Araştırma Makalesi
Yıl 2025,
Cilt: 52 Sayı: 2, 309 - 318, 20.06.2025
Öz
Kaynakça
- 1.Palanisamy A, Mitani AA, Tsen LC. Generalanesthesia for cesarean delivery at a tertiary carehospital: a retrospective analysis and 10-year update.Int J Obstet Anesth. 2011;20(1):10-6.
- 2.World Health Organization. Appropriate technologyfor birth revisited. BJOG. 2005;112(9):1219-22.
- 3.Türkiye Nüfus ve Sağlık Araştırması 2018 -Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü.https://www.hips.hacettepe.edu.tr/tnsa2018/rapor/TNSA2018_anaRapor.pdf. Erişim: 15.09.2024.
- 4.Liu S, Liston RM, Joseph KS, Heaman M, Sauve R,Kramer MS. Maternal mortality and severe morbidityassociated with low-risk planned cesarean deliveryversus planned vaginal delivery at term. CMAJ.2007;176(4):455-60.
- 5.Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB,Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health.2014;2(6):e323-33.
- 6.Guglielminotti J, Landau R, Li G. Temporal trends inanesthesia-related adverse events in cesareandeliveries in the United States, 2003–2012. AnesthAnalg. 2015;121(1):183-92.
- 7.Knight M, Bunch K, Tuffnell D, Shakespeare J, KotnisR, Kenyon S, Kurinczuk JJ (Eds). Saving Lives,Improving Mothers’ Care – Lessons learned to informmaternity care from the UK and Ireland ConfidentialEnquiries into Maternal Deaths and Morbidity 2017–19.MBRRACE-UK, 2021.
- 8.Li G, Warner M, Lang BH, Huang L, Sun LS.Epidemiology of anesthesia-related mortality in theUnited States, 1999–2005. Anesthesiology.2009;110(4):759-65.
- 9.Bauer ME, Bernstein K, Dinges E, Deering SH,Bernstein J, Mhyre JM. Obstetric anesthesia workforcesurvey: a 2020 update. Anesth Analg.2020;131(2):552-61.
- 10.Gizzo S, Noventa M, Faggian D, et al. Spinalanesthesia in caesarean delivery: pharmacological andclinical aspects of drugs and adjuvants. Biomed Res Int.2014;2014:307543.
- 11.Kinsella SM, Carvalho B, Dyer RA, et al.International consensus statement on themanagement of hypotension with vasopressors duringcaesarean section under spinal anaesthesia.Anaesthesia. 2018;73(1):71-92.
- 12.Afolabi BB, Lesi FE, Merah NA. Regional versusgeneral anaesthesia for caesarean section. CochraneDatabase Syst Rev. 2006;(4):CD004350.
- 13.Costley PL, Eke AC, Adebayo A, et al. Effects ofanesthesia type on neonatal outcomes in very preterminfants delivered by cesarean section. J Perinatol.2021;41(10):2365-71.
- 14.Vallejo MC, Mandell GL, Sabo DP, Ramanathan S.Postdural puncture headache: a randomizedcomparison of five treatments. Anesth Analg.2000;91(4):916-20.
- 15.Saygı A, Özdamar Ö, Gün İ, Emirkadı H, Müngen E,Akpak YK. Comparison of maternal and fetal outcomesamong patients undergoing cesarean section undergeneral and spinal anesthesia: a randomized clinicaltrial. Sao Paulo Med J. 2015;133(3):227-34.
- 16.Yılmaz Ergani S, Dicle İ, Aksan A, et al.Postoperative care in the caesarean intensive careunit: experience from a tertiary maternity hospital. JTurk Ger Gynecol Assoc. 2023;24(1):42-7.
- 17.Bauer ME, Bernstein K, Dinges E, et al.Complications of anesthesia for cesarean delivery.Obstet Gynecol Clin North Am. 2021;48(1):67-82.
