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 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 Formulating an anesthetic plan using a list of high-risk pregnant women on cloud-based business communication tools: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Junnosuke Kimura ◽  
Kento Kawamura ◽  
Manami Minoura ◽  
Ayako Hiramoto ◽  
Yoshifumi Suga ◽  
...  
Keyword(s):  
Case Report ◽  
High Risk ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
Business Communication ◽  
Communication Tools ◽  
Case Presentation ◽  
Emergency Cesarean

Abstract Background We report a case in which a list of high-risk pregnant women on cloud-based business communication tools was useful in formulating an anesthetic plan for unscheduled cesarean section. Case presentation A 37-year-old woman, who had been prescribed icosapentate for hypertriglyceridemia, received an antenatal anesthetic evaluation for possible cesarean delivery, and it was agreed that the anesthetic method for emergency cesarean section was general anesthesia if the surgery would take place within 7 days after the discontinuation of the drug, and regional anesthesia if it would take place any time later. Then this agreement was uploaded on the cloud-based business communication tools, and updated until she delivered her baby via unscheduled cesarean section. Conclusions A cloud-based business communication tools was useful in formulating an anesthesia plan for a patient undergoing a cesarean delivery. However, more discussion would be needed to utilize it in security.

scholarly journals Regional anaesthesia in pregnant women with cardiovascular diseases

2020 ◽  
Vol 6 (6) ◽  
pp. 29-39
Author(s):  
A. E. Bautin ◽  
Yu. N. Bel'skih ◽  
V. V. Moskalenko ◽  
E. V. Frederiks ◽  
A. V. Yakybov ◽  
...  
Keyword(s):  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Medical Research ◽  
General Anesthesia ◽  
Pregnant Women ◽  
Regional Anesthesia ◽  
Maternity Hospital ◽  
Research Centre ◽  
National Medical ◽  
Abdominal Delivery

Background. Currently in developed countries, up to 4 % of pregnant women have cardiovascular diseases, which are one of the leading causes of maternal mortality. Anesthesia method have an important role in the abdominal delivery in this category of patients. Objective. To summarize the experience of different anesthesia approaches to abdominal delivery in pregnant women with cardiovascular diseases.Materials and methods. A retrospective analysis of the use of various methods of anesthesia during abdominal delivery of pregnant women with cardiovascular diseases was performed.Results. In “Maternity Hospital № 13” and the Almazov National Medical Research Centre for the period from 2014 to 2018 2140 abdominal deliveries were carried out in pregnant women with heart diseases (1450 and 690, respectively). In the Maternity Hospital №13 1374 (94.8 %) of abdominal deliveries were performed under regional anesthesia, 76 (5.2 %) under general anesthesia. In Almazov National Medical Research Centre 513 (74.3 %) of abdominal deliveries were performed under regional anesthesia, 177 (25.7 %) under general anesthesia. The features of the hemodynamic profile of general and regional anesthesia in pregnant women with various heart disease are presented.Conclusion. In pregnant women with heart disease, up to 88 % of cesarean section are performed under regional anesthesia. General anesthesia is used for contraindications to regional anesthesia, as well as for obstetric indications. The use of advanced monitoring, methods of slow titration of local anesthetic dose and the use of vasopressors allow to avoid hemodynamic disorders in patients with concomitant heart disease.

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.

scholarly journals The Risk of Post-Partum Hemorrhage after Cesarean Section with General versus Spinal/Epidural Anesthesia

2020 ◽  
pp. 1-5
Author(s):  
Raghda Ahmed El-Dakhakhni ◽  
◽  
Maram Ibrahim El Mazny ◽  
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Postpartum Hemorrhage ◽  
Post Partum ◽  
Anesthetic Techniques ◽  
Uterine Contractility ◽  
Hospital Data ◽  
Spinal Epidural

