Abstract:

Aim: The aim of this study is to evaluate the maternal and fetal effects of frequently used inhalational anaesthetic agents sevoflurane, isoflurane and desflurane in cesarean operations performed under general anaesthesia. Material and Methods: 75 ASA I-II parturients undergoing elective caesarean section were included in the study. Anesthesia induction was performed induction with propofol 2 mg/kg and rocuronium 0.6 mg/kg. In Group S, anesthesia maintenance was done with sevoflurane 1.5 % and N2O 50 % in oxygen inhalation while in Group D and Group I maintainance was done desflurane 3 % and isoflurane 1 % and N2O 50 % in oxygen inhalation respectively. Hemodynamic data were recorded before induction (baseline), at 1, 5, 10, 15, 20, 25 and 30 minutes following intubation. Anesthesia induction-delivery time, anesthesia emergence time and orientation time were recorded. Uterine tonus and blood loss were assessed. Venous blood sample for maternal complete blood count was collected before anaesthesia induction and at 30 minutes postoperatively. Neonatal blood samples for umbilical blood gas analysis were collected after the clamping of cord. A blinded observer to the study protocol evaluated the APGAR score at 1 and 5 minutes after the clamping of the umbilical cord. Same observer also evaluated the NACS at 2nd and 24th hours postoperatively. Results: Maternal demographic data and duration of anesthesia and surgery, anesthesia induction-delivery time, anesthesia emergence and orientation times were similar among groups. The hemodynamic parameters of Group S at 1st minute was higher when compared with the baseline values and Group D at 1st minute was higher when compared with baseline values and Group S and Group I. Estimated blood loss was similar in three groups. There was no difference between the groups in terms of APGAR scores, while the NAC scores at 2nd hour of Group I were lower than the other two Groups. Conclusion: In elective cesarean operations performed with general anaesthesia, sevoflurane and desflurane may be preferred instead of isoflurane in terms of neonatal effects. As desflurane cause a slight increase in maternal hemodynamic parameters, sevoflurane may be the preferred inhalational anaesthetic agent.

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