scholarly journals Influence of the options for the induction of general anesthesia for elective abdominal delivery on condition of newborns

2019 ◽  
Vol 10 (3) ◽  
pp. 18-23
Author(s):  
A. N. Biryukov ◽  
A. G. Klimov ◽  
E. N. Ershov ◽  
O. V. Pashchenko
Keyword(s):  
Cesarean Section ◽  
General Anesthesia ◽  
General Anaesthesia ◽  
Adaptive Capacity ◽  
Elective Cesarean Section ◽  
Sodium Thiopental ◽  
Somatic Status ◽  
Elective Cesarean ◽  
Thiopental Sodium ◽  
Abdominal Delivery

Objective: to evaluate and compare the influence of the options for the induction of general anesthesia for elective abdominal delivery on the condition of newborns. Materials and Methods: The study included 160 newborns, which were born via elective cesarean section under general anaesthesia. All newborns were divided into 4 groups, 40 in each, depending on the anesthetics used for the induction of general anesthesia. In the 1st group, thiopental sodium 5 mg/kg was used; in the 2nd - sodium thiopental 7 mg/kg; in the 3rd - propofol 2,5 mg/kg; in the 4th- sodium thiopental 5 mg/kg with sevoflurane (0,5 MAC). The influence of anesthesia on condition of newborns was evaluated by the Apgar scale and the neurological and adaptive capacity scale NACS.Results: statistically significant differences were not found in assessing newborns on scales. Conclusion: All the researched drugs and their doses used for the induction of general anesthesia during elective abdominal delivery do not adversely effect on the neurological and somatic status of the newborn.

scholarly journals Comparison of Anesthesia Techniques Used in Cesarean Deliveries on the Neonate - Anesthesia Techniques and Neonate?

2019 ◽  
Vol 5 (1) ◽  
pp. 014-021
Author(s):  
Bedih Balkan ◽  
Mehmet can Ozbas ◽  
Furkan Tontu ◽  
Gunes Ozlem Yıldız ◽  
Gulsum Oya Hergunsel ◽  
...  
Keyword(s):  
Intensive Care ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Pregnant Women ◽  
Spinal Anesthesia ◽  
Statistical Significance ◽  
Elective Cesarean Section ◽  
Cesarean Deliveries ◽  
Elective Cesarean ◽  
Thiopental Sodium

Background: Though there are many studies on the effects of anesthesia methods used for cesarean section on the newborn, research on this topic still continues. In our prospective observational study, we investigated the effects of different anesthesia techniques used in routine cesarean deliveries on early neonatal outcomes in our hospital. Methods: This prospective, observational, randomized study included a total of 222 ASA II risk group pregnant women undergoing elective cesarean section at term (38-41 weeks’ gestation) without fetal distress. The women were randomized into three groups. In the general anesthesia with propofol group (Group P, n = 74), anesthesia was induced with 2 mg∙kg-1 propofol and 0.6-0.9 mg∙kg-1 rocuronium. In the general anesthesia with thiopental sodium group (Group T, n = 74), anesthesia was induced with 5 mg∙kg-1 thiopental sodium and 0.6-0.9 mg∙kg-1 rocuronium. Women in the spinal anesthesia group (Group SA, n = 74) were administered 0.5% (10 mg) hypertonic bupivacaine and 10 mcg fentanyl. Results: There were no significant differences between Group SA, Group P, and Group T in terms of delivery time; neonatal 1- and 5-min Apgar scores; neonatal jaundice rates; neonatal systolic, diastolic, or mean blood pressure or peak heart rate; neonatal intensive care requirement; pH, PCO2, PO2 values in cord blood gas; or neonatal glucose and lactate values. The rate of ephedrine use was significantly higher in Group SA than in Group P and Group T. Maternal satisfaction score was higher in Group SA at postoperative 4 hours and in Group P at 24 hours. The number of newborns taken into intensive care unit in Group T was significantly higher in the 1st hour, 4th hour, 5th hour and total. Respectively p value (0.006, 0,048, 0,048, and 0,005). Pain on injection was present in 55% of patients (n = 81), mild in 36% (n = 54), and severe in 18% (n = 27). Myoclonies occurred in 4% of patients (n = 7) and local rash in 6% of patients (n = 10). Differences between formulations did not reach statistical significance. Conclusion: None of the three anesthesia methods showed superiority after elective cesarean delivery. However, spinal anesthesia and general anesthesia with propofol are more appropriate for pregnant women in terms of effects on the neonate.

