Obstetrik anestezi yöntemlerinin preterm bebeklerde gastrointestinal sistem fonksiyonu üzerine etkisi var mı?
Yıl 2020,
Cilt: 45 Sayı: 1, 22 - 28, 31.03.2020
Ufuk Çakır
,
Duran Yildiz
Dilek Kahvecioglu
,
Emel Okulu
,
Serdar Alan
,
Omer Erdeve
,
Saadet Arsan
Begum Atasay
Öz
Amaç: Prematüre bebeklerde gastrointestinal sistem (GİS) motilite problemlerinin nedeni multifaktöriyeldir ve intestinal immatürite en önemli faktördür. Sezaryen (C/S) ile doğum yapan prematüre bebeklerde epidural anestezi (EA) veya genel anestezinin (GA) GİS fonksiyonu ve erken neonatal morbidite üzerine etkisinin araştırılması amaçlanmıştır.
Gereç ve Yöntem: Bu çalışma Ekim 2011 ile Nisan 2015 arasında tek bir yenidoğan yoğun bakım ünitesinde (YDYBÜ) yapılmıştır. Bu çalışmaya C/S ile doğan ≤32 hafta ve ≤1500 g pretermler dahil edildi. Anestezi yöntemi, demografik, klinik özellikler, ilk mekonyum geçiş zamanı, mekonyum obstrüksiyonu, dismotilite için ilaç kullanımı ve diğer preterm morbiditeleri değerlendirildi.
Bulgular: Çalışma döneminde 364 preterm bebek kaydedildi. Dismotilite için ilaç kullanımı, ilk mekonyum geçiş zamanı ve mekonyum obstrüksiyonu oranı GA grubunda anlamlı olarak daha yüksekti.
Sonuç: Bu literatürde anestezi yöntemlerinin preterm bebeklerde GİS motilitesi üzerine rolünü araştıra ilk çalışmadır. Doğum sırasındaki anestezi yöntemleri, preterm bebeklerde GİS fonksiyonu üzerinde etkili olabilir.
Kaynakça
- Referans1 Hu L, Pan J, Zhang S, Yu J, He K, Shu S et al. Propofol in combination with remifentanil for cesarean section: Placental transfer and effect on mothers and newborns at different induction to delivery intervals. Taiwan J Obstet Gynecol. 2017; 56: 521-526.
- Referans2 American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Anesthesiology. 2007; 106 :843-863.
- Referans3 Chooi C, Cox JJ, Lumb RS, Middleton P, Chemali M, Emmett RS et al. Techniques for preventing hypotension during spinal anaesthesia for caesarean section. Cochrane Database Syst Rev. 2017; 8: CD002251.
- Referans4 Bader AM, Datta S. Anaesthesia for obstetrics. In: Rogers MC, Tinker JH, Covino BG, editors. Principles and Practice of Anaesthesiology. Vol. 2. Toronto: Mosby Year Book; 1993. pp.2065‑2103.
- Referans5 Davidson AJ, Disma N, de Graaff JC, Withington DE, Dorris L, Bell G et al. GAS consortium: Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial. Lancet. 2016; 387: 239-250.
- Referans6 McPherson C, Inder T. Perinatal and neonatal use of sedation and analgesia. Semin Fetal Neonatal Med. 2017; 22: 314-320.
- Referans7 Mattei P, Rombeau JL. Review of the pathophysiology and management of postoperative ileus. World J Surg. 2006; 30: 1382-1391.
- Referans8 Siddiqui MM, Drewett M, Burge DM. Meconium obstruction of prematurity. Arch Dis Child Fetal Neonatal Ed. 2012; 97: F147-150.
- Referans9 Tachecí I, Květina J, Kuneš M, Pavlík M, Kopáčová M, Černý V et al. The effect of general anaesthesia on gastric myoelectric activity in experimental pigs. BMC Gastroenterol. 2013; 13:48.
- Referans10 de Boer HD, Detriche O, Forget P. Opioid-related side effects: Postoperative ileus, urinary retention, nausea and vomiting, and shivering. A review of the literature. Best Pract Res Clin Anaesthesiol. 2017; 31: 499-504.
- Referans11 Boscan P, Cochran S, Monnet E, Webb C, Twedt D. Effect of prolonged general anesthesia with sevoflurane and laparoscopic surgery on gastric and small bowel propulsive motility and pH in dogs. Vet Anaesth Analg. 2014; 41: 73-81.
