Sezaryen Hastalarında Uygulanan Bölgesel ve Genel Anestezinin Doğum Sonrası Depresyon İle İlişkisi

Abstract

Amaç: Çalışmanın amacı sezaryen ile doğum yapan kadınlara verilen anestezi tipi ile doğum sonrası depresyon sıklığı arasındaki ilişkiyi araştırmaktır.
Gereç ve Yöntem: Çalışma prospektif olarak sezaryen hastalarında yapıldı. Çalışmaya 58 genel anestezi (GA) hastası ve 61 spinal anestezi (SA) hastası dahil edildi. Ameliyattan hemen önce hastalardan anestezi endişelerini araştıran bir form olan Durumluk-Sürekli Kaygı Envanteri-1'i (STAI-1) doldurmaları istendi. Edinburg Doğum Sonrası Depresyon Ölçeği, doğumdan altı hafta sonra dolduruldu. Veriler IBM SPSS 20 istatistiksel analiz programı ile analiz edildi.
Bulgular: GA ve SA grupları arasında yaş, eğitim, sosyoekonomik düzey ve gebelik sayısı açısından fark yoktu (p <0.05). Her iki grupta da yüksek STAI-1 ortalama değerleri vardı ancak aralarındaki fark önemsizdi (p> 0.05). Edinburg Doğum Sonrası Depresyon Ölçeği, GA grubunun% 15.5'inde ve SA grubunun% 8.1'inde depresyon düzeylerinin yüksek olduğunu göstermiştir. Bu fark istatistiksel olarak anlamlı olarak bulunmuştur (p <0.01).
Sonuç: Bu çalışma, GA uygulanan hastalarda, doğum sonu depresyon oranının SA uygulanan hastalara göre daha yüksek olduğunu göstermiştir. Bu nedenle, hastanın dikkatle incelenmesinden sonra anestezi tipinin seçilmesi çok önemlidir.

Keywords

• Anestezi öncesi anksiyete
• anestezi
• sezaryen
• doğum sonrası depresyon

The Relation of Regional and General Anesthesia Applied in Cesarean Patients with Postpartum Depression

Abstract

Abstract Aim: The purpose of the study is to investigate the relationship between the frequency of depression and the type of anesthesia given to the women that deliver by cesarean section. Methods: The study was carried out prospectively on cesarean patients. The study included 58 patients with general anesthesia (GA) and 61 patients with spinal anesthesia (SA). Right before the surgery the patients filled State Trait Anxiety Inventory-1(STAI-1), a form surveying the anesthesia concerns. Edinburg Postpartum Depression Scale was filled six weeks after the delivery.The data were analyzed by IBM SPSS 20 statistical analysis program. Results: The difference between the GA and SA groups were insignificant in terms of age, education, socio-economic level and number of pregnancy (p<0.05). Both groups had high STAI-1 mean values but the difference between them were insignificant (p>0.05). Edinburg Postpartum Depression Scale indicated that depression points were high in 15.5% of the GA group and 8.1% of the SA group. This was statistically significant (p< 0.01). Conclusion: This study showed that postpartum depression rate was higher in patients that had GA compared to the patients with SA. Thus, it is crucial to select the type of anesthesia after careful examination of the patient.

Keywords

• Pre-anesthetic anxiety
• anesthesia
• cesarean
• postpartum depression

References

1. 1. Betrán AP, Torloni MR, Zhang J-J, et al. WHO statement on caesarean section rates. BJOG: An International Journal of Obstetrics & Gynaecology. 2016;123(5): 667-670.
2. 2. Update OO. Organization for Economic Co-operation and Development. 2017. Links. 2017.
3. 3. Field T. Prenatal anxiety effects: a review. Infant Behavior and Development. 2017;49: 120-128.
4. 4. Fernández-Campos FJ, Escrivá D, Palanca JM, Ridocci F, Barrios C, Gallego J. Women’s acute anxiety variations before and after epidural anesthesia for childbirth. Journal of Psychosomatic Obstetrics & Gynecology. 2017;38(2): 152-158.
5. 5. Maheshwari D, Ismail S. Preoperative anxiety in patients selecting either general or regional anesthesia for elective cesarean section. Journal of anaesthesiology, clinical pharmacology. 2015;31(2): 196.
6. 6. Henshaw C. Mood disturbance in the early puerperium: a review. Archives of women’s mental health. 2003;6(2): s33-s42.
7. 7. Clay EC, Seehusen DA. A review of postpartum depression for the primary care physician. Southern Medical Journal. 2004;97(2): 157-162.
8. 8. Robertson E, Grace S, Wallington T, Stewart DE. Antenatal risk factors for postpartum depression: a synthesis of recent literature. General hospital psychiatry. 2004;26(4): 289-295.

