بررسي تاثير بيهوشي نخاعي بر فشارخون مادران و آپگا نوزادان در عمل سزارين مبتلايان به پره اكلامپسي

Effects of General and Spinal Anesthesia With Marcaine on Maternal Hemodynamic and Newbornsʹ Apgar Score

Background: Several investigations on safe anesthesia in preeclamptic parturients show that general anesthesia has greater risk than spinal anesthesia. This study was conducted on preeclamptic parturients to show spinal anesthesia with slow acting drugs not only accompanying stable maternal hemodynamic but also can bypass difficult intubation and consecutive hypoxia. Materials and Methods: It was a randomized clinical trial study (RCT). After we received institutional ethics committee approval and informed patient consent, all preeclamptic parturients aged 18-40 yr and scheduled to undergo elective cesarean section, were randomly divided in two groups: general anesthesia with sodium thiopental .5 mg/kg and succinylcholine 1.5 mg/kg IV, and spinal anesthesia with marcaine 2mg plus epinephrine 0.2 mg CSF. Blood pressure was measured at 1S` 5th 10`h & 15th minutes and Apgar scores of 1" and 5ʹh minutes were recorded. Data analysis was achieved using chi-square test and SPSS soft ware. Results: There was no significant difference regarding the age and body weight prior to study. IV fluid intake was greater in spinal than general anesthesia (P=0.026). There was no significant difference between desirable and undesirable apgar score of 5th minute (P>0.0.5). Undesirable apgar score of first minute was greater in general than spinal anesthesia (P=0.004). At the first minute of anesthesia all blood pressures in the spinal anesthesia were desirable but 68.8% of them were desirable in general anesthesia. (P=0.0002). At 15ʹh minute in the spinal anesthesia only 85.4% of blood pressures were desirable but in general anesthesia all blood pressures were desirable. (P=0.0123) Conclusion: In preeclamptic parturients undergoing cesarean section spinal anesthesia with marcaine is safer than general anesthesia.