Sezaryen Hastalarında Post Spinal Baş Ağrısı ile Serebral Oksijen Saturasyonu Arasındaki İlişkinin Değerlendirilmesi
Öz
Amaç: Bu çalışmada amacımız spinal anestezi ile elektif şartlarda sezaryen olan hastalarda NIRS ile PSBA arasındaki ilişkiyi araştırmaktır.
Materyal ve metot: Bu çalışmaya, elektif şartlarda spinal anestezi ile sezaryen uygulanan 205 hasta dahil edildi. İntraoperatif genel anesteziye geçildiği için 5 hasta çalışma dışı bırakıldı. Çalışma sonunda Preoperatif dönemde hastalara Beck anksiyete testi doldurtuldu. Hastaların preoperatif, intraoperatif ve postoperatif sol ve sağ alın bölgesinden 5 dk. serebral somatik saturasyon değerleri (NIRS değerleri) kayıt edildi. Tüm hastalar postoperatif 15 gün PSBA gelişme açısından takip edildi. PSBA (-) gelişmeyenler Grup A (n:126), PSBA (+) gelişenler ise Grup B (n:74) olarak iki gruba ayrılarak istatistiksel olarak veriler karşılaştırıldı. Çalışma sonunda PSBA gelişen ve gelişmeyen hastaların NIRS değerleri ortalamaları, NIRS değişim oranları, demografik verileri ( yaş, boy, kilo, beden kitle indeksi, ek hastalık, migren, kronik ağrı, kronik sinüzit, alerji, sigara, spinal anestezi öyküsü ), sosyokültürel durumları (öğrenim durumları, çocuk sayıları, çalışma durumu, kimlerle yaşadıkları ), BAÖ verileri karşılaştırıldı.
Bulgular: Hastalar gruplara ayrılmış haliyle, demografik veriler, ek hastalıklar ve alışkanlıklarına göre değerlendirildiğinde gruplar arasında anlamlı fark olmadığı görüldü (p > 0,05). Hastaların öğrenim durumları, çocuk sayıları, çalışma durumları (çalışıyor -çalışmıyor), yaşadıkları yer (kırsal - kent), kimlerle yaşadıkları (çekirdek aile - aile büyükleriyle) gibi sosyokültürel durumları ile preopreratif anksiyete seviyeleri gruplara göre anlamlı fark olmadığı görüldü (p > 0,05;)
Gruplar kendi içinde preoperatif sol ve sağ NIRS değerlerine göre; intraoperatif spinal anestezi sonrası 1.dk., 4.dk., 7.dk., 10.dk., 15.dk., 30.dk., ve postoperatif 24. saatteki NIRS değişim yüzdeleri arasında anlamlı fark bulunmadı. (p > 0,05).
Hastaların preoperatif, intraoperatif spinal anestezi sonrası 1.dk, 4.dk, 7.dk, 10.dk, 15.dk, 30.dk ve postoperatif Ortalama arteryal basınç (OAB) ve NIRS değerleri arasındaki korelasyon analizinde; intraoperatif 4. dk ve 7. dk sol ve sağ NIRS değerlerindeki azalma ile OAB değerlerindeki azalma arasında istatistiksel olarak pozitif korelasyon olduğu görüldü ( p < 0,05; r < 0,4 ).
Sonuç: Bu çalışmada, spinal anestezi sonrası görülebilen PSBA olan ve olmayan hastaların preoperatif, imntraoperatif ve postoperatif NIRS değerleri ve değişimleri arasında istatiksel olarak anlamlı bir fark olmadığını bulduk.
Anahtar Kelimeler
Spinal anestezi sezaryen post spinal baş ağrısı Near infrared spektroskopi
Kaynakça
- 1. Brendan T. Complications of Regional Anesthesia. Second edition. New york. 2007;149-165.
- 2. Atlee John L. Anestezide Komplikasyonlar 2. Baskı. Çiçek M (editör). Adana. 2012; 223-236.
- 3. Erdine S. Rejyonel Anestezi 2. baskı. İstanbul: Nobel tıp kitabevleri. 2005;159-184.
- 4. Gita Nath, Maddirala Subrahmanyam. Headache in the parturient: Pathophysiology and management of post-dural puncture headache. Journal of Obstetric Anaesthesia and Critical Care. 2011; 1; 2.
- 5. Lin W, Geiderman J. Myth: Fluids, bed rest, and caffeine are effective in preventing and treating patients with post-lumbar puncture headache. 2002; 176; 69-70.
- 6. Basurto Ona X, Osorio D, Bonfill Cosp X. Drug therapy for treating post‐dural puncture headache. Cochrane Database Syst Rev. 2015; CD007887.
- 7. Coyle S, Ward T, Markham C ve ark. On the suitability of near-infrared (NIR) systems for next-generation brain-computer interfaces. Physiol Meas. 2004; 25; 815-822.