- Referans12 Desmet M, Vander Cruyssen P, Pottel H, Carlier S, Devriendt D, Van Rooy F et al. The influence of propofol and sevoflurane on intestinal motility during laparoscopic surgery. Acta Anaesthesiol Scand. 2016; 60: 335-342.
- Referans13 Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L et al. Neonatal necrotizing enterocolitis. Therapeutic decision based upon clinical staging. An Surg. 1978; 187: 1–7.
- Referans14 Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978; 187: 1-7.
- Referans15 International Committee for the Classification of Retinopathy of Prematurity. The international classification of retinopathy of prematurity revisited. Arch Ophthalmol. 2005; 123: 991–999.
- Referans16 Northway Jr WH, Rosan RC, Porter DY. Pulmonary disease following respiratory therapy of hyaline-membrane disease. Bronchopulmonary dysplasia. N Engl J Med. 1967; 276: 357e68.
- Referans17 Rickham PP, Boeckman CR. Neonatal meconium obstruction in the absence of mucoviscidosis. Am J Surg. 1965; 109: 173–177.
- Referans18 Dailly E, Drouineau MH, Gournay V, Rozé JC, Jolliet P. Population pharmacokinetics of domperidone in preterm neonates. Eur J Clin Pharmacol. 2008; 64: 1197-2000. Referans19 Soltanifar S, Russell R. The National Institute for Health and Clinical Excellence (NICE) guidelines for caesarean section, 2011 update: implications for the anaesthetist. Int J Obstet Anesth. 2012; 21: 264-272.
- Referans20 Merchant R, Chartrand D, Dain S, Dobson G, Kurrek MM, Lagacé A et al.; Canadian Anesthesiologists’ Society. Guidelines to the practice of anesthesia--revised edition 2015. Can J Anaesth. 2015; 62: 54-67.
- Referans21 Nwafor MI, Aniebue UU, Nwankwo TO, Onyeka TC, Okafor VU. Perinatal outcome of preterm cesarean section in a resource-limited centre: a comparison between general anaesthesia and subarachnoid block. Niger J Clin Pract. 2014; 17: 613-618.
- Referans22 Wang Q, Zheng SX, Ni YF, Lu YY, Zhang B, Lian QQ et al. The effect of labor epidural analgesia on maternal-fetal outcomes: a retrospective cohort study. Arch Gynecol Obstet. 2018; 298: 89-96. Referans23 Noskova P, Blaha J, Bakhouche H, Kubatova J, Ulrichova J, Marusicova P et al. Neonatal effect of remifentanil in general anaesthesia for caesarean section: a randomized trial. BMC Anesthesiol. 2015; 15: 38.
- Referans24 Chattopadhyay S, Das A, Pahari S. Fetomaternal outcome in severe preeclamptic women undergoing emergency cesarean section under either general or spinal anesthesia. J Pregnancy 2014; 2014: 325098.
- Referans25 Afolabi BB, Lesi FE, Merah NA. Regional versus general anaesthesia for caesarean section. Cochrane Database Syst Rev. 2006; (4): CD004350.
- Referans26 Havas F, Orhan Sungur M, Yenigün Y, Karadeniz M, Kılıç M, Özkan Seyhan T. Spinal anesthesia for elective cesarean section is associated with shorter hospital stay compared to general anesthesia. Agri. 2013; 25: 55-63.
- Referans27 Ozden Omaygenc D, Dogu T, Omaygenc MO, Ozmen F, Albayrak MD, Babur Guler G et al. Type of anesthesia affects neonatal wellbeing and frequency of transient tachypnea in elective cesarean sections. J Matern Fetal Neonatal Med. 2015; 28: 568-572.
- Referans28 Saygı Aİ, Özdamar Ö, Gün İ, Emirkadı H, Müngen E, Akpak YK. Comparison of maternal and fetal outcomes among patients undergoing cesarean section under general and spinal anesthesia: a randomized clinical trial. Sao Paulo Med J. 2015; 133: 227-234.
- Referans29 Heesen M, Böhmer J, Klöhr S, Hofmann T, Rossaint R, Straube S. The effect of adding a background infusion to patient-controlled epidural labor analgesia on labor, maternal, and neonatal outcomes: a systematic review and meta-analysis. Anesth Analg. 2015; 121: 149-158.