- 18.Aksoy M, Aksoy AN, Dostbil A, et al. Anaesthesiatechniques for caesarean operations: retrospectiveanalysis of the last decade. Turk J Anaesthesiol Reanim. 2014;42(3):128-32.
- 19.Yıldız A, Kaya FN, Aksu R, Güler G. Retrospectiveevaluation of anesthesia techniques used foremergency gynecological surgeries. Dicle Med J.2018;45(3):205-11.
- 20.Van de Velde M, Carvalho B. Advances in regionalanesthesia for obstetrics. Curr Opin Anaesthesiol.2016;29(3):262-7.
- 21.Rafiq S, Rajesh MC. Neonatal outcomes followingcesarean delivery under general versus spinalanesthesia: a prospective cohort study. J ObstetAnaesth Crit Care. 2019;9(2):79-84.
- 22.Allen TK, Gordon ET, Nielsen KC, et al. Safety andefficacy of neuraxial anesthesia in patients withpreeclampsia: a matched case-control study. AnesthAnalg. 2020;130(1):187-93.
- 23.Sarı MA, Küçükgüçlü S, Özbilgin Ş, et al.Retrospective evaluation of anaesthetic techniques forcaesarean. Turk J Anaesthesiol Reanim.2015;43(6):373-80.
- 24.Bidon C, Desgranges FP, Riegel AC, et al. Type ofanaesthesia and neonatal outcome in code-redemergency caesarean sections: a retrospective cohortstudy. Anaesth Crit Care Pain Med. 2019;38(6):623-30.
- 25.Olutoye OA, Soyannwo OA. Trends in anaesthesiatechniques for caesarean delivery in Nigeria: a 10-yearreview. Niger J Clin Pract. 2021;24(4):520-5.
- 26.Mhyre JM, Riesner MN, Polley LS, Naughton NN. Aseries of anesthesia-related maternal deaths inMichigan, 1985–2003. Anesthesiology.2007;106(6):1096-104.
- 27.Imarengiaye CO, Ande AB. Anaesthesia-relatedcomplications requiring ICU admission followingcaesarean delivery: a 5-year review. Niger PostgradMed J. 2016;23(3):133-7.
- 28.Eze GU, Ihedioha OC. Maternal and fetal outcomesin preeclamptic/eclamptic women undergoingcaesarean delivery under different anaesthesiamodalities: a comparative study. Int J Obstet Anesth.2020;41:58-64.
- 29.Burrows LJ, Meyn LA, Weber AM. Maternalmorbidity associated with elective cesarean delivery.Obstet Gynecol. 2004;103(6):1066-71.
- 30.Hadzic A, Williams BA, Karaca PE, et al. Foroutpatient hand surgery, a prospective comparison ofclinical outcomes and cost savings between regionaland general anesthesia. Reg Anesth Pain Med.2005;30(6):508-14.
Üçüncü Basamak Bir Üniversite Hastanesinde Sezaryen Vakalarının Klinik Analizi: Retrospektif Klinik Çalışma
Öz
Amaç: Bu çalışma, bir üçüncü basamak üniversite hastanesinde uygulanan sezaryen operasyonlarında tercih edilen anestezi yöntemleri ile postoperatif yoğun bakım ihtiyacı, intraoperatif ve postoperatif mortalite oranları arasındaki ilişkileri değerlendirmeyi amaçlamaktadır.
Yöntem: Retrospektif tasarımlı bu kohort çalışma kapsamında, 2018 ile 2023 yılları arasında Van Yüzüncü Yıl Üniversitesi Dursun Odabaşı Tıp Merkezi Hastanesi'nde genel veya rejyonal anestezi ile gerçekleştirilen 2709 sezaryen vakası analiz edilmiştir. Katılımcılara ait veriler, hastanenin dijital veri sisteminden retrospektif olarak toplanmıştır.
