Fadıl HAVAS, MUKADDER ORHAN SUNGUR, Yılmaz YENİGÜN, MELTEM SAVRAN KARADENİZ, Miray KILIÇ, TÜLAY ÖZKAN SEYHAN

Spinal anesthesia for elective cesarean section is associated with shorter hospital stay compared to general anesthesia

Amaç: Bu prospektif çalışmada elektif sezaryen ameliyatlarında spinal ve genel anestezinin anne ve yenidoğan üzerine etkilerinin kıyaslanması amaçlanmıştır. Gereç ve Yöntem: Elektif sezaryen ameliyatı için rutin spinal (Grup SA, n=95) veya genel anestezi (Grup GA, n=93) ile standart postoperatif analjezi uygulanan miyadında gebeler çalışmaya alınmıştır. Ameliyat süresi, cilt insizyonu-histerotomi (TS-H) ve histe- rotomi-umbilikal kordona klemp konması arası geçen süre (TH-U), oksitosin gereksinimi, intraoperatif sıvı, efedrin gereksinimi, hipo- tansiyon gelişen hasta sayısı, ilk analjezik gereksinimine dek geçen süre (Tanalg), petidin tüketimi, yan etkiler, ilk emzirme, annenin oral gıda alımı (TOI), gaz çıkarma (TF), defekasyon (TD), mobilizasyon ve hastanede kalış süresi gruplar arasında kıyaslanmıştır. Yenidoğanın Apgar skorları, umblikal venöz kan gazı, hastanede kaldığı süre boyunca hipoglisemi gelişimi, ek gıda, fototerapi ve solunum desteği gereksinimi karşılaştırılmıştır. Bulgular: Spinal anestezide genel anesteziye oranla daha uzun TS-H, TH-U süreleri gözlenmiş, oksitosin gereksinimi azalmış, hipotan- siyon insidansı, efedrin ve sıvı gereksiniminde artış saptanmış, Tanalg süresi uzamıştır. Ayrıca spinal anestezi sonrası TOI, TF, TD ve hastanede kalış süresinin genel anesteziye oranla (sırasıyla 48 ve 52 saat, p

Elektif sezaryen ameliyatlarında spinal anestezi genel anesteziye kıyasla hastanede kalış süresini kısaltmaktadır

Objectives: This prospective study aims to compare maternal and neonatal effects of spinal and general anesthesia for elective cesarean section. Methods: Term parturients receiving routine spinal (Group SA, n=95) or general (Group GA, n=93) anesthesia and stan- dard postoperative analgesia for elective cesarean section were included in this study. Operation time, incision-hysterotomy (TS-H) and hysterotomy-umbilical cord clamping (TH-U) intervals, oxytocine requirement, intraoperative fluids, ephedrine re- quirement, incidence of hypotension, time to first analgesic requirement (Tanalg), pethidine consumption, adverse events, time to first breastfeeding, oral food intake (TOI), flatulence (TF), defecation (TD), mobilization, and postoperative hospital stay were compared between the groups. Newborn Apgar scores, umbilical venous blood gas analysis, incidence of hypoglycemia, nutritional support, phototherapy and ventilatory support were also analyzed. Results: Spinal anesthesia was associated with longer TS-H and TH-U durations, lower oxytocine requirements, higher inci- dence of hypotension, increased ephedrine and fluid consumption, and delayed Tanalg. Furthermore, TOI, TF, TD and postop- erative hospital stay was shorter in patients given spinal anesthesia when compared with patients given general anesthesia (48h vs. 52 h, respectively; p<0.01). No difference in postoperative analgesic consumption and neonatal outcomes, except 1st min Apgar scores and umbilical blood gas analysis, was detected. Conclusion: Spinal anesthesia, when compared to general anesthesia shortens postoperative hospital stay with early return of gastrointestinal functions in elective cesarean section.

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