- 8. Ghosh A, Elwell C, Smith M. Review article: cerebral nearinfrared spectroscopy in adults: a work in progress. Anesth Analg. 2012; 115; 1373-1383.
- 9. Sakudo A. Near-infrared spectroscopy for medical applications: Current status and future perspectives. Clin Chim Acta. 2016; 455; 181-188.
- 10. Vretzakis G, Georgopoulou S, Stamoulis K ve ark. Cerebral oximetry in cardiac anesthesia. J Thorac Dis. 2014; 6; 60-69.
- 11. Ito H, Ibaraki M, Kanno I. ve ark. Changes in the arterial fraction of human cerebral blood volume during hypercapnia and hypocapnia measured by positron emission tomography. J Cereb Blood Flow Metab. 2005; 25; 852-857.
- 12. Highton D, Elwell C, Smith M. Noninvasive cerebral oximetry: Is there light at the end of the tunnel? Curr Opin Anaesthesiol. 2010; 23; 576-581.
- 13. Denault A, Deschamps A, Murkin JM. A proposed algorithm for the intraoperative use of cerebral near-infrared spectroscopy. Seminars in cardiothoracic and vascular anesthesia. 2007; 11; 274-281.
- 14. Yu Y, Zhang K, Zhang L ve ark. Cerebral near-infrared spectroscopy (NIRS) for perioperative monitoring of brain oxygenation in children and adults. Cochrane Database of Systematic Reviews 2018; 1; CD010947.
- 15. Hirose N, Kondo Y, Maeda T ve ark. Relationship between regional cerebral blood volume and oxygenation and blood pressure during spinal anesthesia in women undergoing cesarean section. J Anesth. 2016; 30; 639-609.
- 16. Ito H, Ibaraki M, Kanno I ve ark. Changes in the arterial fraction of human cerebral blood volume during hypercapnia and hypocapnia measured by positron emission tomography. Journal of Cerebral Blood Flow & Metabolism. 2005; 25; 852-857.
- 17. Germon TJ, Evans PD, Barnett NJ ve ark. Cerebral near infrared spectroscopy: emitter-detector separation must be increased. Br J Anaesth. 1999; 82; 831-837.
- 18. Murkin JM, Arango M. Near-infrared spectroscopy as an index of brain and tissue oxygenation. Br J Anaesth. 2009; 103; 3-13.
- 19. Brawanski A, Faltermeier R, Rothoerl RD ve ark. Comparison of near-infrared spectroscopy and tissue p(O2) time series in patients after severe head injury and aneurysmal subarachnoid hemorrhage. J Cereb Blood Flow Metab. 2002; 22; 605-611.
- 20. Bakshı R, Laszlo L, Kamran Sv ve ark. MRI Finding in lumber puncture headache syndrome: abnormal dural-meningeal and Dural venous sinüs enhancement. Clinical İmaging. 1999; 23; 73-76.
- 21. Shahriari A, Sheikh M. Post-Spinal Headache: A New Possible Pathophysiology. Anesth Pain Med. 2017; 7; 1.
- 22. Ning Zhang, Liangliang He and Jia-Xiang Ni, Level of sensory block after spinal anesthesia as a predictor of hypotension in parturient. Medicine (Baltimore). 2017; 96; 7184.
- 23. Borgeat A, Ekatodramis G, Schenker CA. Postoperative Nausea and Vomiting in Regional Anesthesia. Anesthesiology 2003; 98; 530-547.
- 24. Tarhan O, Canbay O, Celebi N ve ark. Subhypnotic doses of midazolam prevent nausea and vomiting during spinal anesthesia for cesarean section. Minerva Anestesiol. 2007; 73: 629-633.
- 25. Magnia BJ, Dyer RA, van Dyk D ve ark. Incidence of intraoperative nausea and vomiting during spinal anaesthesia for Caesarean section in two Cape Town state hospitals. Southern African Journal of Anaesthesia and Analgesia 2016; 22; 131-134.
- 26. Bezov D, Lipton RB, Ashina S. Post-dural puncture headache: part I diagnosis, epidemiology, etiology, and pathophysiology. Headache. 2010; 50; 1144-1152.
- 27. Lavi R, Yarnitsky D, Rowe JM ve ark. Standard vs atraumatic Whitacre needle for diagnostic lumbar puncture: A randomized trial. Neurology. 2006; 67; 1492-1494.
- 28. Faure E, Moreno R, Thisted R. Incidence of postdural puncture headache in morbidly obese parturients. Reg anesth. 1994; 19; 361-363.
- 29. Van Oosterhout PJ, Van der Plas AA, Van Zwet EW ve ark. Postdural puncture headache in migraineurs and nonheadache subjects. Neurology. 2013; 5; 80; 941-948.
- 30. Song J, Breidenbach K, Lynn Penaco Duong A ve ark. Impact of migraine headaches and depression/anxiety on the incidence of post-dural puncture headache during postpartum course. in Australasian Medical Journal. 2018; 11; 3.
