Comparison of The Effects of General and Spinal on Apgar Scores of Babies Born Through Caesarean Section in RSUP Haji Adam Malik Medan from 2018 to 2019

Background. General anesthesia and spinal anesthesia in cesarean section both have advantages and disadvantages. The scoring system of APGAR is a standardized tool that can inform the condition of newborn infants, which might be influenced by gestational age, medication, resuscitation, cardiorespiratory and neurological conditions of the mother. This study aimed to compare the effect of general and spinal anesthesia usage to the APGAR score of newborn infants at Haji Adam Malik General Hospital Medan. Methode. This study uses an observational-analytic design with a cross-sectional approach, conducted using secondary data through the medical records of mothers who gave birth through cesarean section and obtained at the Medical Record Installation at the Haji Adam Malik Hospital Medan from 2018 to 2019. Result. In spinal anesthesia, there are 52 samples for a score of 8-10. Whereas in general anesthesia, there are 52 samples to score 8-10. The APGAR score of 1 minute in infants born through cesarean section under spinal anesthesia had an average of 8.63, with general anesthesia of 8.00 (p=0.001). The 5-minute APGAR score in infants born through cesarean section under spinal anesthesia had an average of 9.85, and with general anesthesia of 8.67 (p=1.000). Conclusion: The 1-minute APGAR score for infants using spinal anesthesia showed a statistically better effect than the 1-minute APGAR score for infants using general anesthesia.

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PERBANDINGAN LUARAN SEKSIO SESAREA DENGAN ANESTESI UMUM DAN SPINAL: PERUBAHAN KADAR HEMOGLOBIN, HEMATOKRIT IBU DAN SKOR APGAR BAYI

Jurnal Kesehatan Reproduksi ◽

10.22146/jkr.4912 ◽

2014 ◽

Vol 1 (1) ◽

Author(s):

Ifrinda Giantari ◽

Ibnu Pranoto ◽

Risanto Siswosudarmo

Keyword(s):

