Comparison of The Effects of Propofol Sedation on Mother and Newborn During Spinal Anesthesia for Elective Cesarean Section

Faruk Savaş; Handan Güleç; Akın Yurdal Kepek; Esra Özayar; Dilek Sarıcı; Eyüp Horasanlı

Araştırma Makalesi

Elektif Sezeryan Operasyonlarında Spinal Anestezi Uygulama Sırasında Propofol Sedasyonunun Anne ve Yenidoğan Üzerindeki Etkilerinin Karşılaştırılması

Yıl 2016, Cilt: 1 Sayı: 1, 7 - 13, 25.08.2016

Faruk Savaş Handan Güleç , Akın Yurdal Kepek Esra Özayar Dilek Sarıcı Eyüp Horasanlı

Öz

Regional anestezi, bilinç açıklığı sağlaması, spontan solunumun devamı, havayolu reflekslerinin korunması, aspirasyon riskinin olmaması, yeni doğanda solunum depresyonu olmaması, uterusta atoni olmaması nedeniyle sezaryen operasyonlar ında tercih edilir. 30 hastaya herhangi bir sedasyon olmadan (Grup K), 30 hastalık başka bir gruba da (Grup P) 0.5 mg/kg propofol spinal anestezi başlangıcında bolus tarzında verildi. Oksijen satürasyonu, Ramsey Sedasyon Skalası ve yüze yansıyan ağrı skalası 0, 1, 5, 7, 10, 15, 20nci dakikalarda ve operasyon sona erene kadar beşer dakika arayla ölçüldü ve kaydedildi.

Sonuç olarak; propofol her ne kadar sezaryen operasyonlarında güvenilir ve geçerli bir anestezik ajan olarak kabul edilse de propofolün yeni doğan üzerindeki nörolojik, davranışsal ve ağrı etkisini değerlendirmek için gelecekte daha kapsamlı çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Ağrı, Propofol

