Mehtap HONCA, B. Berna KÜLAH, E.Arzu KÖSE, Türker TÜRKER, Eyüp HORASANLI

Preeklamptik ve sağlıklı gebelerde spinal anestezi altında gerçekleştirilen sezaryen operasyonunun hemodinamik etkilerinin karşılaştırılması

Amaç: Preeklamptik ve sağlıklı gebelerde spinal bupivakain ve fentanil uygulanarak gerçekleştirilen nöroaksiyel anestezinin hemodinamik parametreler üzerine etkilerini retrospektif olarak karşılaştırmaktır. Metod: Ocak-Aralık 2012 arası, preeklampsi tanısı alan ve sağlıklı ASA I kadınlarda spinal anestezi altında sezaryen operasyonu geçirenlerin dahil edildiği retrospektif randomize bir çalışma planlanmıştır. Hastaların yaşı, vücut ağırlığı, gebelik haftası, operasyon süresi, anestezi süresi, intraoperatif dönemdeki hemodinamik parametreleri ( non invazif kan basıncı, kalp hızı, periferik oksijen satürasyonu), intraoperatif volüm tedavisi (kristaloid, kolloid), efedrin ihtiyacı, neonatal vücut ağırlıkları ve APGAR skorları kaydedilmiştir. Bulgular: Spinal anestezi altında sezaryen operasyonu yapılan, 223 preeklamptik hasta ve 221 sağlıklı gebeden oluşan toplam 444 olgu çalışmaya dahil edilmiştir. Preeklamptik hasta grubunda daha az hipotansiyon gözlenmiştir ve efedrin ihtiyacı daha az olmuştur. Preeklamptik hasta grubunda neonatal vücut ağırlıkları ve APGAR skorları daha düşük olarak bulunmuştur. Sonuç: Preeklamptik hastalarda spinal anestezi esnasında hipotansiyon ve efedrin ihtiyacı daha az olarak bulunmuş ve güvenli bir yöntem olduğu sonucuna varılmıştır.

Comparıson of the hemodynamıc parameters between preeclamptıc and healthy women undergoıng cesarean delıvery wıth spınal anesthesıa

Objective: The aim of this study was to compare the hemodynamic parameters between preeclamptic and healthy women undergoing cesarean delivery with spinal bupivacaine and fentanyl retrospectively. Methods: A retrospective randomised study of women with severe preeclampsia and ASA I healty women requiring cesarean section with spinal anesthesia from January 2012 to December 2012 was carried out. Maternal age, weight, gestational age at delivery, duration of operation, duration of anesthesia, hemodynamic parameters during intraoperative period (non invasive blood pressure, heart rate, peripheral oxygen saturation), intraoperative volume replacement (colloidcrystalloid) , requirement of ephedrine, neonatal body weight and APGAR scores were recorded. Results: Consisting of 223 preeclamptic patients and 221 and healty women, a total of 444 patients were included in the study. The incidence of hypotension and ephedrine treatment were less in preeclamptic women. Neonatal body weight and APGAR scores were lower in the preeclamptic patient group. Conclusion: The incidence of hypotension and requirement of ephedrine were less in preeclamptic patients undergoing cesarean delivery with spinal anesthesia and it was concluded that this method was safe.

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