- Referans30 Shyken JM, Smeltzer JS, Baxi LV, Blakemore KJ, Ambrose SE, Petrie RH. A comparison of the effectof epidural, general and no anesthesia on funic acid–base values by stage of labor and type of delivery. Am J Obstet Gynecol. 1990; 163: 802–807.
- Referans31 Mattingly JE, D’Alessio J, Ramanathan J. Effects of obstetric analgesic and anesthetics on the neonate: a review. Paediatr Drugs. 2003; 5: 615–627.
- Referans32 Laudenbach V, Mercier FJ, Rozé JC, Larroque B, Ancel PY, Kaminski M et al; Epipage Study Group. Anaesthesia mode for cesarean section and mortality in very preterm infants: An epidemiologic study in the EPIPAGE cohort. Int J Obstet Anesth. 2009; 18: 142‑149.
- Referans33 Maayan-Metzger A, Schushan-Eisen I, Todris L, Etchin A, Kuint J. Maternal hypotension during elective cesarean section and shortterm neonatal outcome. Am J Obstet Gynecol. 2010; 202: 56.e1-5.
- Referans34 Urmey WF. Regional Anaesthesia Topic of the Week: Obstetric Anaesthesia. New York: School of Regional Anaesthesia. 2009; 21: 47.
- Referans35 Trevor AJ, Miller RD. General anaesthetics. In: Katzung BG, editor. Basic and Clinical Pharmacology. 6th ed. East Norwalk: Appleton and Lange; 1995. p.381‑94.
- Referans36 Somri M, Matter I, Parisinos CA, Shaoul R, Mogilner JG, Bader D et al. The effect of combined spinal-epidural anesthesia versus general anesthesia on the recovery time of intestinal function in young infants undergoing intestinal surgery: a randomized, prospective, controlled trial. J Clin Anesth. 2012; 24: 439-445.
- Referans37 Behm B, Stollman N. Postoperative ileus: etiologies and interventions. Clin Gastroenterol Hepatol. 2003; 1: 71-80.
- Referans38 De Corte W, Delrue H, Vanfleteren LJ, Dutré PE, Pottel H, Devriendt DK et al. Randomized clinical trial on the influence of anaesthesia protocol on intestinal motility during laparoscopic surgery requiring small bowel anastomosis. Br J Surg. 2012; 99: 1524-1529.
- Referans39 Garza-Cox S, Keeney SE, Angel CA, Thompson LL, Swischuk LE. Meconium obstruction in the very low birth weight premature infant. Pediatrics 2004; 114:285–290.
Do obstetric anesthesia methods have an impact on gastrointestinal system function in preterm infants?
Yıl 2020,
Cilt: 45 Sayı: 1, 22 - 28, 31.03.2020
Ufuk Çakır
,
Duran Yildiz
Dilek Kahvecioglu
,
Emel Okulu
,
Serdar Alan
,
Omer Erdeve
,
Saadet Arsan
Begum Atasay
Öz
Purpose: The reason for gastrointestinal system (GIS) motility problems in premature infants is multifactorial and intestinal immaturity is the most important contributing factor. To investigate the effect of epidural (EA) or general anesthesia (GA) on GIS function and early neonatal morbidity in preterm infants delivered by cesarean section (CS).
Materials and Methods: This study was conducted in a single neonatal intensive care unit (NICU) between October 2011 and April 2015. Preterms ≤32 weeks and ≤1500g who were delivered by CS were enrolled in this study. Mode of anesthesia, demographic, clinical characteristics, first meconium passage time, meconium obstruction, use of drug for dysmotility and other preterm morbidities were evaluated.
Results: Three hundred and sixty four preterm infants were enrolled during the study period. Use of drug for dysmotility, time to first meconium passage, and meconium obstruction rate, were significantly higher in the GA group.
Conclusion: This was the first study in the literature that investigated the role of anesthesia methods, effect on preterm infant GIS motility. Anesthesia modalities during delivery may have an effect on GIS function in preterm infants.
Kaynakça
- Referans1 Hu L, Pan J, Zhang S, Yu J, He K, Shu S et al. Propofol in combination with remifentanil for cesarean section: Placental transfer and effect on mothers and newborns at different induction to delivery intervals. Taiwan J Obstet Gynecol. 2017; 56: 521-526.
- Referans2 American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Anesthesiology. 2007; 106 :843-863.