Bulgular: Çalışma kapsamındaki bireylerin yaş ortalaması 30,48 ± 6,76 yıldır. Sezaryen doğumların %66,3'ünde genel anestezi, %33,7'sinde ise spinal anestezi tercih edilmiştir. Postoperatif yoğun bakıma alınan hastaların oranı %0,6 olarak bulunmuştur. Genel anestezi kullanımının; artmış komorbidite sayısı, 1. ve 5. dakikalarda düşük APGAR skorları, yüksek ASA değerleri, HELLP sendromu, preeklampsi, plasenta invazyon bozuklukları, artmış eritrosit süspansiyonu ve taze donmuş plazma gereksinimi ile ilişkili olduğu tespit edilmiştir. Aynı faktörler, postoperatif yoğun bakım gereksinimi ile de anlamlı düzeyde ilişkili bulunmuştur.
Sonuç: Bulgular, merkezimizde genel anestezinin sezaryen doğumlarda daha sık tercih edildiğini, ancak spinal anestezinin daha avantajlı klinik sonuçlar sunduğunu ortaya koymaktadır. Bu kapsamda, genel anestezi endikasyonlarının yeniden değerlendirilmesi gerekmektedir.
Anahtar Kelimeler
Sezaryen Genel anestezi Spinal anestezi APGAR skoru Yoğun bakım
Kaynakça
- 1.Palanisamy A, Mitani AA, Tsen LC. Generalanesthesia for cesarean delivery at a tertiary carehospital: a retrospective analysis and 10-year update.Int J Obstet Anesth. 2011;20(1):10-6.
- 2.World Health Organization. Appropriate technologyfor birth revisited. BJOG. 2005;112(9):1219-22.
- 3.Türkiye Nüfus ve Sağlık Araştırması 2018 -Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü.https://www.hips.hacettepe.edu.tr/tnsa2018/rapor/TNSA2018_anaRapor.pdf. Erişim: 15.09.2024.
- 4.Liu S, Liston RM, Joseph KS, Heaman M, Sauve R,Kramer MS. Maternal mortality and severe morbidityassociated with low-risk planned cesarean deliveryversus planned vaginal delivery at term. CMAJ.2007;176(4):455-60.
- 5.Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB,Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health.2014;2(6):e323-33.
- 6.Guglielminotti J, Landau R, Li G. Temporal trends inanesthesia-related adverse events in cesareandeliveries in the United States, 2003–2012. AnesthAnalg. 2015;121(1):183-92.
- 7.Knight M, Bunch K, Tuffnell D, Shakespeare J, KotnisR, Kenyon S, Kurinczuk JJ (Eds). Saving Lives,Improving Mothers’ Care – Lessons learned to informmaternity care from the UK and Ireland ConfidentialEnquiries into Maternal Deaths and Morbidity 2017–19.MBRRACE-UK, 2021.
- 8.Li G, Warner M, Lang BH, Huang L, Sun LS.Epidemiology of anesthesia-related mortality in theUnited States, 1999–2005. Anesthesiology.2009;110(4):759-65.
- 9.Bauer ME, Bernstein K, Dinges E, Deering SH,Bernstein J, Mhyre JM. Obstetric anesthesia workforcesurvey: a 2020 update. Anesth Analg.2020;131(2):552-61.
- 10.Gizzo S, Noventa M, Faggian D, et al. Spinalanesthesia in caesarean delivery: pharmacological andclinical aspects of drugs and adjuvants. Biomed Res Int.2014;2014:307543.
- 11.Kinsella SM, Carvalho B, Dyer RA, et al.International consensus statement on themanagement of hypotension with vasopressors duringcaesarean section under spinal anaesthesia.Anaesthesia. 2018;73(1):71-92.
- 12.Afolabi BB, Lesi FE, Merah NA. Regional versusgeneral anaesthesia for caesarean section. CochraneDatabase Syst Rev. 2006;(4):CD004350.
- 13.Costley PL, Eke AC, Adebayo A, et al. Effects ofanesthesia type on neonatal outcomes in very preterminfants delivered by cesarean section. J Perinatol.2021;41(10):2365-71.
- 14.Vallejo MC, Mandell GL, Sabo DP, Ramanathan S.Postdural puncture headache: a randomizedcomparison of five treatments. Anesth Analg.2000;91(4):916-20.