Blood loss of over 40 percent of total blood volume (approx. 2800 ml) is typically considered a’ life danger.’ It seems rational to introduce PPH protocols at an average blood loss far below this level, as the aim of management is to prevent hemorrhage from rising to the point that it is life-threatening Objectives Caesarean anesthetic treatment, which involves general anesthesia and spinal / epidural anesthesia, was seldom examined for the risks associated with postpartum hemorrhage and was focused on only a small number of cases from single hospital data sets. The function of different types of anesthesia in postpartum hemorrhage therefore needs to be further explained. Patients and methods This are a retrospective study on patients complicated by postpartum hemorrhage after cesarean section with history of type of anesthesia used; general or spinal or epidural to improve outcome of cesarean section. We included all women complicated by postpartum hemorrhage after cesarean section and collect data about the anesthesia used during cesarean section and also recorded other risk factors for postpartum hemorrhage if recorded in files in antenatal care sheet and the intraoperative circumstances as recorded in the operative sheet of the patient. Heart rates and blood pressures of patients of both groups were measured before delivery and at 1 min interval for 15 min after injection of oxytocin. Uterine contractility was assessed for both groups at 1,2,4,6,8,10 and 15 min after oxytocin injection. Results Our results showed that the age of the studied group ranged from 18 to 40 years with mean 23.97 years. Regarding parity 44.5% of them had one child and 36.7% of them had two, 42.3% of the studied group had general anesthesia and 57.7% of them had spinal. Also 82.2% of the cases were previous and 17.8% of them were emergent. Conclusion Anesthetic techniques might be affected by the possibility of bleeding or concern. We found that women who have undergone general anesthesia have a higher risk of postpartum hemorrhage compared with women who have received epidural, spinal anesthesia

scholarly journals The Risk of Post-Partum Hemorrhage after Cesarean Section with General versus Spinal/Epidural Anesthesia

2020 ◽  
pp. 1-5
Author(s):  
Raghda Ahmed El-Dakhakhni ◽  
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Postpartum Hemorrhage ◽  
Post Partum ◽  
Anesthetic Techniques ◽  
Uterine Contractility ◽  
Hospital Data ◽  
Spinal Epidural

Blood loss of over 40 percent of total blood volume (approx. 2800 ml) is typically considered a’ life danger.’ It seems rational to introduce PPH protocols at an average blood loss far below this level, as the aim of management is to prevent hemorrhage from rising to the point that it is life-threatening Objectives Caesarean anesthetic treatment, which involves general anesthesia and spinal / epidural anesthesia, was seldom examined for the risks associated with postpartum hemorrhage and was focused on only a small number of cases from single hospital data sets. The function of different types of anesthesia in postpartum hemorrhage therefore needs to be further explained. Patients and methods This are a retrospective study on patients complicated by postpartum hemorrhage after cesarean section with history of type of anesthesia used; general or spinal or epidural to improve outcome of cesarean section. We included all women complicated by postpartum hemorrhage after cesarean section and collect data about the anesthesia used during cesarean section and also recorded other risk factors for postpartum hemorrhage if recorded in files in antenatal care sheet and the intraoperative circumstances as recorded in the operative sheet of the patient. Heart rates and blood pressures of patients of both groups were measured before delivery and at 1 min interval for 15 min after injection of oxytocin. Uterine contractility was assessed for both groups at 1,2,4,6,8,10 and 15 min after oxytocin injection. Results Our results showed that the age of the studied group ranged from 18 to 40 years with mean 23.97 years. Regarding parity 44.5% of them had one child and 36.7% of them had two, 42.3% of the studied group had general anesthesia and 57.7% of them had spinal. Also 82.2% of the cases were previous and 17.8% of them were emergent. Conclusion Anesthetic techniques might be affected by the possibility of bleeding or concern. We found that women who have undergone general anesthesia have a higher risk of postpartum hemorrhage compared with women who have received epidural, spinal anesthesia.

scholarly journals The relationship between anxiety and satisfaction level in women who had cesarean section with spinal or general anesthesia

2020 ◽  
Vol 7 (7) ◽  
pp. 560-565
Author(s):  
Semra Eroglu ◽  
Alperen Eroglu ◽  
Vusale Aziz ◽  
Songül Simar ◽  
Sibel Mutlu
Keyword(s):  
Cesarean Section ◽  
General Anesthesia ◽  
Pregnant Women ◽  
Depression Scale ◽  
Anxiety Level ◽  
Satisfaction Level ◽  
Analgesia Requirement ◽  
Observational Cohort ◽  
Anxiety Levels ◽  
The Relationship

Objective: Although regional anesthesia is frequently used in cesarean section, patient satisfaction and comfort can change with the anesthesia method preference. Our aim is to determine the level of anesthesia satisfaction in women with cesarean surgery with Spinal (SA) and General anesthesia (GA) and to examine its relationship with anxiety level. Material and Methods: In this prospective observational cohort study, 144 pregnant women who were admitted to the Obstetrics and Gynecology Clinic between January 2019 and April 2019 were included. Demographic information of the pregnant women including age, height, weight, gestational history and education level were recorded. Hospital Anxiety and Depression Scale (HADS), preoperative anxiety levels and which anesthesia method they preferred were questioned and recorded. Results: 72 SA and 72 GA patients were included in the study. Age, BMI (Body mass index), obstetric history, preoperative HADS were similar in both groups (p> 0.05). Patients with SA were significantly higher satisfaction level than those who had cesarean with GA (p = 0.000). Anxiety level during cesarean was correlated positively with preoperative HADS (p = 0.001, p = 0.005, respectively). First analgesia requirement didn’t differ in both group (p=0.409). Conclusion: The satisfaction score founded higher in those who were cesarean with SA. Evaluating anxiety levels of patients and providing support before surgery will increase postoperative comfort.

