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Amaç: Spinal anestezi sonrası gebenin kilosu veya karın çevresine göre hipotansiyon, efedrin ihtiyacı ve duysal blok seviyesini araştıran çalışmalar vardır. Gebenin kilosu veya karın çevresi uterus içeriğinin (fetüs ağırlığı, plesenta ağırlığı ve amniyon sıvı miktarı) kaba bir tasviridir. Bu çalışma ile amacımız fetüs ağırlığı, plesanta ağırlığı ve amnion sıvı miktarı ile spinal anestezi sonrası hipotansiyon ve efedrin ihtiyacı arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntem: Elektif şartlarda spinal anestezi ile sezaryen planlanan 51 gebe çalışmaya alındı. Gebelere standart dozda L3-4 intervertebral aralıktan 12,5 mg hiperbarik bupivakain uygulandı. Spinal anestezi sonrası hipotansiyon sistolik kan basıncı <100 mmHg veya bazal değere göre %30 azalma olarak tanımlandı. Hipotansiyon olduğunda efedrin (5 mg) yapıldı. Bradikardi kalp tepe atımı <60 atım/dakika olarak tanımlandı. Bradikardi olduğunda atropin (0,5 mg) yapıldı. Spinal anestezi öncesi ve spinal anestezi sonrası 2, 5, 10, 20 ve 30’uncu dakika kan basıncı değerleri kaydedildi. Çalışma sonunda fetüs ağırlığı, plesenta ağırlığı ve amniyon sıvı miktarına göre kan basıncı değişikliği, efedrin ve atropin ihtiyacı değerlendirildi. Bulgular: Fetüs ağırlığı, plesenta ağırlığı ve amnion sıvı indeksi ile efedrin ihtiyacı arasında önemli bir korelasyon bulunmadı (sırasıyla r =0,063, p =0,660; r =0,093, p =0,518; r =0,162, p =0,257). Sonuç: Gebelerde spinal anestezi sonrası hemodinamik değişiklikler, kullanılan efedrin ve atropin miktarı ile fetüs ağırlığı, plesenta ağırlığı ve amnion sıvı miktarı arasında bir ilişki yoktur.
Purpose: After spinal anesthesia, there are studies that study the level of hypotension, the need for epidermis and the sensual block according to the weight of the spine or the surrounding abdomen. The weight of the stomach or the surrounding abdomen is a crude image of the uterus content (the fetus weight, the plessenta weight and the amniotic fluid amount). With this study, our goal is to explore the relationship between the fetus weight, the plissanta weight and the amnion fluid amount and post-spinal anesthesia hypotension and the need for efedrin. Instrument and Method: 51 pregnancies planned with spinal anesthesia in elective conditions were taken to study. Pregnancies were given a standard dose of 12,5 mg hyperbaric bupivakain from the L3-4 intervertebral range. Post-spinal anesthesia is defined as a 30% reduction in systolic blood pressure <100 mmHg or based value. When hypotension occurred, efedrin (5 mg) was made. Bradicardi heart rate is defined as <60 runs/minute. Atropin (0.5 mg) was given when Bradicard was. Blood pressure values were recorded in the 2nd, 5th, 10th, 20th and 30th minutes before and after spinal anesthesia. At the end of the study, the change in blood pressure, the need for efedrin and atropin was assessed according to the fetus weight, the weight of the plessenta and the amount of amnione fluid. Results: There was no significant correlation between the fetus weight, the plessenta weight and the amnion liquid index and the need for efedrin (r = 0,063, p = 0,660; r = 0,093, p = 0,518; r = 0,162, p = 0,257). There is no connection between hemodynamic changes after spinal anesthesia in pregnancy, the amount of efedrin and atropin used and the weight of the fetus, the weight of the plessenta and the amount of amnion fluid.
Aim: After spinal anesthesia, there are studies investigating the hypotension, ephedrine need and sensory block level according to the weight or abdominal circumference of the pregnant woman. Pregnant’s weight or abdominal circumference is a rough description of the uterine content (the weight of the fetus, the weight of the placenta and amount of the amniotic fluid). The aim of this study was to investigate the relationship between weight of the fetus, weight of the placenta and amount of the amniotic fluid and the ephedrine need after spinal anesthesia. Material and Method: Fifty-one parturients who underwent cesarean section with spinal anesthesia were included in the study. 12.5 mg hyperbaric bupivacaine was injected into the subarachnoid space at the L3-4 intervertebral level. After spinal anesthesia, hypotension was defined as systolic blood pressure <100 mmHg or 30% decrease compared to baseline. Ephedrine (5 mg) was administered when hypotension was present. Bradycardia was defined as heart beat <60 beats / min. Atropine (0.5 mg) was made when bradycardia was present. Before spinal anesthesia and after spinal anesthesia, blood pressure values at 2, 5, 10, 20 and 30th minutes were recorded. At the end of the study, blood pressure variation, ephedrine and atropine requirement were evaluated according to fetus weight, placenta weight and amnion fluid amount. Result: No significant correlation was found between fetal weight, placenta weight, amniotic fluid index and ephedrine requirement (r = 0.063, p = 0.660; r = 0.093, p = 0.518; r = 0.162, p = 0.257, respectively). Conclusion: After spinal anesthesia, there are no relation between amount of the ephedrine used and fetal weight, placenta weight, amniotic fluid amount in pregnant women.
Alan : Sağlık Bilimleri
Dergi Türü : Ulusal
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