- Referans3 Chooi C, Cox JJ, Lumb RS, Middleton P, Chemali M, Emmett RS et al. Techniques for preventing hypotension during spinal anaesthesia for caesarean section. Cochrane Database Syst Rev. 2017; 8: CD002251.
- Referans4 Bader AM, Datta S. Anaesthesia for obstetrics. In: Rogers MC, Tinker JH, Covino BG, editors. Principles and Practice of Anaesthesiology. Vol. 2. Toronto: Mosby Year Book; 1993. pp.2065‑2103.
- Referans5 Davidson AJ, Disma N, de Graaff JC, Withington DE, Dorris L, Bell G et al. GAS consortium: Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial. Lancet. 2016; 387: 239-250.
- Referans6 McPherson C, Inder T. Perinatal and neonatal use of sedation and analgesia. Semin Fetal Neonatal Med. 2017; 22: 314-320.
- Referans7 Mattei P, Rombeau JL. Review of the pathophysiology and management of postoperative ileus. World J Surg. 2006; 30: 1382-1391.
- Referans8 Siddiqui MM, Drewett M, Burge DM. Meconium obstruction of prematurity. Arch Dis Child Fetal Neonatal Ed. 2012; 97: F147-150.
- Referans9 Tachecí I, Květina J, Kuneš M, Pavlík M, Kopáčová M, Černý V et al. The effect of general anaesthesia on gastric myoelectric activity in experimental pigs. BMC Gastroenterol. 2013; 13:48.
- Referans10 de Boer HD, Detriche O, Forget P. Opioid-related side effects: Postoperative ileus, urinary retention, nausea and vomiting, and shivering. A review of the literature. Best Pract Res Clin Anaesthesiol. 2017; 31: 499-504.
- Referans11 Boscan P, Cochran S, Monnet E, Webb C, Twedt D. Effect of prolonged general anesthesia with sevoflurane and laparoscopic surgery on gastric and small bowel propulsive motility and pH in dogs. Vet Anaesth Analg. 2014; 41: 73-81.
- Referans12 Desmet M, Vander Cruyssen P, Pottel H, Carlier S, Devriendt D, Van Rooy F et al. The influence of propofol and sevoflurane on intestinal motility during laparoscopic surgery. Acta Anaesthesiol Scand. 2016; 60: 335-342.
- Referans13 Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L et al. Neonatal necrotizing enterocolitis. Therapeutic decision based upon clinical staging. An Surg. 1978; 187: 1–7.
- Referans14 Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978; 187: 1-7.
- Referans15 International Committee for the Classification of Retinopathy of Prematurity. The international classification of retinopathy of prematurity revisited. Arch Ophthalmol. 2005; 123: 991–999.
- Referans16 Northway Jr WH, Rosan RC, Porter DY. Pulmonary disease following respiratory therapy of hyaline-membrane disease. Bronchopulmonary dysplasia. N Engl J Med. 1967; 276: 357e68.
- Referans17 Rickham PP, Boeckman CR. Neonatal meconium obstruction in the absence of mucoviscidosis. Am J Surg. 1965; 109: 173–177.
- Referans18 Dailly E, Drouineau MH, Gournay V, Rozé JC, Jolliet P. Population pharmacokinetics of domperidone in preterm neonates. Eur J Clin Pharmacol. 2008; 64: 1197-2000. Referans19 Soltanifar S, Russell R. The National Institute for Health and Clinical Excellence (NICE) guidelines for caesarean section, 2011 update: implications for the anaesthetist. Int J Obstet Anesth. 2012; 21: 264-272.
- Referans20 Merchant R, Chartrand D, Dain S, Dobson G, Kurrek MM, Lagacé A et al.; Canadian Anesthesiologists’ Society. Guidelines to the practice of anesthesia--revised edition 2015. Can J Anaesth. 2015; 62: 54-67.
- Referans21 Nwafor MI, Aniebue UU, Nwankwo TO, Onyeka TC, Okafor VU. Perinatal outcome of preterm cesarean section in a resource-limited centre: a comparison between general anaesthesia and subarachnoid block. Niger J Clin Pract. 2014; 17: 613-618.
- Referans22 Wang Q, Zheng SX, Ni YF, Lu YY, Zhang B, Lian QQ et al. The effect of labor epidural analgesia on maternal-fetal outcomes: a retrospective cohort study. Arch Gynecol Obstet. 2018; 298: 89-96. Referans23 Noskova P, Blaha J, Bakhouche H, Kubatova J, Ulrichova J, Marusicova P et al. Neonatal effect of remifentanil in general anaesthesia for caesarean section: a randomized trial. BMC Anesthesiol. 2015; 15: 38.