STUDY OF THE STATE OF STRESS-IMPLEMENTING SYSTEMS IN ABDOMINAL DELIVERY DEPENDING ON ANESTHETIC TECHNIQUES

2020 ◽  
Vol 73 (11) ◽  
pp. 2378-2385
Author(s):  
Marine A. Georgiyants ◽  
Olena V. Vуsotska ◽  
Nataliia P. Seredenko ◽  
Tatiana V. Chernii ◽  
Hanna N. Strashnenko ◽  
...  
Keyword(s):  
Cesarean Section ◽  
General Anesthesia ◽  
Pregnant Women ◽  
Pain Intensity ◽  
Stress Hormones ◽  
Anesthetic Techniques ◽  
Protective Effects ◽  
Sodium Thiopental ◽  
State Of Stress ◽  
Abdominal Delivery

The aim: Evaluation of stress-protective effects of various anesthetic techniques on Cesarean section (CS). Materials and methods: 127 pregnant women who delivered by cesarean section, were divided into 4 subgroups: 1a (n = 31) – general anesthesia (GA) with ketamine, 1b (n = 31) – GA with sodium thiopental, 2a (n = 31) – spinal anesthesia (SA), 2b (n = 34) – SA with intravenous administration of ondansetron at a dose of 8 mg. The assessment was performed at 5 stages: 1 – initial; 2 – infant extraction; 3 – 6 hours after surgery; 4 – 12 hours after surgery. Results: At stage 2, insulin levels in 1a and 1b subgroups decreased by 23.9% and 34.1%, while in 2a and 2b subgroups there were no significant changes. There was an increase in the levels of cortisol, prolactin and cortisol/insulin ratio at the 2 and 3 stages in the 1a and 1b subgroups. Pain intensity increased by the 3 stage in patients of all groups. It was the highest in the 1a and 1b subgroups. At the 4 stage, pain intensity was reduced in all groups, remaining significantly higher in patients of 1a and 1b subgroups. Conclusions: The dynamics of the content of stress hormones, the pain intensity in patients undergoing CS under SA give reason to consider this method as an optimal and adequate one for protection from surgery stress.

scholarly journals Comparison between the Effects of Thiopental Sodium and Propofol on Maternal Hemodynamics during Cesarean Section Under General Anesthesia and Apgar score of the newborns

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
E Elshaer ◽  
H Omar ◽  
A Elshaer ◽  
T Youssif ◽  
W Abdelmoneim
Keyword(s):  
Blood Pressure ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Umbilical Cord ◽  
Apgar Score ◽  
Well Being ◽  
Elective Cesarean Section ◽  
Anesthetic Drugs ◽  
Significant Difference ◽  
Thiopental Sodium

