practice.

References

  • 1. Kayhan Z. Klinik Anestezi (2. Baskı). İstanbul, Logus Yayıncılık; 1997:623-638.
  • 2. Bacon DR. The historical narrative: Tales or professionalism? Anesthesiology Clin 2008;26:67-74
  • 3. Erdem MK, Özgen S, Coflkun F. Obstetrik Anestezi ve Analjezi. In: Kişnişçi H, Gökşin E (Eds) Temel Kadın Hastalıkları ve Doğum Bilgisi. Ankara, Melisa Matbaacılık; 1996: 173-186
  • 4. Arias IM, Gartner LM, Seifter S, Furman M. Prolonged neonatal unconjugated hyperbilirubinemia associated with breast feding and a steroid, pregnane-3(a), 20(b)-diol in maternal milk that inhibits glucuronid formation in vitro. J Clin Invest 1964; 43: 2037–2047.
  • 5. Rane A, Lunde PKM, Jalling B, Yaffe SJ, Sjoqvist F. Plasma protein binding of diphenylhydantoin in normal and hyperbilirubinemia infants. Journal of Pediatrics 1971;78: 877–822.
  • 6. Rane A, Lunde PKM, Jalling B, Yaffe SJ, Sjoqvist F. Plasma protein binding of diphenylhydantoin in normal and hyperbilirubinemia infants. Journal of Pediatrics 1971;78: 877–822.
  • 7. Jouppilla R, Larva L, Jouppilla P, Koivisto M, Pakarinen A. Effect of segmental Epidural analgesia on neonatal serum bilirubin concentration and incidence of neonatal hyperbilirubinemia. Acta Obstet Gynecol Scand. 1983: 62;179–82.
  • 8. Gale R, Ferguson JE, Stevenson DK. Effect of epidural analgesia with bupivacaine hydrochloride on neonatal bilirubin production. Obstetric and gynecology 1987: 70(5):692-5. PMID: 3116476.
  • 9. Chester BM. Normal fetal physiology and behavior, and adaptive responses with hypoxemia. Semin Perinatol 2008; 32: 239-242.
  • 10. De Amici D, Delmonte P, Martinotti L, Gasparoni A, Zizzi S, Ramajoli I, Ramajoli F. Can anesthesiologic strategies for caesarian section influence newborn jaundice? A retrospective and prospective study. Biol Neonate 2001:79;97–102.
  • 11. Frink EJ. The hepatic effects of sevoflorane. Anesth Analg 1995;81:1–5.
  • 12. Watkins JB III. Exposure of rats to inhalational anesthetics alters the hepatobiliary clearance of cholephilic xenobiotics. J Pharmacol Exp Ther 1989;250:421–427.
  • 13. Scanlon JW. Neurobehavioral response and drug concentrations in newborns after maternal epidural anesthesia with Bupivacaine. Anesthesiology 1976;45: 400.
  • 14. Kayacan N, Bigat Z, Yeğin A, et al. A randomized prospective study on the maternal and neonatal outcome of epidural, combined spinal-epidural and general anesthesia for elective caesarean sections. Turkiye Klinikleri J Med Sci. 2004;24(5):476-82
  • 15. Phuapradit W, Chaturachinda K, Auntlamai S. Risk faktors for neonatal hyperbilirubinemia. Med Assoc Thai 1993;76:424-8.
  • 16. Bakar FT, Ozen A, Karatepe HO, Berber M, Ercan H. Impact of early weight loss on growth of Caesarean delivered babies: how long does it last? Childcare Health Dev. 2012;38(5):706-13.

ELEKTİF SEZARYEN OPERASYONLARINDA UYGULANAN ANESTEZİ YÖNTEMİNİN, YENİDOĞAN BİLURUBİN SEVİYESİ ÜZERİNE OLAN ETKİLERİNİN KARŞILAŞTIRILMASI

Year 2023, Volume: 30 Issue: 4, 644 - 650, 30.12.2023
https://doi.org/10.17343/sdutfd.1338003

Abstract

Amaç
Günümüzde oransal olarak artma eğilimi gösteren
sezaryen operasyonlarında, genel ve rejyonel anestezi
teknikleri uygulanmaktadır. Bu çalışmada; genel
anestezi yönteminin yenidoğan bilurubini üzerine olan
etkisini incelemek ve rejyonel anestezi yöntemi ile
doğan bebeklerin bilurubin seviyesi ile karşılaştırmak
amaçlanmıştır.
Gereç ve Yöntem
Mart 2022- Eylül 2022 tarihleri arasında,18 yaşın üzerinde
term gebelik ile elektif olarak sezaryen planlanan,
komplikasyonsuz 154 hasta rastgele çalışmaya
dahil edilmiştir. Karaciğer ve safra yolları hastalığı tanısı
alan, sistemik karaciğer ve safra yolları etkili etkili
ilaç kullanımı olan, direkt coombs testi (Dcoombs) (+)
ve covid (+) kliniği olan vakalar ekarte edilmiştir.
Bulgular
Çalışmamıza dahil edilen hastalardan 75’i (%48,8)
genel anestezi yöntemi, 79’una (%51,2) spinal anestezi
yöntemi uygulanarak sezaryen operasyonu gerçekleştirilmiştir.
Genel anestezi grubunda; yenidoğanlardan
transkutanöz yolla ciltten bakılan, 1.saat ve
4.saat bilurubin değeri spinal anestezi grubundan anlamlı
(p <0.05) olarak daha yüksek olduğu saptanmıştır.
Spinal anestezi grubunda APGAR 1. dk, APGAR 5.
dk skoru genel anestezi grubundan anlamlı (p <0.05)
olarak daha yüksek saptanmıştır. Genel anestezi ve
spinal anestezi grupları arasında yenidoğan kilo, baş
çevresi, bebek boyu anlamlı (p> 0.05) farklılık göstermemiştir.
Gruplarda cinsiyet farkı gözetilmeksizin, tamamen
rastgele olarak gruplar belirlenmiştir.
Sonuç
Genel anestezi ve spinal anestezi uygulanan; sezaryen
ile doğan bebekler arasında ölçülen bilurubin
değeri spinal anestezi lehine farklılık göstermektedir.
Sistemik etkili uygulamalardan mümkün olduğunca
kaçınmanın daha faydalı olabileceği görülmektedir.
Bununla birlikte rejyonel anestezi uygulamalarının klinik
pratikte daha fazla yer bulması önemli bir husus
olarak karşımıza çıkmaktadır.

