BibTex RIS Kaynak Göster

The Effects of Intrathecal Bupivacaine-Fentanyl and Bupivacaine-Morphine on Ephedrine Requirements and Health Status of Fetus in Elective Cesarean Section.

Yıl 2005, Cilt: 12 Sayı: 1, 5 - 9, 01.02.2005

Öz

Objectives: In this study, we aimed to compare the effects of intrathecal bupivacaine-fentanyl and bupivacainemorphine on ephedrine requirements and on health status of fetus. Methods: We enrolled 54 cases undergoing elective cesarean section in this study. Ringer's lactate was infused to all patients at a rate of 10-12 mL kg-1 preoperatively and 8-10 mL kg hr-1 during operation. Spinal anesthesia was achieved with 2 mL of bupivacaine %0.5 in Group I (n=18), with 1.5 mL of bupivacaine %0.5 + 0.5 mL fentanyl, 25 μg, in Group II (n=18) and with 1.5 mL of bupivacaine %0.5 + 0.5 mL morphine, 0.1 mg, in Group III (n=18). After spinal anesthesia, ephedrine infusion was given following a bolus dose of 5 mg ephedrine, to maintain arterial pressure during the operation at the level of 80-110% of the basal value. Results: We found that total ephedrine requirements during operation was 58.4±25.4 mg in Group I, 46.3±22.3 mg in Group II and 38.6±16.3 mg in Group III. The total amount of ephedrine administered in Group III was found to be significantly lower than that in Group I (p<0.05). Umblical blood pH in Group I was detected lower than that in Group III (p<0.05). Conclusion: We concluded that; combination of bupivacaine+morphine with lower doses of ephedrine achieved the same hemodynamic states than bupivacaine alone in elective cesarean sections. Key words: Cesarean section, Bupivacaine, Fentanyl, Morphine, Efedrine

Kaynakça

  • Kee WD, Khaw KS, Lee BB, Lau TK, Gin T. A dose-response study of prophylactic intravenous ephedrine for the prevention of hypotension during spinal anesthesia for cesarean delivery. Anesth Analg 2000; 90:1390-1395.
  • Mercier FJ, Riley ET, Frederickson WL, et al. Phenylephrine added to prophylactic ephedrine infusion during spinal anesthesia for elective cesarean section. Anesthesiology 2001; 95:668-674.
  • Vercauteren MP, Coppejans HC, Hoffmann VH, Mertens E, Adriaensen HA. Prevention of hypotension by a single 5-mg dose of ephedrine during small-dose spinal anesthesia in prehydrated cesarean delivery patients. Anesth Analg 2000; 90:324-327.
  • Ayorinde BT, Buczkowski P, Brown J, Shah J, Buggy DJ. Evaluation of pre-emptive intramuscular phenylephrine and ephedrine for reduction of spinal anaesthesia- induced hypotension during caesarean section. Br J Anaesth 2001; 86:372-376.
  • Ngan Kee WD, Lau TK, Khaw KS, Lee BB. Comparison of metaraminol and ephedrine infusions for maintaining arterial pressure during spinal anesthesia for elective cesarean section. Anesthesiology 2001; 95:307-313.
  • Hawkins JL, Koonin LM, Palmer SK, Gibbs CP. Anesthesia-related deaths during obstetric delivery in the United States, 1979-1990. Anesthesiology 1997; 86:277–284.
  • Pan PH, Moore C. Intraoperative antiemetic efficacy of prophylactic ondansetron versus droperidol for Cesarean section patients under epidural anesthesia. Anesth Analg 1996; 83:982-986.
  • Rout CC, Rocke DA, Levin J, Gouws E, Reddy D. A re-evaluation of the role of crystalloid preload in the prevention of hypotension associated with spinal anesthesia for elective Cesarean section. Anesthesiology 1993; 79:262-269.
  • Critchley LA, Stuart JC, Conway F, Short TG. Hypotension during subarachnoid anaesthesia: haemodynamic effects of ephedrine. Br J Anaesth 1995; 74:373-378.
  • Vincent RD, Werhan CF, Norman PF, et al. Prophylactic angiotensin II infusion during spinal anesthesia for elective cesarean delivery. Anesthesiology 1998; 88:1475- 1479.
  • Datta S, Alper MH, Ostheimer GW, Weiss JB. Method of ephedrine administration and nausea and hypotension during spinal anesthesia for cesarean section. Anesthesiology 1982; 56:68-70.
  • Bakan N, Özpolat S, Ayas A, Ersoy MÖ. Sezaryen ameliyatlarında intratekal uygulanan fentanilin etkileri. Türk Anest Rean Cem Mecmuası 2000; 28:430-436.
  • Morgan P: The role of vasopressors in the management of hypotension induced by spinal and epidural anaesthesia. Can J Anaesth 1994; 41:404–413.

