ÖZET

Amaç:

Sezaryen ile doğumlarda rejyonal anestezi çoğunlukla tercih edilir. Bu çalışmada genel, epidural ve spinal anestezi tekniklerinin fetal ve maternal etkileri açısından karşılaştırılması amaçlandı

Yöntemler:

Sezaryen ile doğum yapan gebeler rastgele üç gruba ayrıldı: genel anestezi (GA), epidural anestezi (EA) ve spinal anestezi (SA). APGAR skoru, fetal kan gazı seviyesi, serbest O₂ gereksinimi ve pozitif basınçlı ventilasyon, fototerapi gereksinimi, bilirubin seviyesi ve kilo kaybı kaydedildi. Ayrıca ilk emzirme zamanı, perioperatif kanama, kristalloid gereksinimi, efedrin tüketimi, ilk analjezik gereksinimi, ilk defekasyon ve mobilizasyon süresi ölçüldü.

Bulgular:

APGAR skorları ve SpO₂ GA grubunda düşüktü (p<0,05). Altı yenidoğanda O₂ desteği ve pozitif basınçlı ventilasyon gerekti ve GA grubundan bir yenidoğan entübe edildi ve NICU'ya transfer edildi. İlk emzirme zamanı GA grubunda diğer gruplara göre uzadı (p<0,05). Yenidoğanların doğum sonrası 48 saatlik kilo kaybı EA ve SA gruplarında GA grubundan daha yüksekti (p <0,05). Peropertif kanama GA grubunda daha yüksekti. SA grubunda, efedrin ve sıvı gereksinimleri daha yüksekti ve mobilizasyon süresi daha kısa idi (p<0,05). İlk analjezik gereksinimi ve ilk defekasyon süresi EA grubunda daha kısaydı (p<0,05).

Sonuç:

Genel anestezi ile, daha düşük APGAR skorları, serbest O_₂ gereksinimi ve daha sık pozitif basınçlı ventilasyon gereksinimi ve ilk emzirme zamanı rejyonel anestezi ile karşılaştırıldığında daha uzundu. Bu nedenle sezaryen ile doğumda rejyonel teknikler tercih edilebilir.

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References