Kaynakça

1. Erdine S: Neural Blockage. Istanbul: Emre Press, 1993: 9-24.
2. Yegul I: Regional Analgesia and Anesthesia in Obstetrics. VI. National Congress, 5-8 December 1996, Bursa: SummaryBook1996: 80-85.
3. Ready LB. Acute Perioperative Pain in Miller RD. Anesthesia, Churchill Livingstone, Inc Fifth Edition, 2000; 2323-50
4. Can G:Accessment of Newborn. Neyzi O, Ertuğrul T (Eds.)Pediatrics. Second edition. Vol1, 1993: 186-201. 33 5. Senses DA: Assesment of Newborn. Kinisci H, Göksin E (Eds.) Essentials of Gynecological Diseases and Obstetrics. Ankara: Melisa Press, 1996: 214-219
6. Lawrence J Alcock D et al. The development of a tool to assess neonatal pain. Neonatal Network. 1993; 12 : 59-66.
7. Kocamanoğlu İS, Sarıhasan B, Şener B, Tür A, Şahinoğlu H, Sunter S.Methods and complications of anesthesia in cesarian/section operations: Retrospective evaluationos 3552 cases. J. Med Sci. 2005; 25: 810-16
8. G. Edward Morgan JR, Maged S. Mikhail. Clinical Anaesthesiology 2 nd Ed. Apleton&Lange 696–697, 1996.
9. Carvalho B, Collins J, Drover DR, AtkinsonRalls L, Riley ET. ED(50) And ED(95) Of İntrathecal Bupivacaine İn Morbidly Obese Patients Undergoing Cesarean Delivery. Anesthesiology. 2011 Mar;114 :529-35.
10. Michie AR, Freeman, Dutton DA, Howie HB. Subarachnoid anaesthesia for elective Caserean section, Anaesthesia 1988, 43: 96–99.
11. Albani A, Renghi A, Ciarlo M et al. Peridural anesthesia versus subarachnoid anesthesia in cesarean section. Prospective clinical study. Minerva Anestesiol 1998;64:387-391
12. Turkoz A, Togal T, Gokdeniz R et al. Effectiveness of intravenous ephedrine infusion during spinal anaesthesia for caesarean section based on maternal hypotension, neonatal acid-base status and lactate levels. Anaesth Intensive Care 2002;30 :316- 320
13. Dahlgren G, Granath FK, Pregner PG, Rosblad H. Irestedt and Wessel L. Colloid vs. crystalloid preloading toprevent maternal hypotension during spinal anesthesia for elective cesarean section, Acta Anaesthesiol Scand 2005, 49: 1200– 12065
14. Sahar M. Siddik, Marie T. Aouad, Ghada E. Kai, Maria M. Sfeirand Anis S. Baraka. Hydroxyethyls tarch 10 % is superior to Ringer’s solution for preloading before spinal anesthesia for Cesarean section, Canadian Journal of Anesthesia 2000, 47: 616–621.
15. Glosten B. Epidural and Spinal Analgesia, Anesthesia, Obstetric Anesthesia, 2 th Ed 1999, 360–386. 16. Corke BC, Datta S, Ostheimer GW, Weiss JB, Alper MH. Spinal anaesthesia for Caesarean section. The influence of hypotension on neonatal outcome. Anaesthesia 1982; 37:658-662. 17. Morgan P. Spinal anaesthesia in obstetrics. Can J Anaesth 1995; 45:1145-1163
18. Kasaba T, Yamaga M, Iwasaki T, Yoshimura Y, Takasaki M: Ephedrine, dopamine, or do butamine to treat hypotension with propofol during epidural anesthesia. Can J Anaesth ; 2000;47:237-41
19. Roud, CC. Rocke, DA. Levin, J., Gouws, E., Reedy, D., A revolution of the role of crystalloid preload in the prevention of hypotansion associated with spinal anesthesia for elective caesarean section, Anesthesiology 1993;79: 262–9
20. Tarkkila PJ, Kaukinen S: Complications during spinal anesthesia a prospective study. Reg Anesth 1991; 16: 100-106.
21. Carpenter RL, Caolan RA, Brown DL, Stephenson C, Wu R: Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology 1992; 76: 906-916.
22. Hollmen AL, Jouppila R, Albright GA, Jouppila P, Vierola H, Kolvula A. İntervillous blood flow during caesarea section with prophylactic ephedrine and epidural anesthesia. Acta Anaesth Scand 1984, 28: 396–400
23. Roberts SW, Levena KJ, Sidaw JE, et al. Fetal acidemia associated with regional anesthesia for elective cesarean delivery. ObstetGynecol, 1995; 85: 79-83
24. Mueller MD, Brühwiler H, Schüpfer GK, Lüscher KP. Higher rate of fetal acidemia after regional anesthesia for elective cesarean delivery. Obstet Gynecol 1997;90:131-134
25. Datta S, Ostheimer GW, Weiss JB, Brown JR. WU, Alper MH. Neonatal effect of prolonged anesthetic inductionfor cesarean section, Obstetrics and Gynecology 1981,58: 331– 335
26. Mackenzie N. Sedation during regional anesthesia: indications, advantages and methods. Eur J Anaesthesiol 1996;13:2-7.
27. Jungheinrich C, Scharpf R, Wargenau M, Dilger C, Bepperling F. Pharmacokinetics of the generic formulati on propofol 1% fresenius in comparison with the original formulation (Disoprivan 1%) Clin Drug Investig 2002; 22: 417–27.
28. Smith I, Monk TG, VVhite PF, Ding Y Propofolin fusion during regional anaesthesia: sedative, amnesticandanxiolyticproperties. Anesth Analg 1994; 79:313-9.
29. Sebel PS, Lowdon JD. Propofol: a newintravenousanesthetic. Anesthesiology 1989;71:260–77.
30. Iyilikçi L, Cakmak S, Ogdul E, Canduz B, Boyacı F, Ozdemir F ve ark. Remote Location Anesthesia: Experience of Our Team. Turk J. Anesth Reanim 2006;10:169-76
31. Anderson EL, Reti IM. ECT in pregnancy: a review of the literature from 1941to 2007. Psychosom Med 2009; 71: 235-42.
32. Alon E, Ball RH, Gillie MH, Parer JT, Rosen MA, Shnider SM. Effects of propofol and thiopental on maternalandfetal cardiovascular and acid-base variables in the pregnantewe. Anesthesiology 1993;78:562–76.
33. Mongardon N, Servin F, Perin M, Bedairia E, Retout S, Yazbeck C. Predicted propofol effect-site concentration for induction and emergence of anesthesia during early pregnancy. AnesthAnalg 2009;109:90–5
34. Cheng YJ, Wang YP, Fan SZ, Liu CC. Intravenous infusion of low dose propofol for conscious sedation in cesarean section before spinal anesthesia. Acta Anaesthesiol Sin 1997; 35:79–84.
35. White PF, Negus JB: Sedative infusions during local and regional anaesthesia. Clin Anesth 1991; 3:32-9.
36. Tulunay M, Tulunay FC (2000) Ağrı Değerlendirilmesi ve Ağrı Ölçümleri, S Erdine (Ed), Agrı, Istanbul, Pres Alemdar, s.91-107.
37. Celleno D, Capogna G, Tomassetti M, Costantino P, DiFeo G, Nisini R. Neuro behavioural effects of propofol on the neonate following elective caesarean section. Br J Anaesth. 1989;62:649-54.
38. Gregory M A, Gin T, You G et al. Propofol infusion anaesthesia for Caesarean section. Canadian Journal of Anaesthesia 1990; 37:514-520