- 15.Saygı A, Özdamar Ö, Gün İ, Emirkadı H, Müngen E,Akpak YK. Comparison of maternal and fetal outcomesamong patients undergoing cesarean section undergeneral and spinal anesthesia: a randomized clinicaltrial. Sao Paulo Med J. 2015;133(3):227-34.
- 16.Yılmaz Ergani S, Dicle İ, Aksan A, et al.Postoperative care in the caesarean intensive careunit: experience from a tertiary maternity hospital. JTurk Ger Gynecol Assoc. 2023;24(1):42-7.
- 17.Bauer ME, Bernstein K, Dinges E, et al.Complications of anesthesia for cesarean delivery.Obstet Gynecol Clin North Am. 2021;48(1):67-82.
- 18.Aksoy M, Aksoy AN, Dostbil A, et al. Anaesthesiatechniques for caesarean operations: retrospectiveanalysis of the last decade. Turk J Anaesthesiol Reanim. 2014;42(3):128-32.
- 19.Yıldız A, Kaya FN, Aksu R, Güler G. Retrospectiveevaluation of anesthesia techniques used foremergency gynecological surgeries. Dicle Med J.2018;45(3):205-11.
- 20.Van de Velde M, Carvalho B. Advances in regionalanesthesia for obstetrics. Curr Opin Anaesthesiol.2016;29(3):262-7.
- 21.Rafiq S, Rajesh MC. Neonatal outcomes followingcesarean delivery under general versus spinalanesthesia: a prospective cohort study. J ObstetAnaesth Crit Care. 2019;9(2):79-84.
- 22.Allen TK, Gordon ET, Nielsen KC, et al. Safety andefficacy of neuraxial anesthesia in patients withpreeclampsia: a matched case-control study. AnesthAnalg. 2020;130(1):187-93.
- 23.Sarı MA, Küçükgüçlü S, Özbilgin Ş, et al.Retrospective evaluation of anaesthetic techniques forcaesarean. Turk J Anaesthesiol Reanim.2015;43(6):373-80.
- 24.Bidon C, Desgranges FP, Riegel AC, et al. Type ofanaesthesia and neonatal outcome in code-redemergency caesarean sections: a retrospective cohortstudy. Anaesth Crit Care Pain Med. 2019;38(6):623-30.
- 25.Olutoye OA, Soyannwo OA. Trends in anaesthesiatechniques for caesarean delivery in Nigeria: a 10-yearreview. Niger J Clin Pract. 2021;24(4):520-5.
- 26.Mhyre JM, Riesner MN, Polley LS, Naughton NN. Aseries of anesthesia-related maternal deaths inMichigan, 1985–2003. Anesthesiology.2007;106(6):1096-104.
- 27.Imarengiaye CO, Ande AB. Anaesthesia-relatedcomplications requiring ICU admission followingcaesarean delivery: a 5-year review. Niger PostgradMed J. 2016;23(3):133-7.
- 28.Eze GU, Ihedioha OC. Maternal and fetal outcomesin preeclamptic/eclamptic women undergoingcaesarean delivery under different anaesthesiamodalities: a comparative study. Int J Obstet Anesth.2020;41:58-64.
- 29.Burrows LJ, Meyn LA, Weber AM. Maternalmorbidity associated with elective cesarean delivery.Obstet Gynecol. 2004;103(6):1066-71.
- 30.Hadzic A, Williams BA, Karaca PE, et al. Foroutpatient hand surgery, a prospective comparison ofclinical outcomes and cost savings between regionaland general anesthesia. Reg Anesth Pain Med.2005;30(6):508-14.
Toplam 30 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Tıp Eğitimi, Sağlık Hizmetleri ve Sistemleri (Diğer) |
| Bölüm | Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 20 Haziran 2025 |
| Gönderilme Tarihi | 1 Ocak 2025 |
| Kabul Tarihi | 12 Haziran 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 52 Sayı: 2 |
