The Effects of General and Spinal Anesthesia on Apgar scores, thyroid and liver functions of babies delivered with Cesarean Section

Year 2013, Volume: 15 Issue: 2, 41 - 45, 01.07.2013

Abdulkadir İskender İbrahim Karagöz

Abstract

Purpose: In our study we aimed to compare the Apgar scores, thyroid and liver functions ofneonates, who were delivered with elective caesarean section undergoing general anesthesia orspinal anesthesia.Methods: 60 patients with age 18–40 were included. Patients were randomized in 3 groups:general anesthesia inducted with propofol or with thiopenthal or spinal anesthesia. In propofolgroup induction was perf ormed with propofol 2 mg/kg and rocuronium 0,6 mg/kg and thenpatients were intubated. In thiopenthal group induction was performed with thiopental 4–5mg/kg and rocuronium 0,6 mg/kg and then patients were intubated. In both groups anesthesiamaintenance was provided with sevoflurane. In spinal anesthesia group, spinal anesthesia wasperformed with bupivacaine intrathecally. In all 3 groups maternal haemodynamic parametersat zero, 5, 10, 15, 20, 25, 30, 35, 40, 45 th minutes were recorded. When the neonate is 5 daysold, tyroid functions and liver functions were evaluated.Results: In thiopenthal group, FT3 values of neonates were significantly decreased (p

Keywords

Apgar score, induction, intubation, propofol, thiopental

Sezaryen ile Doğurtulan Bebeklerin Apgar Skoru, Troid ve Karaciğer Fonksiyonları Üzerine Genel ve Spinal Anestezinin Etkileri

Abstract

Amaç: Çalışmamızda, genel ve spinal anestezi uygulanarak elektif sezaryen ile doğurtulanbebeklerin troid ve karaciğer fonksiyonlarının karşılaştırılması amaçlandı.Yöntem: Çalışmaya yaşları 18 – 40 arası 60 gebe alındı. Olgular indüksiyonda propofol vetiyopental uygulanan ile spinal anestezi uygulanan grup olarak üçe ayrıldı. Propofol grubuna,indüksiyonda 2 mg/kg propofol, 0,6 mg/kg roküronyum uygulandıktan sonra, tiyopental grubunaindüksiyonda 4–5 mg/kg tiyopental, 0,6 mg/kg roküronyum uygulandıktan sonra entübasyongerçekleştirildi. İki grupta da anestezi idamesi sevofluran ile sağlandı. Spinal anestezi grubunaintratekal bupivakain verilerek spinal anestezi uygulandı. Gebelerin 0, 5, 10, 15, 20, 25, 30, 35,40, 45. dakikalardaki maternal hemodinamik parametreleri kaydedildi. Bebeklerin doğumunun5. gününde, troid ve karaciğer fonksiyonlarına bakıldı.Bulgular: Tiyopental uygulanan gebelerin bebeklerinde, FT3 düzeyleri anlamlı olarak düşükbulundu (p

Keywords

Apgar skoru, entübasyon, indüksiyon, propofol, tiyopental

References

• G. Edward Morgan JR, Maged S. Mikhail. Clinical Anaesthesiology 2 nd Ed. Apleton & Lange 696–697, 1996.
• G. Edward Morgan JR, Maged S. Mikhail. Clinical Anaesthesiology 2 nd Ed. Appleton & Lange 712–713, 1996.
• Dahlgren G, Granath FK, Pregner PG, Rosblad H. Irestedt and Wessel L. Colloid vs. crystalloid preloading to prevent maternal hypotension during spinal anesthesia for elective cesarean section, Acta Anaesthesiol Scand 2005, 49: 1200– 1206.
• Sahar M. Siddik, Marie T. Aouad, Ghada E. Kai, Maria M. Sfeir and Anis S. Baraka. Hydroxyethylstarch 10 % is superior to Ringer's solution for preloading before spinal anesthesia for Cesarean section, Canadian Journal of Anesthesia 2000, 47: 616–621.
• Glosten B. Epidural and Spinal Analgesia, Anesthesia, Obstetric Anesthesia, 2 th Edition 1999, 360–386.
• Gogarten W. Spinal Anaesthesia For Obstetrics, Best Practice & Research Clinical Anaesthesiology, 2003, 17: 377–392.
• Simon LB, Ziane F, Noblesse E, Mathiot JL, Toublas MF, Hamaza J, Effect of enjection rate on hypotantion associated with spinal anesthesia for ceserean section, International Journal of Obstetric Anesthesia 2000, 9: 10–14.
• Rout. C, Rocke DA. A Reevaluation of The Role of Cristalloid Preload in The Prevention of Hypotension Associated with Spinal Anesthesia for Elective Cesarean Section Anesthesiology 1993, 79: 262–269.
• Moermon N, Bonke B, Oustung S.Awareness and recall during general anesthesia. Facts and Feelings, Anesthesiology 1993, 79: 454–464.
• Hollmen AL, Jouppila R, Albright GA, Jouppila P, Vierola H, Kolvula A. İntervillous blood flow during caesarean section with prophylactic ephedrine and epidural anesthesia. Acta Anaesth Scand 1984, 28: 396–400.
• Gin T, Gregory MA. Oh TE. The haemodynamic effects of propofol and thiopentone for induction of caesarean scetion. Anaesth Intensive Care 1990, 18 (2):175–179.
• Adams HA, Biscoping J, Baumann P, Borgmann A, Hempelmann G. Mother and child stres parameters during cesarean section with general and peridural anesthesia. Regional anaesthesia 1989 Sep, 12 (5): 87–94.
• Michie AR, Freeman, Dutton DA, Howie HB. Subaracnoid anaesthesia for elective Caserean section, Anaesthesia 1988, 43: 96–99.
• Chung CJ, Bae KY, Chae YJ. Spinal anaesthesia with 0.25 % hyperbaric bupivacaine for Caesarean section. effect of volume, British Journal of Anaesthesia 1996, 77: 145–149.
• Datta S, Ostheimer GW, Weiss JB, Brown JR. WU, Alper MH. Neonatal effect of prolonged anesthetic induction for cesarean section, Obstetrics and Gynecology 1981, 58: 331– 335.
• Kavak ZN, Basgul A, Ceyhan N. Short term outcome of newborn infants. Spinal versus general anesthesia for elective cesarean section. a prospective randomized study, European Journal of Obstetrics Gynecology and Reproductive Biology 2001, 100: 50–54.
• Rao MV, Chari P, Malhotra SK, Dash RJ. Role of epidural analgesia on endocrine & metabolic responses to surgery. Indian J. Med. Res 1990, 92: 13–16.
• Noreng MF, Jensen P, Tjelleden NU. Per and postoperative changes in the concentration of serum thyreotropin under general anaesthesia, compared to general anaesthesia with epidural analgesia. Acta Anaesthesiol Scand 1987, 31: 292– 294.