Cesarean Section ◽

General Anesthesia ◽

Spinal Anesthesia ◽

Apgar Score ◽

T Test ◽

Chi Square ◽

Advantages And Disadvantages ◽

The Difference ◽

Clinically Significant ◽

Spinal Anesthesia Group

PERBANDINGAN LUARAN SEKSIO SESAREA DENGANANESTESI UMUM DAN SPINAL: PERUBAHAN KADARHEMOGLOBIN, HEMATOKRIT IBU DAN SKOR APGAR BAYIIfrinda Giantari, Ibnu Pranoto, Risanto SiswosudarmoABSTRACTBackground: Cesarean section is the most common surgical procedure in obstetrics. In 2008, nearly a third ofdeliveries was done by cesarean section. Two types of anestesi are used in cesarean section i.e., general andregional anestesi with their advantages and disadvantages. General anestesi is often used in emergency casesbut is often associated with greater risk of blood loss during surgery and depression of central nervous system ofthe newborn. Based on these facts, the decision of the type of anesthesia for cesarean section is still debated.Objective: To compare the effects between general and spinal anestesi in the alteration of maternal hemoglobinand hematocrit levels and the neonatal Apgar score.Method: This study was conducted at Setjonegoro Hospital Wonosobo, Banjarnegara, and Sardjito HospitalYogyakarta between September to December 2010. Patients undergoing cesarean section, who met inclusionand exclusion criteria were included in this study. Hemoglobin and hematocrit levels before and 6-12 hours aftersurgery were recorded, as well as the first minute Apgar score. Chi-square and t-test were used for statisticalanalysis.Results and Discussion: A total of 114 patients consisting of 59 cases for general anestesi and 55 for spinalgroups were recruited. They were comparable in terms ofmaternal age, age of gestation, parity, BMI and indicationof operation. Hemoglobin and hematocrit levels before surgery were also comparable.The decrease of hemoglobin level after operation in the group of general anesthesia was greater than in thespinal group (1,75 ± 1,09 mg/dL vs 1,00 ± 0,96 mg/d; p=0,00). The same was seen in the decrease of hematocritlevel (4,47 ± 2,77% vs 3,26 ± 3,04%, p=0,02). There were 28 cases of asphyxia in the group of general comparedto 22 cases in the group of spinal anestesi, but it was not statistically different (RR 1,16; 95% CI 0,81-1,65).Conclusion: The decreased level of hemoglobin and hematocrit after cesarean section in general anesthesia werehigher than spinal anesthesia group, although the difference was not clinically significant. There was no significantdifference in the incidence of asphyxia at first minute in both groups.Keywords: general anestesi, spinal anesthesia, cesarean section, hemoglobin, hematocrit, Apgar score ABSTRAKLatar belakang: Seksio sesarea merupakan prosedur operatif obstetri yang paling sering dilakukan. Pada tahun2008, hampir sepertiga dari persalinan dilakukan dengan cara seksio sesarea. Dua jenis anestesi sering digunakanyakni anestesi umum dan spinal yang masing-masing mempunyai kelebihan dan kekurangannya. Anestesi umumsering digunakan pada kasus kedaruratan meskipun sering dikaitkan dengan risiko kehilangan darah yang lebihbesar dan penekanan pada susunan syaraf pusat bayi. Anestesi spinal sering dikaitkan dengan keadaan hipotensimaternal.Tujuan: Membandingkan penurunan kadar hemoglobin dan hematokrit ibu dan skor Apgar bayi pada seksiosesarea dengan anestesi umum dan spinal.Metode: Kohort prospektif.Penelitian dilakukan di RS Setjonegoro Wonosobo, RS Banjarnegara, dan RS Sardjitopada bulan September sampai Desember 2010. Pasien yang menjalani seksio sesarea dan memenuhi kriteriainklusi dan eksklusi dimasukkan dalam penelitian ini. Sampel penelitian diikuti sesuai dengan kelompok jenisanestesi. Kadar hemoglobin dan hematokrit sebelum operasi dan 6-12 jam sesudah operasi serta skor Apgar 1menit dicatat. X-square dan t-test dipakai untuk analisis data.Hasil dan Pembahasan: Sebanyak 114 kasus seksio sesarea memenuhi kriteria kelayakan, yang terdiri dari 59kasus kelompok anestesi umum dan 55 kasus anestesi spinal. Kedua kelompok komparabel dalam hal umur,umur kehamilan, paritas BMI dan indikasi operasi. Demikian juga kadar hemoglobin dan hematokrit sebelumoperasi, tidak menunjukkan perbedaan yang bermakna. Penurunan kadar hemoglobin setelah operasi padakelompok anestesi umum lebih besar dibanding kelompok spinal (1,75 ± 1,09 mg/dL vs 1,00 ± 0,96 mg/d;p=0,00), demikian juga penurunan kadar hematocrit (4,47 ± 2,77% vs 3,26 ± 3,04%, p=0,02). Pada penilaianmenit pertama terdapat 28 kasus asfiksia (skor Apgar < 6) pada kelompok anestesi umum dan 22 kasus padakelompok anestesi spinal (RR 1,16, 95%CI 0,81-1,65), tetapi tidak bermakna secara statistik (p=0,42).Kesimpulan: Terdapat penurunan kadar hemoglobin dan hematokrit ibu yang bermakna pada kelompok yangmenjalani seksio sesarea dengan anestesi umummeskipun secara klinis tidak bermakna. Tidak terdapat perbedaanbermakna secara statistik pada kejadian asfiksia pada menit pertama.Kata kunci: anestesi umum, anestesi spinal, seksio sesarea, hemoglobin, hematokrit, skor Apgar

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Perbandingan Nilai Apgar antara Persalinan Normal dengan Seksio Sesarea Elektif

Jurnal Kesehatan Andalas ◽

10.25077/jka.v5i1.480 ◽

2016 ◽

Vol 5 (1) ◽

Author(s):

Neila Azka ◽

Syahredi Syahredi ◽

Eva Chundrayetti

Keyword(s):