- Referans24 Chattopadhyay S, Das A, Pahari S. Fetomaternal outcome in severe preeclamptic women undergoing emergency cesarean section under either general or spinal anesthesia. J Pregnancy 2014; 2014: 325098.
- Referans25 Afolabi BB, Lesi FE, Merah NA. Regional versus general anaesthesia for caesarean section. Cochrane Database Syst Rev. 2006; (4): CD004350.
- Referans26 Havas F, Orhan Sungur M, Yenigün Y, Karadeniz M, Kılıç M, Özkan Seyhan T. Spinal anesthesia for elective cesarean section is associated with shorter hospital stay compared to general anesthesia. Agri. 2013; 25: 55-63.
- Referans27 Ozden Omaygenc D, Dogu T, Omaygenc MO, Ozmen F, Albayrak MD, Babur Guler G et al. Type of anesthesia affects neonatal wellbeing and frequency of transient tachypnea in elective cesarean sections. J Matern Fetal Neonatal Med. 2015; 28: 568-572.
- Referans28 Saygı Aİ, Özdamar Ö, Gün İ, Emirkadı H, Müngen E, Akpak YK. Comparison of maternal and fetal outcomes among patients undergoing cesarean section under general and spinal anesthesia: a randomized clinical trial. Sao Paulo Med J. 2015; 133: 227-234.
- Referans29 Heesen M, Böhmer J, Klöhr S, Hofmann T, Rossaint R, Straube S. The effect of adding a background infusion to patient-controlled epidural labor analgesia on labor, maternal, and neonatal outcomes: a systematic review and meta-analysis. Anesth Analg. 2015; 121: 149-158.
- Referans30 Shyken JM, Smeltzer JS, Baxi LV, Blakemore KJ, Ambrose SE, Petrie RH. A comparison of the effectof epidural, general and no anesthesia on funic acid–base values by stage of labor and type of delivery. Am J Obstet Gynecol. 1990; 163: 802–807.
- Referans31 Mattingly JE, D’Alessio J, Ramanathan J. Effects of obstetric analgesic and anesthetics on the neonate: a review. Paediatr Drugs. 2003; 5: 615–627.
- Referans32 Laudenbach V, Mercier FJ, Rozé JC, Larroque B, Ancel PY, Kaminski M et al; Epipage Study Group. Anaesthesia mode for cesarean section and mortality in very preterm infants: An epidemiologic study in the EPIPAGE cohort. Int J Obstet Anesth. 2009; 18: 142‑149.
- Referans33 Maayan-Metzger A, Schushan-Eisen I, Todris L, Etchin A, Kuint J. Maternal hypotension during elective cesarean section and shortterm neonatal outcome. Am J Obstet Gynecol. 2010; 202: 56.e1-5.
- Referans34 Urmey WF. Regional Anaesthesia Topic of the Week: Obstetric Anaesthesia. New York: School of Regional Anaesthesia. 2009; 21: 47.
- Referans35 Trevor AJ, Miller RD. General anaesthetics. In: Katzung BG, editor. Basic and Clinical Pharmacology. 6th ed. East Norwalk: Appleton and Lange; 1995. p.381‑94.
- Referans36 Somri M, Matter I, Parisinos CA, Shaoul R, Mogilner JG, Bader D et al. The effect of combined spinal-epidural anesthesia versus general anesthesia on the recovery time of intestinal function in young infants undergoing intestinal surgery: a randomized, prospective, controlled trial. J Clin Anesth. 2012; 24: 439-445.
- Referans37 Behm B, Stollman N. Postoperative ileus: etiologies and interventions. Clin Gastroenterol Hepatol. 2003; 1: 71-80.
- Referans38 De Corte W, Delrue H, Vanfleteren LJ, Dutré PE, Pottel H, Devriendt DK et al. Randomized clinical trial on the influence of anaesthesia protocol on intestinal motility during laparoscopic surgery requiring small bowel anastomosis. Br J Surg. 2012; 99: 1524-1529.
- Referans39 Garza-Cox S, Keeney SE, Angel CA, Thompson LL, Swischuk LE. Meconium obstruction in the very low birth weight premature infant. Pediatrics 2004; 114:285–290.