Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study
Yıl: 2021 Cilt: 59 Sayı: 1 Sayfa Aralığı: 9 - 16 Metin Dili: İngilizce DOI: 10.4274/haseki.galenos.2021.6620 İndeks Tarihi: 19-06-2021
Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study
Öz: Aim: To compare the effect of bupivacaine and bupivacaine/fentanyl combination on cerebral oxygenation values with the Near-infrared spectroscopy (NIRS) technique in elective cesarean sections performed under spinal anesthesia.Methods: Fifty patients who underwent cesarean section under spinal anesthesia were randomly divided into two groups. 7.5-10 mg 0.5% hyperbaric bupivacaine was administered to the bupivacaine group (n=25) and 7.5-10 mg 0.5% hyperbaric bupivacaine+20-25 mcg fentanyl was given to the combination group (n=25). Heart rate, mean arterial pressure, peripheral oxygen saturation, mean values of regional cerebral oxygen saturation after spinal anesthesia were recorded preoperatively and the 1st, 5th, 10th, 15th and 20th minutes after anesthesia. The presence of perioperative nausea and vomiting was assessed with the Verbal Descriptive Scale.Results: Significant difference was observed in mean arterial pressure values between groups (p=0.001). There was a statistically significant change in cerebral oxygenation values during surgery in both groups (p=0.001). The frequency of nausea and vomiting was lower in the combination group (p=0.009).Conclusion: The non-invasive NIRS technique can be safely applied in the monitoring of cerebral oxygenation and hemodynamics in elective cesarean section procedures undergoing spinal anesthesia.
Anahtar Kelime: Spinal Anestezi ile Yapılan Elektif Sezaryen Vakalarında Serebral Oksimetre Kullanımı: Randomize Prospektif Çalışma
Öz: Amaç: Spinal anestezi ile yapılan elektif sezaryen vakalarında bupivakain ve bupivakain/fentanil kombinasyonunun serebral oksijenizasyon değerlerine etkisini Near-infrared Spektroskopi (NIRS) tekniği ile karşılaştırmak. Yöntemler: Spinal anestezi ile sezaryen operasyonu olan 50 hasta rastgele yöntemle iki gruba ayrıldı. Hastalardan bupivakain grubuna (n=25) 7,5-10 mg %0,5 hiperbarik bupivakain ve kombine grubuna (n=25) 7,5-10 mg %0,5 hiperbarik bupivakain+20-25 mcg fentanil uygulandı. Hastaların, spinal anestezi uygulaması sonrası kalp atım hızı, ortalama arteriyel basıncı, periferik oksijen satürasyonu, rejyonel serebral oksijen satürasyonunun ortalama değerleri preoperatif ve anestezi uygulamasının 1, 5, 10, 15, 20 dk sonrasında kaydedildi. Peroperatif bulantı kusma varlığı Verbal Deskriptif Skala ile takip edildi. Bulgular: Her iki grupta ortalama arter basıncı değerleri arasında anlamlı değişim gözlendi (p=0,001). Gruplarda cerrahi süresince serebral oksijenizasyon değerleri arasında istatistiksel olarak anlamlı değişim oldu (p=0,001). Kombine grupta bulantı-kusma görülme sıklığı daha az saptandı (p=0,009). Sonuç: Spinal anestezi uygulanan elektif sezaryen vakalarında serebral oksijenizasyon ve hemodinami takibinde girişimsel olmayan NIRS tekniği güvenle uygulanabilir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1.Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014. PLoS One. 2016;11:0148343.
- 2.T.C. Sağlık Bakanlığı Sağlık İstatistikleri Yıllığı 2016. Available from: https://dosyasb.saglik.gov.tr/Eklenti/13160,sy2016enpdf.pdf?0 Ankara; 2017
- 3.Braga AA, Frias JA, Braga FS, Potério GB, Hirata ES, Torres NA. Spinal anesthesia for cesarean section. Use of hyperbaric bupivacaine (10mg) combined with different adjuvants. Rev Bras Anestesiol 2012;62:775-87.