Cesarean Section ◽

Vaginal Delivery ◽

Apgar Score ◽

Cross Sectional Study ◽

Elective Cesarean Section ◽

Normal Vaginal Delivery ◽

Sectional Study ◽

Cross Sectional ◽

Elective Cesarean ◽

Minute Apgar Score

AbstrakPada masa sekarang ini telah terjadi perubahan tren dalam persalinan, yaitu berupa peningkatan angka seksio sesarea. Peningkatan ini dipengaruhi berbagai faktor seperti: adanya kekhawatiran akan terjadinya cedera janin, peningkatan permintaan ibu untuk melakukan persalinan seksio sesarea, serta faktor sosioekonomi. Beberapa penelitian justru menunjukkan seksio sesarea dapat menimbulkan morbiditas pada bayi. Tujuan penelitian ini adalah membandingkan kondisi bayi antara persalinan normal dan seksio sesarea elektif dilihat dari nilai Apgar Penelitian dilaksanakan dari Mei 2014 sampai Januari 2014 di bagian rekam medis RSUP Dr. M. Djamil Padang.. Jenis penelitian yang digunakan adalah analitik dengan desain cross-sectional study. Sampel dalam penelitian ini terdiri dari 179 pasien dengan persalinan normal dan 56 pasien dengan seksio sesarea. Hasil penelitian menunjukkan bahwa pada menit pertama nilai Apgar 4-6 adalah 3,4% pada persalinan normal. Nilai Apgar 7-10 sebanyak 96,6% pada persalinan normal dan 100% pada seksio sesarea pada menit pertama. Pada menit kelima, nilai Apgar 4-6 adalah 1,1% pada persalinan normal, sedangkan nilai Apgar 7-10 sebanyak 98,9% pada persalinan normal dan 100% pada seksio sesarea pada menit kelima. Setelah dilakukan analisis dengan mann-whitney test didapatkan bahwa tidak terdapat perbedaan nilai Apgar pada menit-1 (p=0,777) dan menit-5 (p=0,887) antara persalinan normal dengan seksio sesarea.Kata kunci: persalinan normal, seksio sesarea elektif, nilai Apgar AbstractIn recent years, cesarean section have increased. Several factor are contributing, such as fears of injury to the fetus, increased women's request to do a cesarean section deliveries and socioeconomic factors. Some studies have also shown that cesarean section can lead to morbidity in infants. The objective of this study was to compare between Apgar scores of infant born by elective cesarean section and normal vaginal deliveries. The research was done from May 2013 to January 2014 at the medical records department of general hospital center Dr. M. Djamil Padang. This was an analytic study with cross-sectional study design. This study used 179 samples with normal vaginal delivery and 56 samples with cesarean section. The result showed that 1st minute Apgar score of 4-6 in normal vaginal delivery was 3.4%, and Apgar score 7-10 was 96.6% in normal vaginal delivery while in cesarean section was 100%. The 5th minute Apgar score of 4-6 in normal vaginal delivery was 1.1%, and Apgar score 7-10 was 98.9% in normal vaginal delivery while in cesarean section was 100%. After being analyzed using Mann-Whitney test, the study showed that there was no significant different in Apgar score of neonates born through normal vaginal delivery and neonates born trough cesarean section at first minute (p=0.777) and fifth minute (p=0.887).Keywords: normal vaginal delivery, elective cesarean section, Apgar score

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Comparison of maternal and fetal outcomes among patients undergoing cesarean section under general and spinal anesthesia: a randomized clinical trial

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2014.8901012 ◽

2015 ◽

Vol 133 (3) ◽

pp. 227-234 ◽

Cited By ~ 8

Author(s):

Anıl İçel Saygı ◽

Özkan Özdamar ◽

İsmet Gün ◽

Hakan Emirkadı ◽

Ercüment Müngen ◽

...

Keyword(s):