Elektif Sezaryenlerde İntratekal Bupivakaine İlave Edilen Fentanil ve Morfinin Efedrin Gereksinimi ve Fetusa Etkisi

Yıl 2005, Cilt: 12 Sayı: 1, 5 - 9, 01.02.2005

Öz

Amaç: Bu çalışmada elektif sezaryenlerde intratekal bupivakaine ilave edilen fentanil ve morfinin, efedrin gereksinimine ve fetus üzerine etkilerini karşılaştırmayı amaçladık. Gereç ve Yöntem: Elektif sezaryen planlanan 54 olgu çalışmaya alındı ve tüm olgulara laktatlı ringer; anestezi öncesi 10-12 mL kg-1 ve operasyon süresince 8-10 mL kg sa-1 verildi. Grup I (n=18)'de 2 mL %0.5 bupivakain, Grup II (n=18)'de 1.5 mL %0.5 bupivakain + 0.5 mL'de 25 μg fentanil ve Grup III (n=18)'te 1.5 mL %0.5 bupivakain + 0.5 mL'de 0.1 mg morfin kullanılarak spinal anestezi uygulandı. Spinal anestezi sonrası 5 mg bolus efedrini takiben operasyon süresince kan basıncı, giriş sistolik arter basıncı değerinin %80-110'ları olacak şekilde efedrin infüzyonu uygulandı. Bulgular: Operasyon süresince grupların total efedrin ihtiyacı Grup I'de 58.4±25.4 mg, Grup II'de 46.3±22.3 mg ve Grup III'te 38.6±16.3 mg idi. Kullanılan total efedrin miktarı Grup III'te Grup I'e göre anlamlı olarak düşük bulundu (p<0.05). Fetal umblikal pH, Grup I'de Grup III'e göre daha düşük tespit edildi (p<0.05) Sonuç: Spinal anestezi uygulanmış elektif sezaryenlerde, bupivakain ile morfin kombinasyonunun, bupivakainin tek başına kullanımına göre daha az dozda efedrin ile aynı hemodinamik koşulları sağladığı kanısına varıldı. Anahtar kelimeler: Sezaryen, Bupivakain, Fentanil, Morfin, Efedrin

Kaynakça

  • Kee WD, Khaw KS, Lee BB, Lau TK, Gin T. A dose-response study of prophylactic intravenous ephedrine for the prevention of hypotension during spinal anesthesia for cesarean delivery. Anesth Analg 2000; 90:1390-1395.
  • Mercier FJ, Riley ET, Frederickson WL, et al. Phenylephrine added to prophylactic ephedrine infusion during spinal anesthesia for elective cesarean section. Anesthesiology 2001; 95:668-674.
  • Vercauteren MP, Coppejans HC, Hoffmann VH, Mertens E, Adriaensen HA. Prevention of hypotension by a single 5-mg dose of ephedrine during small-dose spinal anesthesia in prehydrated cesarean delivery patients. Anesth Analg 2000; 90:324-327.
  • Ayorinde BT, Buczkowski P, Brown J, Shah J, Buggy DJ. Evaluation of pre-emptive intramuscular phenylephrine and ephedrine for reduction of spinal anaesthesia- induced hypotension during caesarean section. Br J Anaesth 2001; 86:372-376.
  • Ngan Kee WD, Lau TK, Khaw KS, Lee BB. Comparison of metaraminol and ephedrine infusions for maintaining arterial pressure during spinal anesthesia for elective cesarean section. Anesthesiology 2001; 95:307-313.
  • Hawkins JL, Koonin LM, Palmer SK, Gibbs CP. Anesthesia-related deaths during obstetric delivery in the United States, 1979-1990. Anesthesiology 1997; 86:277–284.
  • Pan PH, Moore C. Intraoperative antiemetic efficacy of prophylactic ondansetron versus droperidol for Cesarean section patients under epidural anesthesia. Anesth Analg 1996; 83:982-986.
  • Rout CC, Rocke DA, Levin J, Gouws E, Reddy D. A re-evaluation of the role of crystalloid preload in the prevention of hypotension associated with spinal anesthesia for elective Cesarean section. Anesthesiology 1993; 79:262-269.
  • Critchley LA, Stuart JC, Conway F, Short TG. Hypotension during subarachnoid anaesthesia: haemodynamic effects of ephedrine. Br J Anaesth 1995; 74:373-378.
  • Vincent RD, Werhan CF, Norman PF, et al. Prophylactic angiotensin II infusion during spinal anesthesia for elective cesarean delivery. Anesthesiology 1998; 88:1475- 1479.
  • Datta S, Alper MH, Ostheimer GW, Weiss JB. Method of ephedrine administration and nausea and hypotension during spinal anesthesia for cesarean section. Anesthesiology 1982; 56:68-70.
  • Bakan N, Özpolat S, Ayas A, Ersoy MÖ. Sezaryen ameliyatlarında intratekal uygulanan fentanilin etkileri. Türk Anest Rean Cem Mecmuası 2000; 28:430-436.
  • Morgan P: The role of vasopressors in the management of hypotension induced by spinal and epidural anaesthesia. Can J Anaesth 1994; 41:404–413.
Toplam 13 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