9. 9. Teissèdre F, Chabrol H. Detecting women at risk for postnatal depression using the Edinburgh Postnatal Depression Scale at 2 to 3 days postpartum. The Canadian Journal of Psychiatry. 2004;49(1): 51-54.
10. 10. Reck C, Stehle E, Reinig K, Mundt C. Maternity blues as a predictor of DSM-IV depression and anxiety disorders in the first three months postpartum. Journal of Affective Disorders. 2009;113(1-2): 77-87.
11. 11. Howard LM, Molyneaux E, Dennis C-L, Rochat T, Stein A, Milgrom J. Non-psychotic mental disorders in the perinatal period. The Lancet. 2014;384(9956): 1775-1788.
12. 12. Castillo R, Carlat D, Millon T, et al. Diagnostic and statistical manual of mental disorders. American Psychiatric Association Press, Washington, DC. 2007.
13. 13. Evins GG, Theofrastous JP. Postpartum depression: a review of postpartum screening. Primary Care Update for Ob/Gyns. 1997;4(6): 241-246.
14. 14. Miller LJ, Rukstalis M. Beyond the" blues". Hypotheses about postpartum reactivity. Postpartum mood disorder. 1999: 3-19.
15. 15. Klint Carlander A-K. Mode of delivery: does it affect contact with the newborn child, future reproduction and health-related quality of life five years after the birth of the first child?: Inst för kliniska vetenskaper, Danderyds sjukhus/Dept of Clinical Sciences …; 2014.
16. 16. Carter FA, Frampton CM, Mulder RT. Cesarean section and postpartum depression: a review of the evidence examining the link. Psychosomatic medicine. 2006;68(2): 321-330.
17. 17. Goker A, Yanikkerem E, Demet MM, Dikayak S, Yildirim Y, Koyuncu FM. Postpartum depression: is mode of delivery a risk factor? ISRN obstetrics and gynecology. 2012;2012.
18. 18. Meltzer-Brody S, Maegbaek M, Medland S, Miller W, Sullivan P, Munk-Olsen T. Obstetrical, pregnancy and socio-economic predictors for new-onset severe postpartum psychiatric disorders in primiparous women. Psychological medicine. 2017;47(8): 1427-1441.
19. 19. Laufenberg-Feldmann R, Kappis B. Assessing preoperative anxiety using a questionnaire and clinical rating: a prospective observational study. European Journal of Anaesthesiology (EJA). 2013;30(12): 758-763.
20. 20. Bieling PJ, Antony MM, Swinson RP. The State--Trait Anxiety Inventory, Trait version: structure and content re-examined. Behaviour research and therapy. 1998;36(7-8): 777-788.
21. 21. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. The British journal of psychiatry. 1987;150(6): 782-786.
22. 22. Zanardo V, Giliberti L, Volpe F, Parotto M, De Luca F, Straface G. Cohort study of the depression, anxiety, and anhedonia components of the Edinburgh Postnatal Depression Scale after delivery. International Journal of Gynecology & Obstetrics. 2017;137(3): 277-281.
23. 23. Jlala H, French J, Foxall G, Hardman J, Bedforth N. Effect of preoperative multimedia information on perioperative anxiety in patients undergoing procedures under regional anaesthesia. British journal of anaesthesia. 2010;104(3): 369-374.
24. 24. Buonanno P, Laiola A, Palumbo C, Spinelli G, Terminiello V, Servillo G. Italian validation of the Amsterdam Preoperative Anxiety and Information Scale. Minerva anestesiologica. 2017;83(7): 705-711.
25. 25. Burkle C, Mann C, Steege J, Stokke J, Jacob A, Pasternak J. Patient fear of anesthesia complications according to surgical type: potential impact on informed consent for anesthesia. Acta Anaesthesiologica Scandinavica. 2014;58(10): 1249-1257.
26. 26. Ross LE, Evans SG, Sellers E, Romach M. Measurement issues in postpartum depression part 1: anxiety as a feature of postpartum depression. Archives of Women's Mental Health. 2003;6(1): 51-57.