Clinical Trial ◽

Cesarean Section ◽

General Anesthesia ◽

Spinal Anesthesia ◽

Apgar Score ◽

Urine Volume ◽

Fetal Distress ◽

Controlled Clinical Trial ◽

Fetal Outcomes ◽

General Anesthesia Group

CONTEXT AND OBJECTIVE: As the rates of cesarean births have increased, the type of cesarean anesthesia has gained importance. Here, we aimed to compare the effects of general and spinal anesthesia on maternal and fetal outcomes in term singleton cases undergoing elective cesarean section.DESIGN AND SETTING: Prospective randomized controlled clinical trial in a tertiary-level public hospital.METHODS: Our study was conducted on 100 patients who underwent cesarean section due to elective indications. The patients were randomly divided into general anesthesia (n = 50) and spinal anesthesia (n = 50) groups. The maternal pre and postoperative hematological results, intra and postoperative hemodynamic parameters and perinatal results were compared between the groups.RESULTS: Mean bowel sounds (P = 0.036) and gas discharge time (P = 0.049) were significantly greater and 24th hour hemoglobin difference values (P = 0.001) were higher in the general anesthesia group. The mean hematocrit and hemoglobin values at the 24th hour (P = 0.004 and P < 0.001, respectively), urine volume at the first postoperative hour (P < 0.001) and median Apgar score at the first minute (P < 0.0005) were significantly higher, and the time that elapsed until the first requirement for analgesia was significantly longer (P = 0.042), in the spinal anesthesia group.CONCLUSION: In elective cases, spinal anesthesia is superior to general anesthesia in terms of postoperative comfort. In pregnancies with a risk of fetal distress, it would be appropriate to prefer spinal anesthesia by taking the first minute Apgar score into account.

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PERBANDINGAN NILAI APGAR NEONATUS PADA SEKSIO SESAR ANTARA ANESTESIA UMUM DAN ANESTESIA SPINAL

e-CliniC ◽

10.35790/ecl.2.2.2014.4751 ◽

2014 ◽

Vol 2 (2) ◽

Author(s):

Frans T. Rumahorbo

Keyword(s):

Cesarean Section ◽

General Anesthesia ◽

Spinal Anesthesia ◽

Apgar Score ◽

Elective Cesarean Section ◽

P Value ◽

Whitney Test ◽

Mann Whitney Test ◽

Elective Cesarean ◽

Spinal Anesthesia Group

Abstract: Anesthesia plays an important role in surgery. The use of anesthesia provides a lot of advantages in surgery as well as disadvantages under certain circumstances. In cesarean section, anesthesia can affect the condition of neonates, which can be evaluated by using Apgar score. This study aimed to compare the neonates’Apgar scores of cesarean section using general and spinal anesthesia. The method of this study was Unpair Numeric Comparative Analytic Retrospective. Inclusive criteria were elective cesarean section deliveries, aterm or gestational age 37-40 weeks, birth weight > 2500 grams, and no other surgery. There were 105 samples which were divided into two groups, GA (general anesthesia) and SA (Spinal anesthesia). Group of GA consisted of 70 samples and group of SA 35 samples. Statistical test used was Mann – Whitney test with interpretation value P < 0.05 revealed significant differences. The results showed that neonates of SA group with Apgar score >7 at the first and fifth minute were 57.14% and 100% meanwhile of GA group 28.57% and 87.14%. The average Apgar scores of SA and GA groups at the first minute were 6.43±0.74 vs 5.5±1.53 (P = 0.001) and at the fifth minute 8.43±0.74 vs 7.53±1.51. The Mann – Whitney test showed a P value 0.001. Conclusion Spinal anesthesia provided better condition for neonates compared to the general anesthesia in elective cesarean section deliveries.Keywords: cesarean section, spinal anesthesia, general anesthesia, Apgar scoreAbstrak: Anestesia berperan penting dalam tindakan pembedahan. Penggunaan anestesia memberikan banyak keuntungan dalam tindakan pembedahan namun terdapat juga kerugian – kerugian dalam kondisi tertentu. Pada seksio sesar, tindakan anestesia dapat mempengaruhi kondisi neonatus yang dapat diukur dengan nilai Apgar. Penelitian ini bertujuan untuk membandingkan nilai Apgar neonatus pada seksio sesar antara anestesia umum dan anestesia spinal. Metode penelitian bersifat retrospektif analitik komparatif numerik tak berpasangan. Kriteria inklusi ialah persalinan seksio sesar elektif, aterm atau usia kehamilan 37-40 minggu, berat badan lahir bayi >2500gr, dan pasien tanpa operasi lainnya. Sampel yang didapat berjumlah 105 neonatus yang dibagi menjadi 2 grup, GA (anestesia umum) dan SA (anestesia spinal). Grup GA terdiri dari 70 sampel dan grup SA 35 sampel. Uji statistik yang digunakan ialah uji Mann – Whitney dengan interpretasi nilai P < 0,05 dinyatakan perbedaan signifikan. Hasil penelitian memperlihatkan neonatus dengan nilai Apgar >7 pada menit ke-1 dan ke-5 sebanyak 57,14% dan 100% pada grup SA sedangkan 28,57% dan 87,14% pada grup GA. Rata – rata nilai Apgar menit ke-1 grup SA dan grup GA 6,43±0,74 vs 5,5±1,53 (P = 0,001) dan pada menit ke-5 8,43±0,74 vs 7,53±1,51. Uji Mann – whitney menunjukkan P =0,001. Simpulan. Anestesia spinal memberikan kondisi neonatus yang lebih baik dibandingkan anestesia umum pada persalinan seksio sesar elektif.Kata kunci: seksio sesar, anestesia spinal, anestesia umum, nilai Apgar.