A.Kadir But Bu kişi benim

Erdoğan Öztürk Bu kişi benim

Nurçin Gülhaş Bu kişi benim

Mahmut Durmuş Bu kişi benim

Zafer Doğan Bu kişi benim

M.Özcan Ersoy Bu kişi benim

Yayımlanma Tarihi 1 Şubat 2005
Yayımlandığı Sayı Yıl 2005 Cilt: 12 Sayı: 1

Kaynak Göster

APA But, A., Öztürk, E., Gülhaş, N., Durmuş, M., vd. (2005). Elektif Sezaryenlerde İntratekal Bupivakaine İlave Edilen Fentanil ve Morfinin Efedrin Gereksinimi ve Fetusa Etkisi. Journal of Turgut Ozal Medical Center, 12(1), 5-9.
AMA But A, Öztürk E, Gülhaş N, Durmuş M, Doğan Z, Ersoy M. Elektif Sezaryenlerde İntratekal Bupivakaine İlave Edilen Fentanil ve Morfinin Efedrin Gereksinimi ve Fetusa Etkisi. Turgut Özal Tıp Merk Derg. Şubat 2005;12(1):5-9.
Chicago But, A.Kadir, Erdoğan Öztürk, Nurçin Gülhaş, Mahmut Durmuş, Zafer Doğan, ve M.Özcan Ersoy. “Elektif Sezaryenlerde İntratekal Bupivakaine İlave Edilen Fentanil Ve Morfinin Efedrin Gereksinimi Ve Fetusa Etkisi”. Journal of Turgut Ozal Medical Center 12, sy. 1 (Şubat 2005): 5-9.
EndNote But A, Öztürk E, Gülhaş N, Durmuş M, Doğan Z, Ersoy M (01 Şubat 2005) Elektif Sezaryenlerde İntratekal Bupivakaine İlave Edilen Fentanil ve Morfinin Efedrin Gereksinimi ve Fetusa Etkisi. Journal of Turgut Ozal Medical Center 12 1 5–9.
IEEE A. But, E. Öztürk, N. Gülhaş, M. Durmuş, Z. Doğan, ve M. Ersoy, “Elektif Sezaryenlerde İntratekal Bupivakaine İlave Edilen Fentanil ve Morfinin Efedrin Gereksinimi ve Fetusa Etkisi”, Turgut Özal Tıp Merk Derg, c. 12, sy. 1, ss. 5–9, 2005.
ISNAD But, A.Kadir vd. “Elektif Sezaryenlerde İntratekal Bupivakaine İlave Edilen Fentanil Ve Morfinin Efedrin Gereksinimi Ve Fetusa Etkisi”. Journal of Turgut Ozal Medical Center 12/1 (Şubat 2005), 5-9.
JAMA But A, Öztürk E, Gülhaş N, Durmuş M, Doğan Z, Ersoy M. Elektif Sezaryenlerde İntratekal Bupivakaine İlave Edilen Fentanil ve Morfinin Efedrin Gereksinimi ve Fetusa Etkisi. Turgut Özal Tıp Merk Derg. 2005;12:5–9.
MLA But, A.Kadir vd. “Elektif Sezaryenlerde İntratekal Bupivakaine İlave Edilen Fentanil Ve Morfinin Efedrin Gereksinimi Ve Fetusa Etkisi”. Journal of Turgut Ozal Medical Center, c. 12, sy. 1, 2005, ss. 5-9.
Vancouver But A, Öztürk E, Gülhaş N, Durmuş M, Doğan Z, Ersoy M. Elektif Sezaryenlerde İntratekal Bupivakaine İlave Edilen Fentanil ve Morfinin Efedrin Gereksinimi ve Fetusa Etkisi. Turgut Özal Tıp Merk Derg. 2005;12(1):5-9.