Spinal Anestezi İle Sezaryen Uygulamasında Profilaktik İntravenöz Efedrinin Yenidoğan Laktik Asit Düzeyine Etkisi +
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Dosyalar
Tarih
1999
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Turgut Özal Tıp Merkezi Dergisi
Erişim Hakkı
Attribution 3.0 United States
Özet
Çalışmamızda termde spinal anestezi He elektif sezaryen uygulanacak 30 sağlıklı gebe rasgele iki gruba ayrıldı. Spinal anestezi sonrası duysal blok başlar başlamaz efedrin in füzyonu (yaklaşık 5mg/dk) uygulanan (grup I, n=15) veya annenin kan basıncı baza! değerden %20'den fazla azaldığında intravenöz boius 10 mg efedrin verilenler (grup II, n=15) olmak üzere iki gruba ayrıldı. Anne ve yenidoğanrn kan basıncı He kalp hızı kaydedildi. Bulantı ve kusma insidansı belirlendi. Anne ve bebeğin asit-baz durumu ve laktat düzeyleri karşılaştırıldı.
Sistolik kan basıncı bo/us grubunda infüzyon grubuna göre anlamlı olarak düşüktü (p<0.05). İnfüzyon grubunda bir hastada bulantı (0%6) bolus grubunda 10 hastada bulantı ve kusma (%66) görüldü (p<0.05). Umbilikal arter pH'ı boius grubunda belirgin olarak düşüktü (p<0.05), ancak her iki grup arasında yenidoğanrn Apgar skoru ve kan laktik asit düzeyleri yönünden fark saptanmadı.
Sonuç olarak, spinal anestezi He sezaryen uygulanacak sağlıklı gebelerde hipotansiyon şiddetli olsa bile hipotansif kalma süresinin uzun olmaması yenidoğarn laktik asidozdan koruyan önemli bir faktördür.
Thirty heaithy women undergoing elective caesarean section under spinal anaesthesia at term were allocated randomiy to receive ephedrine infusion (grup I, n=15) (approximately 5mg/min) immediately after onset of sensory block or bo/uses of I. V 10 mg ephedrine (grup I, n=15) when maternai blood pressure decreased by more than 20°% from baseline va/ue. Maternai and newborn blood pressures and heart rates were recorded. Incidences of nausea and vomiting were compared between the groups. Maternai and ne o nata i acid-base status and i a etic acid levels were compared between the groups. Systolic blood pressure in the bolus group was significantiy iower when compared to the infusion group (p<0.05). Nausea occurred in one patient (60%) in the infusion group, and nausea and/or vomiting occurred in 10 patients (66°%) in the bolus group (p<0.05). Umbiiicai artery pH was significantiy iower in the boius group (p<0.05), however no differences were observed in Apgar scores and fetai lactic acid level. As a result, although heaithy parturients undergoing spinai anesthesia for caeserian section have severe hypotension, short hypotensive period is an important factor that proteets the newborn against iactic acidosis.
Thirty heaithy women undergoing elective caesarean section under spinal anaesthesia at term were allocated randomiy to receive ephedrine infusion (grup I, n=15) (approximately 5mg/min) immediately after onset of sensory block or bo/uses of I. V 10 mg ephedrine (grup I, n=15) when maternai blood pressure decreased by more than 20°% from baseline va/ue. Maternai and newborn blood pressures and heart rates were recorded. Incidences of nausea and vomiting were compared between the groups. Maternai and ne o nata i acid-base status and i a etic acid levels were compared between the groups. Systolic blood pressure in the bolus group was significantiy iower when compared to the infusion group (p<0.05). Nausea occurred in one patient (60%) in the infusion group, and nausea and/or vomiting occurred in 10 patients (66°%) in the bolus group (p<0.05). Umbiiicai artery pH was significantiy iower in the boius group (p<0.05), however no differences were observed in Apgar scores and fetai lactic acid level. As a result, although heaithy parturients undergoing spinai anesthesia for caeserian section have severe hypotension, short hypotensive period is an important factor that proteets the newborn against iactic acidosis.
Açıklama
Turgut Özal Tıp Merkezi Dergisi.6 (4) :1999. İnönü Üniversitesi, Malatya.
Anahtar Kelimeler
Spinai anestezi, hipotansiyon, efedrin, laktik asit düzeyi, Spinai anaesthesia, hypotension, ephedrine, lactic acid level
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Türköz, A.;Gökdeniz, R.;Togal, T.; Toprak, Hüseyin İ.; Ersoy, Ö.;Turgut Özal Tıp Merkezi Dergisi.6 (4) :1999. İnönü Üniversitesi, Malatya.