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Scenario of General Anesthesia for Cesarean Section in Rural Tertiary Care Center in High Altitude Karnali Academy of Health Sciences

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v16i3.32751 ◽

2020 ◽

Vol 16 (3) ◽

Author(s):

Ramesh Bhattarai ◽

Rajiv Shah ◽

Sita Dhakal ◽

Pragya Malla ◽

Srijana Sapkota

Keyword(s):

Cesarean Section ◽

General Anesthesia ◽

High Altitude ◽

Spinal Anesthesia ◽

Neonatal Outcome ◽

Care Center ◽

Tertiary Care ◽

Health Sciences ◽

Tertiary Care Center ◽

Cord Prolapse

Background: General anesthesia for cesarean section is being less popular for cesarean section in present days but sometime general anesthesia is inevitable. The aim of the study is to assess the trends of general anesthesia, indications, clinical outcome in mother and fetus in high altitude setting of tertiary care center of Nepal. Methods: We conducted descriptive cross-sectional study all cases of cesarean section in Karnali Academy of health Sciences (KAHS) located at high altitude over three years period in our institute. Data were retrieved from the hospital records during three fiscal year (Jan 1st 2017 to Jan Dec 31st 2019). The record of all the patients who underwent cesarean section under general anesthesia was reviewed for demographic details, indication of general anesthesia, trends for general and spinal anesthesia and maternal and neonatal outcome. Results: Out of total deliveries 2175, 309 (14.2%) cases account for cesarean section. Among them, 52 (17%) required general anesthesia . Eclampsia 19(36%) remain the major indication for General Anesthesia in cesarean section followed by failure of spinal anesthesia number 14 (26%) , cord prolapse six (12%), antepartam haemorrhage five (10%), spinal site infection four (8%), Khiphoscoliosis two(4%), Patients request two (4%). Use for general anesthesia technique was consistent for three years with slow rise in use of spinal anesthesia . There was no any anesthesia related maternal mortality and nine intraoperative neonatal Conclusions: General anesthesia practices are consistently required in rural high-altitude setup. Eclampsia is the commonest indication followed by failure of spinal anesthesia and cord prolapse. Neonatal outcome is still not good.

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Maternal and Neonatal Effect of Fentanyl as a Premedication before Induction of General Anesthesia in Cesarean Surgery: A Systematic Review and Meta-analysis of Randomized Clinical Trials

Current Women s Health Reviews ◽

10.2174/1573404815666190111151651 ◽

2019 ◽

Vol 15 (4) ◽

pp. 232-237

Author(s):

Mir Hadi Musavi ◽

Behzad Jodeiri ◽

Keyvan Mirnia ◽

Morteza Ghojazadeh ◽

Zeinab Nikniaz

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Cesarean Section ◽

General Anesthesia ◽

Apgar Score ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Intravenous Fentanyl ◽