References

  • 1. Kayhan Z. Klinik Anestezi (2. Baskı). İstanbul, Logus Yayıncılık; 1997:623-638.
  • 2. Bacon DR. The historical narrative: Tales or professionalism? Anesthesiology Clin 2008;26:67-74
  • 3. Erdem MK, Özgen S, Coflkun F. Obstetrik Anestezi ve Analjezi. In: Kişnişçi H, Gökşin E (Eds) Temel Kadın Hastalıkları ve Doğum Bilgisi. Ankara, Melisa Matbaacılık; 1996: 173-186
  • 4. Arias IM, Gartner LM, Seifter S, Furman M. Prolonged neonatal unconjugated hyperbilirubinemia associated with breast feding and a steroid, pregnane-3(a), 20(b)-diol in maternal milk that inhibits glucuronid formation in vitro. J Clin Invest 1964; 43: 2037–2047.
  • 5. Rane A, Lunde PKM, Jalling B, Yaffe SJ, Sjoqvist F. Plasma protein binding of diphenylhydantoin in normal and hyperbilirubinemia infants. Journal of Pediatrics 1971;78: 877–822.
  • 6. Rane A, Lunde PKM, Jalling B, Yaffe SJ, Sjoqvist F. Plasma protein binding of diphenylhydantoin in normal and hyperbilirubinemia infants. Journal of Pediatrics 1971;78: 877–822.
  • 7. Jouppilla R, Larva L, Jouppilla P, Koivisto M, Pakarinen A. Effect of segmental Epidural analgesia on neonatal serum bilirubin concentration and incidence of neonatal hyperbilirubinemia. Acta Obstet Gynecol Scand. 1983: 62;179–82.
  • 8. Gale R, Ferguson JE, Stevenson DK. Effect of epidural analgesia with bupivacaine hydrochloride on neonatal bilirubin production. Obstetric and gynecology 1987: 70(5):692-5. PMID: 3116476.
  • 9. Chester BM. Normal fetal physiology and behavior, and adaptive responses with hypoxemia. Semin Perinatol 2008; 32: 239-242.
  • 10. De Amici D, Delmonte P, Martinotti L, Gasparoni A, Zizzi S, Ramajoli I, Ramajoli F. Can anesthesiologic strategies for caesarian section influence newborn jaundice? A retrospective and prospective study. Biol Neonate 2001:79;97–102.
  • 11. Frink EJ. The hepatic effects of sevoflorane. Anesth Analg 1995;81:1–5.
  • 12. Watkins JB III. Exposure of rats to inhalational anesthetics alters the hepatobiliary clearance of cholephilic xenobiotics. J Pharmacol Exp Ther 1989;250:421–427.
  • 13. Scanlon JW. Neurobehavioral response and drug concentrations in newborns after maternal epidural anesthesia with Bupivacaine. Anesthesiology 1976;45: 400.
  • 14. Kayacan N, Bigat Z, Yeğin A, et al. A randomized prospective study on the maternal and neonatal outcome of epidural, combined spinal-epidural and general anesthesia for elective caesarean sections. Turkiye Klinikleri J Med Sci. 2004;24(5):476-82
  • 15. Phuapradit W, Chaturachinda K, Auntlamai S. Risk faktors for neonatal hyperbilirubinemia. Med Assoc Thai 1993;76:424-8.
  • 16. Bakar FT, Ozen A, Karatepe HO, Berber M, Ercan H. Impact of early weight loss on growth of Caesarean delivered babies: how long does it last? Childcare Health Dev. 2012;38(5):706-13.
There are 16 citations in total.

Details

Primary Language Turkish
Subjects Anaesthesiology
Journal Section Research Articles
Authors

Deniz Turan 0000-0002-2215-0531

Publication Date December 30, 2023
Submission Date August 4, 2023
Acceptance Date December 8, 2023
Published in Issue Year 2023 Volume: 30 Issue: 4

Cite

Vancouver Turan D. ELEKTİF SEZARYEN OPERASYONLARINDA UYGULANAN ANESTEZİ YÖNTEMİNİN, YENİDOĞAN BİLURUBİN SEVİYESİ ÜZERİNE OLAN ETKİLERİNİN KARŞILAŞTIRILMASI. Med J SDU. 2023;30(4):644-50.

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