Comparison of The Effects of Propofol Sedation on Mother and Newborn During Spinal Anesthesia for Elective Cesarean Section

Yıl 2016, Cilt: 1 Sayı: 1, 7 - 13, 25.08.2016

Faruk Savaş Handan Güleç , Akın Yurdal Kepek Esra Özayar Dilek Sarıcı Eyüp Horasanlı

Öz

Regional anesthesia is preferred in cesarean sections, since it provides consciousness, continuation of spontaneous respiration, protection of airway reflexes, and causes no risk of aspiration, no respiratory depression in the newborn, and no uterine atony. Spinal anesthesia was administered to 30 patients without the application of any sedation (Group K) and in the other 30 cases, a single dose of 0.5 mg/kg propofol (Group P) was administered as an i.v. bolus at the beginning of the anesthesia. SaO2, Ramsey Sedation Scale and facial expression pain scale were measured and recorded at 0, 1, 5, 7, 10, 15, and 20 minutes and at five-minute intervals until the end of the operation following propofol administration.

In conclusion although propofol is considered as a safe and reliable anesthetic agent in cesarian sections we sug gest that more comprehensive studies to determine the neurologic, behavioral and pain effects of propofol on newborns are needed in the future.

Anahtar Kelimeler

Pain, Propofol

Kaynakça

1. Erdine S: Neural Blockage. Istanbul: Emre Press, 1993: 9-24.
2. Yegul I: Regional Analgesia and Anesthesia in Obstetrics. VI. National Congress, 5-8 December 1996, Bursa: SummaryBook1996: 80-85.
3. Ready LB. Acute Perioperative Pain in Miller RD. Anesthesia, Churchill Livingstone, Inc Fifth Edition, 2000; 2323-50
4. Can G:Accessment of Newborn. Neyzi O, Ertuğrul T (Eds.)Pediatrics. Second edition. Vol1, 1993: 186-201. 33 5. Senses DA: Assesment of Newborn. Kinisci H, Göksin E (Eds.) Essentials of Gynecological Diseases and Obstetrics. Ankara: Melisa Press, 1996: 214-219
6. Lawrence J Alcock D et al. The development of a tool to assess neonatal pain. Neonatal Network. 1993; 12 : 59-66.
7. Kocamanoğlu İS, Sarıhasan B, Şener B, Tür A, Şahinoğlu H, Sunter S.Methods and complications of anesthesia in cesarian/section operations: Retrospective evaluationos 3552 cases. J. Med Sci. 2005; 25: 810-16
8. G. Edward Morgan JR, Maged S. Mikhail. Clinical Anaesthesiology 2 nd Ed. Apleton&Lange 696–697, 1996.
9. Carvalho B, Collins J, Drover DR, AtkinsonRalls L, Riley ET. ED(50) And ED(95) Of İntrathecal Bupivacaine İn Morbidly Obese Patients Undergoing Cesarean Delivery. Anesthesiology. 2011 Mar;114 :529-35.
10. Michie AR, Freeman, Dutton DA, Howie HB. Subarachnoid anaesthesia for elective Caserean section, Anaesthesia 1988, 43: 96–99.
11. Albani A, Renghi A, Ciarlo M et al. Peridural anesthesia versus subarachnoid anesthesia in cesarean section. Prospective clinical study. Minerva Anestesiol 1998;64:387-391
12. Turkoz A, Togal T, Gokdeniz R et al. Effectiveness of intravenous ephedrine infusion during spinal anaesthesia for caesarean section based on maternal hypotension, neonatal acid-base status and lactate levels. Anaesth Intensive Care 2002;30 :316- 320
13. Dahlgren G, Granath FK, Pregner PG, Rosblad H. Irestedt and Wessel L. Colloid vs. crystalloid preloading toprevent maternal hypotension during spinal anesthesia for elective cesarean section, Acta Anaesthesiol Scand 2005, 49: 1200– 12065
14. Sahar M. Siddik, Marie T. Aouad, Ghada E. Kai, Maria M. Sfeirand Anis S. Baraka. Hydroxyethyls tarch 10 % is superior to Ringer’s solution for preloading before spinal anesthesia for Cesarean section, Canadian Journal of Anesthesia 2000, 47: 616–621.