scholarly journals Perioperative management of emergent cesarean section in a patient with peripartum cardiomyopathy and orthopnea: a case report

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110630
Author(s):  
Yuko Kawamoto ◽  
Tasuku Nishihara ◽  
Jun Aono ◽  
Hideyuki Nandate ◽  
Taisuke Hamada ◽  
...  
Keyword(s):  
Cesarean Section ◽  
General Anesthesia ◽  
Pregnant Women ◽  
Perioperative Management ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Left Ventricular Ejection ◽  
Anesthesia Induction ◽  
Cardiopulmonary Support ◽  
Emergent Cesarean Section

Perioperative management of pregnant women with heart failure is difficult. Management of anesthesia in pregnant women is especially difficult because all of the currently available choices present challenges. We report a patient with peripartum cardiomyopathy (PPCM) who required an emergent cesarean section and discuss the possible tactics for managing anesthesia. A 40-year-old primipara with severe cardiac and respiratory failure required an emergent cesarean section at 39+1 gestational weeks. Her left ventricular ejection fraction was between 10% and 15%, and she had orthopnea. General anesthesia was planned after inserting sheaths for percutaneous cardiopulmonary support from the femoral artery and vein. However, when the patient was asked to lie down on the operation bed, she panicked and resisted because of labor pain and dyspnea. Therefore, anesthesia was induced instead of the initial plan. Finally, we successfully managed the anesthesia and delivered the newborn. There are no alternatives to general anesthesia in patients with PPCM presenting with orthopnea. Anesthesia induction in the supine position is impossible in such patients owing to dyspnea. Anesthesia should be started with light sedation in the sitting position, and ketamine or low-dose remifentanil may be an option to maintain maternal hemodynamics and prevent neonatal asphyxia.

Pregnancy-Related Cardiovascular Complications: Case Presentation and Review of Literature

2016 ◽  
Vol 19 (5) ◽  
pp. E248-E254 ◽  
Author(s):  
Hasan Baki Altinsoy ◽  
Ozkan Alatas ◽  
Salih Colak ◽  
Hakan Atalay ◽  
Omer Faruk Dogan
Keyword(s):  
Cardiac Surgery ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Median Time ◽  
Artery Bypass ◽  
Prosthetic Heart Valve ◽  
Cardiovascular Complications ◽  
Time To Diagnosis ◽  
Valve Thrombosis ◽  
Placental Blood

Background: Cardiovascular complications that can cause severe catastrophic outcomes for both the mother and the fetus are rarely seen during pregnancy. Time to diagnosis is often delayed by a low degree of suspicion and atypical presentation. We report surgical strategies in three pregnant women with cardiovascular complications. Methods: A retrospective search from 2009 to 2016 identified three pregnant women who underwent urgent cardiac surgery. We used extracorporeal circulation (ECC) without cesarean section with careful follow-up of the fetuses during the perioperative and postoperative period. We used levosimendan as a potent inodilator in all patients to increase feto-placental blood flow and fetal heart rhythm.Results: Median time to diagnosis was 23.8 h (range 11.7-120 h) and median time from diagnosis to arrival in the operating theater was 9.8 h (range 7.4-19.8 h). One patient with prosthetic heart valve thrombosis underwent concomitant cesarean section prior to cardiac surgery. In a young pregnant woman who had spontaneous dissection of the left anterior descending artery, on-pump beating heart coronary artery bypass grafting was performed without cross clamping. Two and three months after surgery, cesarean sections were performed without any complication in two pregnant women.Conclusion: Because unusual cardiovascular complications are the main cause of maternal and/or fetus death during pregnancy, prompt and exact diagnosis is very important. Life-saving surgical strategy with the help of appropriate teams are necessary to optimize outcome for both mother and baby.

Pulse oximetry-derived respiratory rate monitoring in pregnant women undergoing cesarean section

2020 ◽  
Vol 86 (4) ◽  
Author(s):  
Hideaki Ebana ◽  
Masahiro Murakawa ◽  
Yoshie Noji ◽  
Keisuke Yoshida ◽  
Jun Honda ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pulse Oximetry ◽  
Pregnant Women ◽  
Respiratory Rate
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