- 4.Venkata HG, Pasupuleti S, Pabba UG, Porika S, Talari G. A randomized controlled prospective study comparing a low dose bupivacaine and fentanyl mixture to a conventional dose of hyperbaric bupivacaine for cesarean section. Saudi J Anaesth 2015;9:122-7.
- 5.Gajbhare MKN, Kamble NP. Comparative study of intrathecal bupivacaine versus bupivacaine with fentanyl for cesarean section. Hint J Clin Anaesth 2016;3:271-7.
- 6.Brodsky JB. What intraoperative monitoring makes sense? Chest 1999;115:101-5.
- 7.Hoppenstein D, Zohar E, Ramaty E, Shabat S, Fredman B. The effects of general vs spinal anesthesia on frontal cerebral oxygen saturation in geriatric patients undergoing emergency surgical fixation of the neck of femur. J Clin Anesth 2005;17:431-8.
- 8.Mercier FJ, Augè M, Hoffmann C, Fischer C, Le Gouez A. Maternal hypotension during spinal anesthesia for caesarean delivery. Minerva Anestesiol 2013;79:62-73.
- 9.Kirson LE, Goldman JM, Slover RB. Low-dose intrathecal morphine for postoperative pain control in patients undergoing transurethral resection of the prostate. Anesthesiology 1989;71:192-5.
- 10.F Farzi, Bir Mirmansouri, BN Nabi, et al. Comparing the Effect of Adding Fentanyl, Sufentanil, and Placebo with Intrathecal Bupivacaine on Duration of Analgesia and Complications of Spinal Anesthesia in Patients Undergoing Cesarean Section. Anesth Pain Med 2017;7:127-38.
- 11.Hunt CO, Naulty JS, Bader AM, et al. Perioperative analgesia with subarachnoid fentanyl-bupivacaine for cesarean delivery. Anesthesiology 1989;71:535-40.
- 12.Hamber EA, Viscomi CM. Intrathecal lipophilic opioids as adjuncts to surgical spinal anesthesia. Reg Anesth Pain Med 1999;24:255-63.
- 13.Palmer CM, Cork RC, Hays R, Van Maren G, Alves D. The dose-response relation of intrathecal fentanyl for labor analgesia. Anesthesiology 1998;88:355-61.
- 14.Kang FC, Tsai YC, Chang PJ, Chen TY. Subarachnoid fentanyl with diluted small-dose bupivacaine for cesarean section delivery. Acta Anaesthesiol Sin 1998;36:207-14.
- 15.Meyer RA, Macarthur AJ, Downey K. Study of equivalence: spinal bupivacaine 15 mg versus bupivacaine 12 mg with fentanyl 15 μg for cesarean delivery. Int J Obstet Anesth 2012;21:17-23.
- 16.Prakash S, Pramanik V, Chellani H, Salhan S, Gogia AR. Maternal and neonatal effects of bolus administration of ephedrine and phenylephrine during spinal anaesthesia for caesarean delivery: a randomised study. Int J Obstet Anesth 2010;19:24-30.
- 17.Şahin Ş, Günaydin B, Özkan ST. Santral Blokların Komplikasyonları. Doğumda Analjezi Sezaryende Anestezi. Available from: https://www.tard.org.tr/assets/kilavuz/9.pdf Bursa, Medyay Kitabevi 2019;117-36.
- 18.Berlac PA, Rasmussen YH. Per-operative cerebral near-infrared spectroscopy (NIRS) predicts maternal hypotension during elective caesarean delivery in spinal anaesthesia. Int J Obstet Anesth 2005;14:26-31.
- 19.Fassoulaki A, Paraskeva A, Tsaroucha A. Cesarean delivery under spinal anesthesia is associated with decreases in cerebral oxygen saturation as assessed by NIRS: an observational study. Curr Med Res Opin 2014;30:331-7.
- 20.Kondo Y, Sakatani K, Hirose N, et al. Effect of spinal anesthesia for elective cesarean section on cerebral blood oxygenation changes: comparison of hyperbaric and isobaric bupivacaine. Adv Exp Med Biol 2013;765:109-14.