Neonatal Effect ◽

Fentanyl Group

Background: Although, some clinical trials investigated the maternal and neonatal effect of fentanyl as a premedication before induction of general anesthesia in cesarean section, to the best of our knowledge, there is no systematic review to summarize these results. Objectives: The present systematic review and meta-analysis evaluated the maternal and neonatal effect of intravenous fentanyl as a premedication before induction of general anesthesia in cesarean section. Methods: The databases of Pubmed, Embase, Scopus and Cochrane library were searched till July 2017 to identify randomized clinical trials which evaluated the effects of intravenous fentanyl as a premedication before induction of general anesthesia compared with placebo on neonate first and fifth minute Apgar score and maternal heart rate and mean arterial pressure (MAP) in cesarean section. Standard Mean difference (SMD) was calculated and I-square statistic test was used for heterogeneity analysis. Results: The present systematic review and meta-analysis consisted of three clinical trials including 180 women in labor. Considering the results of meta-analysis, there is no significant differences between fentanyl and placebo in the case of Apgar score at 1 minute; however, the Apgar score of 5 minutes was significantly lower in fentanyl group compared with placebo (SMD -0.68, 95%CI: - 0.98, -0.38, p<0.001). In the term of maternal hemodynamics, the heart rate (SMD -0.43, 95%CI: - 0.72, -0.13, p=0.004) and MAP (SMD -0.78, 95% CI: -1.09, -0.48, p<0.001) in fentanyl group were significantly lower compared with placebo group. Conclusion: The present meta-analysis showed that using intravenous fentanyl as a premedication before induction of general anesthesia had adverse effects on neonate Apgar score. However, it had positive effects on preventing adverse consequences of intubation on maternal hemodynamics.

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Influence of Spinal and General Anesthesia on Newborn’s Status

Macedonian Medical Review ◽

10.1515/mmr-2015-0014 ◽

2015 ◽

Vol 69 (2) ◽

pp. 65-70

Author(s):

Emilija Ivanov ◽

Dafina Karadzova ◽

Sotir Nikolovski ◽

Atanas Sivevski ◽

Kiro Curlinov ◽

...

Keyword(s):

Caesarean Section ◽

General Anesthesia ◽

Spinal Anesthesia ◽

Apgar Score ◽

Base Excess ◽

Rocuronium Bromide ◽

Apgar Scores ◽

Ph Values ◽

Vital Parameters

AbstractIntroduction. The number of caesarean sections has drastically increased and thus arose the idea to examine the effect of the type of anesthesia on the neonates. The objective was to compare vital parameters in the neonates, born under general and spinal anesthesia.Method. A total of 120 patients with need for caesarean section have been divided in two groups of 60, of which the first was lead in general and the second one in spinal anesthesia. The first one was given propophol (2.0-2.5 mg/kg/tt) and succinil colin (1-1.5 mg/kg/tt). The anesthesia was lead with fentanil 0,005 mg/kg/tt and rocuronium bromide 0.4-0.6 mg/kg/tt. O2:N2O was 3:3 l/min. The second group was lead in spinal anesthesia. 2-3 ml Bupivacain 0.5% was spinally applied between L2-L3. Apgar score was defined in the neonates in the first and fifth minutes. The acido-basic status of the neonate was examined through pH values in the blood and the base excess.Results. In the first minute after birth giving with Apgar, 8 newborns 37(61,67%) were born to the group of patients with SA and 29 (48.33%) to the group of patients with GA. In 11 (18.33%) newborns born to the patients led with SA had Apgar score of 9-10, while only 3 (5%) of the newborns born to the patients led with GA had Apgar score of 9-10. Similar ratio was noted in the fifth minute after birth. Ph of the newborns’ blood as well as the base excess (BE) demonstrated significantly lower values in the group of patients led with SA than in the group of patients led with GA. Ph = 7.33 vs 7.37; BE=-4.57±1.8 vs -2.96±2.3.Conclusion. The newborns from the second group had significantly higher Apgar scores than those in the first group. The newborns’ relative acidose (lower SpO2and BE) did not affect the newborns’ Apgar score in the first and fifth minute.

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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 ◽

10.1093/qjmed/hcaa039.059 ◽

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.

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Adequacy of maternal anesthesia depth with two sodium thiopental doses in elective caesarean section: a randomized clinical trial

BMC Anesthesiology ◽

10.1186/s12871-021-01421-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Golnar Sabetian ◽

Farid Zand ◽

Fatemeh Mirhadi ◽

Mohammad Reza Hadavi ◽

Elham Asadpour ◽

...