15. Glosten B. Epidural and Spinal Analgesia, Anesthesia, Obstetric Anesthesia, 2 th Ed 1999, 360–386. 16. Corke BC, Datta S, Ostheimer GW, Weiss JB, Alper MH. Spinal anaesthesia for Caesarean section. The influence of hypotension on neonatal outcome. Anaesthesia 1982; 37:658-662. 17. Morgan P. Spinal anaesthesia in obstetrics. Can J Anaesth 1995; 45:1145-1163
18. Kasaba T, Yamaga M, Iwasaki T, Yoshimura Y, Takasaki M: Ephedrine, dopamine, or do butamine to treat hypotension with propofol during epidural anesthesia. Can J Anaesth ; 2000;47:237-41
19. Roud, CC. Rocke, DA. Levin, J., Gouws, E., Reedy, D., A revolution of the role of crystalloid preload in the prevention of hypotansion associated with spinal anesthesia for elective caesarean section, Anesthesiology 1993;79: 262–9
20. Tarkkila PJ, Kaukinen S: Complications during spinal anesthesia a prospective study. Reg Anesth 1991; 16: 100-106.
21. Carpenter RL, Caolan RA, Brown DL, Stephenson C, Wu R: Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology 1992; 76: 906-916.
22. Hollmen AL, Jouppila R, Albright GA, Jouppila P, Vierola H, Kolvula A. İntervillous blood flow during caesarea section with prophylactic ephedrine and epidural anesthesia. Acta Anaesth Scand 1984, 28: 396–400
23. Roberts SW, Levena KJ, Sidaw JE, et al. Fetal acidemia associated with regional anesthesia for elective cesarean delivery. ObstetGynecol, 1995; 85: 79-83
24. Mueller MD, Brühwiler H, Schüpfer GK, Lüscher KP. Higher rate of fetal acidemia after regional anesthesia for elective cesarean delivery. Obstet Gynecol 1997;90:131-134
25. Datta S, Ostheimer GW, Weiss JB, Brown JR. WU, Alper MH. Neonatal effect of prolonged anesthetic inductionfor cesarean section, Obstetrics and Gynecology 1981,58: 331– 335
26. Mackenzie N. Sedation during regional anesthesia: indications, advantages and methods. Eur J Anaesthesiol 1996;13:2-7.
27. Jungheinrich C, Scharpf R, Wargenau M, Dilger C, Bepperling F. Pharmacokinetics of the generic formulati on propofol 1% fresenius in comparison with the original formulation (Disoprivan 1%) Clin Drug Investig 2002; 22: 417–27.
28. Smith I, Monk TG, VVhite PF, Ding Y Propofolin fusion during regional anaesthesia: sedative, amnesticandanxiolyticproperties. Anesth Analg 1994; 79:313-9.
29. Sebel PS, Lowdon JD. Propofol: a newintravenousanesthetic. Anesthesiology 1989;71:260–77.
30. Iyilikçi L, Cakmak S, Ogdul E, Canduz B, Boyacı F, Ozdemir F ve ark. Remote Location Anesthesia: Experience of Our Team. Turk J. Anesth Reanim 2006;10:169-76
31. Anderson EL, Reti IM. ECT in pregnancy: a review of the literature from 1941to 2007. Psychosom Med 2009; 71: 235-42.
32. Alon E, Ball RH, Gillie MH, Parer JT, Rosen MA, Shnider SM. Effects of propofol and thiopental on maternalandfetal cardiovascular and acid-base variables in the pregnantewe. Anesthesiology 1993;78:562–76.
33. Mongardon N, Servin F, Perin M, Bedairia E, Retout S, Yazbeck C. Predicted propofol effect-site concentration for induction and emergence of anesthesia during early pregnancy. AnesthAnalg 2009;109:90–5
34. Cheng YJ, Wang YP, Fan SZ, Liu CC. Intravenous infusion of low dose propofol for conscious sedation in cesarean section before spinal anesthesia. Acta Anaesthesiol Sin 1997; 35:79–84.
35. White PF, Negus JB: Sedative infusions during local and regional anaesthesia. Clin Anesth 1991; 3:32-9.
36. Tulunay M, Tulunay FC (2000) Ağrı Değerlendirilmesi ve Ağrı Ölçümleri, S Erdine (Ed), Agrı, Istanbul, Pres Alemdar, s.91-107.
37. Celleno D, Capogna G, Tomassetti M, Costantino P, DiFeo G, Nisini R. Neuro behavioural effects of propofol on the neonate following elective caesarean section. Br J Anaesth. 1989;62:649-54.
38. Gregory M A, Gin T, You G et al. Propofol infusion anaesthesia for Caesarean section. Canadian Journal of Anaesthesia 1990; 37:514-520

Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	Klinik Tıp Bilimleri
Bölüm	Makaleler
Yazarlar	Faruk Savaş Bu kişi benim Handan Güleç Akın Yurdal Kepek Bu kişi benim Esra Özayar Bu kişi benim Dilek Sarıcı Bu kişi benim Eyüp Horasanlı Bu kişi benim
Yayımlanma Tarihi	25 Ağustos 2016
Yayımlandığı Sayı	Yıl 2016 Cilt: 1 Sayı: 1

Kaynak Göster

APA	Savaş, F., Güleç, H., Kepek, A. Y., Özayar, E., vd. (2016). Comparison of The Effects of Propofol Sedation on Mother and Newborn During Spinal Anesthesia for Elective Cesarean Section. Akademik Araştırma Tıp Dergisi, 1(1), 7-13.
AMA	Savaş F, Güleç H, Kepek AY, Özayar E, Sarıcı D, Horasanlı E. Comparison of The Effects of Propofol Sedation on Mother and Newborn During Spinal Anesthesia for Elective Cesarean Section. AATD. Ağustos 2016;1(1):7-13.
Chicago	Savaş, Faruk, Handan Güleç, Akın Yurdal Kepek, Esra Özayar, Dilek Sarıcı, ve Horasanlı Eyüp. “Comparison of The Effects of Propofol Sedation on Mother and Newborn During Spinal Anesthesia for Elective Cesarean Section”. Akademik Araştırma Tıp Dergisi 1, sy. 1 (Ağustos 2016): 7-13.
EndNote	Savaş F, Güleç H, Kepek AY, Özayar E, Sarıcı D, Horasanlı E (01 Ağustos 2016) Comparison of The Effects of Propofol Sedation on Mother and Newborn During Spinal Anesthesia for Elective Cesarean Section. Akademik Araştırma Tıp Dergisi 1 1 7–13.
IEEE	F. Savaş, H. Güleç, A. Y. Kepek, E. Özayar, D. Sarıcı, ve E. Horasanlı, “Comparison of The Effects of Propofol Sedation on Mother and Newborn During Spinal Anesthesia for Elective Cesarean Section”, AATD, c. 1, sy. 1, ss. 7–13, 2016.
ISNAD	Savaş, Faruk vd. “Comparison of The Effects of Propofol Sedation on Mother and Newborn During Spinal Anesthesia for Elective Cesarean Section”. Akademik Araştırma Tıp Dergisi 1/1 (Ağustos 2016), 7-13.
JAMA	Savaş F, Güleç H, Kepek AY, Özayar E, Sarıcı D, Horasanlı E. Comparison of The Effects of Propofol Sedation on Mother and Newborn During Spinal Anesthesia for Elective Cesarean Section. AATD. 2016;1:7–13.
MLA	Savaş, Faruk vd. “Comparison of The Effects of Propofol Sedation on Mother and Newborn During Spinal Anesthesia for Elective Cesarean Section”. Akademik Araştırma Tıp Dergisi, c. 1, sy. 1, 2016, ss. 7-13.
Vancouver	Savaş F, Güleç H, Kepek AY, Özayar E, Sarıcı D, Horasanlı E. Comparison of The Effects of Propofol Sedation on Mother and Newborn During Spinal Anesthesia for Elective Cesarean Section. AATD. 2016;1(1):7-13.

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