- 21.Yamazaki K, Suzuki K, Itoh H, et al. Cerebral oxygen saturation evaluated by near-infrared time-resolved spectroscopy (TRS) in pregnant women during caesarean section - a promising new method of maternal monitoring. Clin Physiol Funct Imaging 2013;33:109-16.
- 22. Van Noord BA, Stalker CL, Roffey P, Thangathurai D. The use of regional cerebral oximetry monitoring during controlled hypotension: a case series. J Clin Monit Comput 2014;28:319-23.
- 23.Chan JH, Perez H, Lee H, Saltzman M, Marra G. Evaluation of cerebral oxygen perfusion during shoulder arthroplasty performed in the semi-beach chair position. J Shoulder Elbow Surg 2020;29:79-85.
- 24.Aguirre JA, Etzensperger F, Brada M, et al. The beach chair position for shoulder surgery in intravenous general anesthesia and controlled hypotension: Impact on cerebral oxygenation, cerebral blood flow and neurobehavioral outcome. J Clin Anesth 2019;53:40-8.
- 25.Kunst G, Milan Z. Cerebral oximetry: another blow to non-invasive monitoring? Anaesthesia 2017;72:1435-8.
| APA | ONUR T, KARACA Ü, GÜRA ÇELIK M (2021). Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study. , 9 - 16. 10.4274/haseki.galenos.2021.6620 |
| Chicago | ONUR TUĞBA,KARACA ÜMRAN,GÜRA ÇELIK MELEK Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study. (2021): 9 - 16. 10.4274/haseki.galenos.2021.6620 |
| MLA | ONUR TUĞBA,KARACA ÜMRAN,GÜRA ÇELIK MELEK Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study. , 2021, ss.9 - 16. 10.4274/haseki.galenos.2021.6620 |
| AMA | ONUR T,KARACA Ü,GÜRA ÇELIK M Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study. . 2021; 9 - 16. 10.4274/haseki.galenos.2021.6620 |
| Vancouver | ONUR T,KARACA Ü,GÜRA ÇELIK M Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study. . 2021; 9 - 16. 10.4274/haseki.galenos.2021.6620 |
| IEEE | ONUR T,KARACA Ü,GÜRA ÇELIK M "Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study." , ss.9 - 16, 2021. 10.4274/haseki.galenos.2021.6620 |
| ISNAD | ONUR, TUĞBA vd. "Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study". (2021), 9-16. https://doi.org/10.4274/haseki.galenos.2021.6620 |
| APA | ONUR T, KARACA Ü, GÜRA ÇELIK M (2021). Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study. Haseki Tıp Bülteni, 59(1), 9 - 16. 10.4274/haseki.galenos.2021.6620 |
| Chicago | ONUR TUĞBA,KARACA ÜMRAN,GÜRA ÇELIK MELEK Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study. Haseki Tıp Bülteni 59, no.1 (2021): 9 - 16. 10.4274/haseki.galenos.2021.6620 |
| MLA | ONUR TUĞBA,KARACA ÜMRAN,GÜRA ÇELIK MELEK Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study. Haseki Tıp Bülteni, vol.59, no.1, 2021, ss.9 - 16. 10.4274/haseki.galenos.2021.6620 |
| AMA | ONUR T,KARACA Ü,GÜRA ÇELIK M Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study. Haseki Tıp Bülteni. 2021; 59(1): 9 - 16. 10.4274/haseki.galenos.2021.6620 |
| Vancouver | ONUR T,KARACA Ü,GÜRA ÇELIK M Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study. Haseki Tıp Bülteni. 2021; 59(1): 9 - 16. 10.4274/haseki.galenos.2021.6620 |
| IEEE | ONUR T,KARACA Ü,GÜRA ÇELIK M "Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study." Haseki Tıp Bülteni, 59, ss.9 - 16, 2021. 10.4274/haseki.galenos.2021.6620 |
| ISNAD | ONUR, TUĞBA vd. "Use of Cerebral Oximetry in Elective Cesarean Section Procedures Performed Under Spinal Anesthesia: A Randomized Prospective Study". Haseki Tıp Bülteni 59/1 (2021), 9-16. https://doi.org/10.4274/haseki.galenos.2021.6620 |
