DOI: https://doi.org/10.15587/2313-8416.2015.50225

Influence of anesthesia technique at cesarean section on newborn state assessment and on uterus contraction

Олексій Олегович Волков

Abstract


Anesthetics and anesthesia in whole have an influence on intrauterine state of fetus. All substances that are injected to a pregnant for anesthesia penetrate in organism of fetus in some quantity. It is considered that halogened inhalation anesthetics can moderate the birth activity of uterus and its tonus in quiescence depending on concentration.

Aim of research: to study the techniques of anesthesia (inhalation, total intravenous, spinal) of cesarean section for assess the state of newborn and uterus contraction.

Materials and methods. There were examined 95 women on term of pregnancy 37–42 weeks in 2013–2014 years who underwent cesarean section. They were divided into 3 groups depending on technique of anesthesia. I group (n=30) included women who underwent inhalation anesthesia. The second one (n=34) included women who underwent the total intravenous anesthesia. The third group – the random women (n=31) who underwent the spinal anesthesia. The state of newborns was detected on Apgar score on 1 and 5 minutes after birth. The quality of postnatal uterus contraction was assessed depending on the need of an amount of injected oxytocin and necessity to add another uterotonic preparation after fetus extraction.

Results and discussion. At analysis of the state of newborn on Apgar score on 1 minute in 1 group were received 7,73±0,09 point, in 2 group this indicator was 7,4±0,14 point without statistic difference with 1 group (р=0,06). In 3 group points reached 7,55±0,17, without statistic difference with both (р=0,36), and 2 groups (р=0,50). At analysis of the state of newborn on Apgar on 5 minute statistic difference between the groups also was not established. In the 1 group this indicator reached 8,69±0,9 point, in 2 group – 8,47±0,12point, the difference with the first group was unreliable (р=0,16). In 3 group an assessment on Apgar on 5 minute was 8,64±0,12, without statistic difference with 1 and 2 groups (р=0,76 and р=0,30, respectively). Women of all groups received intraoperatively 10 MO oxytocin (р=1,0). In 1 group the second uterotonic preparation was prescribed to3,3 % women. In 2 group the second uterotonic preparation was prescribed to 5,9 % women, and in 3 group – to 12,9 % patients. The difference between groups was unreliable (р=0,76). The correlative analysis did not reveal connection between the technique of anesthesia and prescription of uterotonics (r=0,029; р=0,84).

Conclusions. The technique of anesthesia for cesarean section has no influence on assessment of the state of newborns on Apgar score neither on 1 minute nor on the 5 one after birth. No one of studied techniques of anesthesia doesn’t influence on postnatal uterus contraction and doesn’t lead to an additional prescription of uterotonic preparations


Keywords


anesthesia; cesarean section; Apgar score; uterotonic remedies; sevoflurane; regional anesthesia

References


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