Keyword(s):

Clinical Trial ◽

Cesarean Section ◽

Apgar Score ◽

Dose Group ◽

Low Dose ◽

Newborn Infants ◽

High Dose Group ◽

High Dose ◽

Depth Of Anesthesia ◽

Sodium Thiopental

Abstract Background Administration of an optimal dose of anesthetic agent to ensure adequate depth of hypnosis with the lowest risk of adverse effects to the fetus is highly important in cesarean section. Sodium thiopental (STP) is still the first choice for induction of anesthesia in some countries for this obstetric surgery. We aimed to compare two doses of STP with regarding the depth of anesthesia and the condition of newborn infants. Methods In this clinical trial, parturient undergoing elective Caesarian section were randomized into two groups receiving either low-dose (5 mg/kg) or high-dose (7 mg/kg) STP. Muscle relaxation was provided with succinylcholine 2 mg/kg and anesthesia was maintained with O2/N2O and sevoflurane. The depth of anesthesia was evaluated using isolated forearm technique (IFT) and bispectral index (BIS) in various phases. Additionally, infants were assessed using Apgar score and neurobehavioral test. Results Forty parturient were evaluated in each group. BIS was significantly lower in high-dose group at skin incision to delivery and subcutaneous and skin closure. Also, significant differences were noticed in IFT over induction to incision and incision to delivery. Apgar score was significantly lower in high-dose group at 1 min after delivery. Newborn infants in low-dose group had significantly better outcomes in all three domains of the neurobehavioral test. Conclusion 7 mg/kg STP is superior to 5 mg/kg in creating deeper hypnosis for mothers. However, it negatively impacts Apgar score and neurobehavioral test of neonates. STP seems to has dropped behind as an acceptable anesthetic in Cesarean section. Trial registration IRCT No: 2016082819470 N45, 13/03/2019.

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Efek Pemberian Cairan Koloid dan Kristaloid terhadap Tekanan Darah

Berkala Kedokteran ◽

10.20527/jbk.v12i1.352 ◽

2016 ◽

Vol 12 (1) ◽

pp. 19

Author(s):

Rebika Nurul Azizah ◽

Kenanga Marwan Sikumbang ◽

Asnawati Asnawati

Keyword(s):

Blood Pressure ◽

Cesarean Section ◽

Spinal Anesthesia ◽

Diastolic Pressure ◽

Statistical Test ◽

Cross Sectional ◽

Crystalloid Fluid

Abstract: Maternal hypotension is a serious problem that most commonly occurs after spinal anesthesia in cesarean section. To reduce the incidence of maternal hypotension, mother with spinal anasthesia for cesarean section can be given fluids intravenously using crystalloid or colloid.The purpose of this study was to determine the effect of colloid and crystalloid fluid to blood pressure in mother with spinal anesthesia for cesarean section. This study was cross sectional observational analytic. There were 2 groups in this study, crystalloid group and colloid group. Sampels in each group were 20 subject. Generalized linier models test showed the value of P > 0.05 for each hemodynamic markers (Systolic and diastolic pressure at 5th, 10th, and 15th minutes). On the statistical test value of systolic ( P= 0.379) and diastolic ( P= 0.654). It can be concluded that crystalloid and colloid fluid were equally efective to defend blood pressure in patients with spinal anesthesia for caesarean sectionKeywords: blood pressure, spinal anesthesia, cesarean section, crystalloid, colloid. Abstrak: Hipotensi pada ibu hamil adalah masalah serius yang paling umum terjadi pasca anestesi spinal pada seksio sesarea. Untuk mengurangi kejadian hipotensi tersebut dapat diberikan cairan intravena berupa kristaloid atau koloid. Tujuan penelitian ini untuk membandingkan efek penggunaan cairan koloid dan kristaloid terhadap tekanan darah pasien seksio sesaria dengan anestesi spinal. Penelitian ini bersifat observasional analitik cross sectional. Dua puluh pasien yang telah diberikan cairan kristaloid dan 20 pasien lainnya yang diberikan cairan koloid. Dari uji statistik dengan generaliz linier model didapatkan nilai P= >0.05 pada setiap penanda hemodinamik (TDS dan TDD pada menit ke-5, 10, dan 15). Pada uji statistik tersebut nilai TDS (P = 0.379) dan TDD (P = 0.654). Dapat disimpulkan bahwa cairan kristaloid dan koloid sama efektifnya dalam mempertahankan tekanan darah pada ibu hamil dengan seksio sesarea yang dilakukan anestesi spinal. Kata-kata kunci: tekanan darah, anestesi spinal, seksio sesarea, kristaloid, koloid.

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