Hakkı ÜNLÜGENÇ, Hasan AKMAN, Yasemin GÜNEŞ, Okan BALCIOĞLU, Ahmet DENKER

Sezaryenlerde kombine spinal-epidural anestezi ile genel anestezinin anne ve yenidoğanda oluşturduğu sistemik etkilerin karşılaştırılması

Çalışmamızda elektif sezaryen ameliyatı planlanan gebelerde kombine spinal-epidural (KSE) anestezi ile genel anestezi uygulamalarının anne ve yenidoğandaki hemodinamik, nöroendokrin yanıt, yeni doğanın APGAR ve nöroadaptif kapasite skorları (NAKS) üzerine etkilerin karşılaştırılması planlandı. I. gruba (n=20) genel anestezi uygulanırken II. gruba (n=20) KSE anestezi uygulandı. Preoperatif, cilt insizyonundan hemen sonra, klemplendikten önce veya hemen sonra ve ameliyattan 30 dk sonra olmak üzere tüm anne adaylarından, yenidoğanın çıkımından hemen sonra kordon klempi konmadan umblikal korddan ve yenidoğanın resüssitasyonunu takiben kübital venlerden renin, ACTH, aldosteron, kortizol, kan şekeri ve kan gazı için kan örnekleri alındı. Tüm yenidoğanlar APGAR ve NACS açısından değerlendirildi. Cilt insizyonundan hemen sonra, kordon klemplenmeden önce ve klemplendikten hemen sonra alınan renin, ACTH, aldosteron, kortizol seviyesi değerlerinin grup I de grup II ye göre yüksek olduğu belirlendi (p

Comparison of the systemic effects of general anaesthesia and combined spinal-epidural anaesthesia during cesarean section

We aimed to compare the effects of isoflurane anaesthesia and combined spinal-epidural (CSE) anaesthesia on haemodynamic, maternal stress response, APGAR and neuro adaptive capacity scores (NACS) during cesarean section. Forty pregnants were divided into two groups equally. General anaesthesia was applied in group I (n=20) whereas CSE black in group II (n-20). Preoperatively, after skin incision, before and after umblical vein clamping and after 30 minutes of operation maternal blood samples were taken for determination of renin, ACTH, aldosterone, cortisole and blood gases. These tests were also repeated in new-borns before and after umblical vein clamping. New-borns performance were assessed using APGAR and NACS. Plasma renin, ACTH, aldosterone, cortisole and glucose levels were found higher after skin incision, before and after umblical vein clamping in group I than in group II (p

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