Abstract Background Cesarean delivery is one of the most current surgeries in women and one of the most significant challenges of anesthesiologists in this kind of surgery is the fetuses' exposure to anesthetic drugs. Regional anesthesia is generally preferred during cesarean section, but general anesthesia may be the only option under certain circumstances such as patient preference, back deformities. The most common drugs which are used in cesarean section to induce general anesthesia are thiopental sodium and propofol. Aim compare the effect of sodium thiopental induction versus propofol induction on hemodynamics of mothers undergoing elective cesarean section under general anesthesia and their effect on Apgar score of their newborns. Materials and Methods A total 260 healthy patients were included in an open randomized study, among whom 130 patients received Thiopentone and 130 received Propofol. These patients were premedicated with granisetron and ranitidine, after induction dose the maintenance was similar for both groups. APGAR scoring and umbilical cord venous gas analysis were among the parameters used for determining the general well-being of newborns. There were no significant difference between the two groups regarding Apgar scoring in 1st, 2nd and 5th minutes. Umbilical cord blood gas values were similar . There was no metabolic acidosis in newborns of mothers receiving thiopental or propofol as anesthetic agents during cesarean section. Results Group (T) received general anesthesia with thiopental at a dose of ( 4-6 mg/kg) while patients in group (P) received general anesthesia with propofol at a dose of (2mg/kg). As regards hemodynamic changes, there were no significant difference in maternal heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure during their measurement throughout the procedure-preoperatively, after delivery of the baby,15 minutes after delivery, after extubation and in recovery room- but after intubation, there were significantly lower in propofol group which suppressed hemodynamic response to intubation . Conclusion Thiopental and propofol can be safely used in cesarean sections, but the use of propofol is more advantageous than thiopental because it provides adequate anesthetic suppression of pressor response of intubation without any depressive effect on newborns.

Effects of sevoflurane and desflurane on oxidative stress during general anesthesia for elective cesarean section

2013 ◽  
Vol 125 (15-16) ◽  
pp. 467-473 ◽  
Author(s):  
Saban Yalcin ◽  
Harun Aydoğan ◽  
Hasan Husnu Yuce ◽  
Ahmet Kucuk ◽  
Mahmut Alp Karahan ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Elective Cesarean Section ◽  
Elective Cesarean

scholarly journals Comparison of Supreme laryngeal mask airway versus endotracheal intubation for airway management during general anesthesia for cesarean section: a randomized controlled trial

2019 ◽  
Author(s):  
Wei Yu Yao ◽  
Shi Yang Li ◽  
Yong Jin Yuan ◽  
Hon Sen Tan ◽  
Nian-Lin Reena Han ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Cesarean Section ◽  
Airway Management ◽  
General Anesthesia ◽  
Endotracheal Intubation ◽  
Airway Device ◽  
Elective Cesarean Section ◽  
Randomized Controlled ◽  
Elective Cesarean ◽  
Reduced Time

Abstract Background The obstetric airway is a significant cause of maternal morbidity and mortality. Endotracheal intubation is considered the standard of care but the laryngeal mask airway (LMA) has gained acceptance as a rescue airway and has been incorporated into the obstetric airway management guidelines. In this randomized controlled equivalence trial, we compared the Supreme LMA (SLMA) with endotracheal intubation (ETT) in managing the obstetric airway during cesarean section. Methods Parturients who underwent elective cesarean section under general anesthesia were randomized to receive either an SLMA or ETT as their airway device. Our primary outcome was first-attempt insertion success. Successful insertion was defined as adequate bilateral air entry with auscultation and the presence of end-tidal carbon dioxide on the capnogram. The first-attempt insertion success rate was compared using the Chi-Square test. Secondary outcomes included time-to-ventilation, seal pressure, ventilation/hemodynamic parameters, occurrence of clinical aspiration, fetal outcomes, and maternal side effects associated with the airway device. Results We recruited 920 parturients (460 SLMA, 460 ETT) who underwent elective cesarean section under general anesthesia. Patient characteristics were similar between the groups. First attempt success was similar (Odds Ratio--ORSLMA/ETA: 1.00 (95%CI: 0.25, 4.02), p = 1.0000). SLMA was associated with reduced time to effective ventilation (Mean Difference--MD -22.96; 95%CI: -23.71, -22.21 seconds) compared to ETT group (p<0.0001). Ventilation parameters, maternal and fetal outcomes were similar between the groups, and there was no aspiration. Conclusions SLMA could be an alternative airway management technique for a carefully selected low-risk obstetric population, with similar insertion success rates, reduced time to ventilation and less hemodynamic changes compared with ETT. Our findings are consistent with the airway guidelines in recommending the second-line use of LMA in the management of the obstetric airway.

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