- 31. Georgieva Zhostova S, Todorov B, Trenova A ve ark. The impact of anxiety on post-dural pucture headache in routine neurology practice. International Journal of Surgery and Medicine. 2015; 1; 53-57.
- 32. Dodge HS, Ekhator NN, Jefferson-Wilson L ve ark. Cigarette smokers have reduced risk for post-dural puncture headache. Pain Physician. 2013;16; 25-30.
- 33. Abdullayev R, Küçükebe ÖB, Celik B ve ark. Smoking and postdural puncture headache. Anestezi Dergisi. 2015; 23; 152-155.
Evaluation of the Relationship Between Post Spinal Headache and Cerebral Oxygen Saturation in Cesarean Section Patients
Öz
Objective: Our purpose in this study is to examine the relationship between NIRS and PSH in patients who had cesarean section under elective conditions with spinal anesthesia.
Materials and Methods: 200 patients who underwent cesarean section with spinal anesthesia in elective conditions were included in this study. Perioperative, intraoperative, and postoperative NIRS values of patients were recorded for 5 min from the left and right forehead areas. All patients were monitored for 15 days postoperatively in terms of PSH development. The patients were divided into two groups as Group A (n:126) with patients who did not develop PSH (-), and Group B (n:74) with patients who developed PSH (+). At the end of the study, NIRS mean values, NIRS change ratios, demographic data, and the scores of Beck Anxiety Scale (BAS) completed by patients during the pre-operative period were compared between the patients who developed PSH and who did not.
Resuts: When the groups were compared among themselves according to the preoperative left and right NIRS values, no significant difference was found between the NIRS percentage changes at minutes 1, 4, 7, 10, 15, 30, and postoperative hour 24 after intraoperative spinal anesthesia (p>0/05).
In the correlation analysis between the patients’ preoperative, intraoperative post spinal anesthesia at minutes 1, 4, 7, 10, 15, 30 mean arterial pressure (MAP) and NIRS values, there was a statistically positive correlation between the decrease in the left and right NIRS values at intraoperative minutes 4 and 7 and the decrease in the MAP values (p<0.05; r<0.4)
Conclusion: In the study, it was found that there was no statistically significant difference between preoperative, intraoperative, and postoperative NIRS values and changes in patients with and without PSH, which can occur after spinal anesthesia.
Anahtar Kelimeler
Spinal anesthesia cesarean section post spinal headache Near infrared spectroscopy
Kaynakça
- 1. Brendan T. Complications of Regional Anesthesia. Second edition. New york. 2007;149-165.
- 2. Atlee John L. Anestezide Komplikasyonlar 2. Baskı. Çiçek M (editör). Adana. 2012; 223-236.
- 3. Erdine S. Rejyonel Anestezi 2. baskı. İstanbul: Nobel tıp kitabevleri. 2005;159-184.
- 4. Gita Nath, Maddirala Subrahmanyam. Headache in the parturient: Pathophysiology and management of post-dural puncture headache. Journal of Obstetric Anaesthesia and Critical Care. 2011; 1; 2.
- 5. Lin W, Geiderman J. Myth: Fluids, bed rest, and caffeine are effective in preventing and treating patients with post-lumbar puncture headache. 2002; 176; 69-70.
- 6. Basurto Ona X, Osorio D, Bonfill Cosp X. Drug therapy for treating post‐dural puncture headache. Cochrane Database Syst Rev. 2015; CD007887.
- 7. Coyle S, Ward T, Markham C ve ark. On the suitability of near-infrared (NIR) systems for next-generation brain-computer interfaces. Physiol Meas. 2004; 25; 815-822.
- 8. Ghosh A, Elwell C, Smith M. Review article: cerebral nearinfrared spectroscopy in adults: a work in progress. Anesth Analg. 2012; 115; 1373-1383.
- 9. Sakudo A. Near-infrared spectroscopy for medical applications: Current status and future perspectives. Clin Chim Acta. 2016; 455; 181-188.
- 10. Vretzakis G, Georgopoulou S, Stamoulis K ve ark. Cerebral oximetry in cardiac anesthesia. J Thorac Dis. 2014; 6; 60-69.
- 11. Ito H, Ibaraki M, Kanno I. ve ark. Changes in the arterial fraction of human cerebral blood volume during hypercapnia and hypocapnia measured by positron emission tomography. J Cereb Blood Flow Metab. 2005; 25; 852-857.
- 12. Highton D, Elwell C, Smith M. Noninvasive cerebral oximetry: Is there light at the end of the tunnel? Curr Opin Anaesthesiol. 2010; 23; 576-581.
- 13. Denault A, Deschamps A, Murkin JM. A proposed algorithm for the intraoperative use of cerebral near-infrared spectroscopy. Seminars in cardiothoracic and vascular anesthesia. 2007; 11; 274-281.
- 14. Yu Y, Zhang K, Zhang L ve ark. Cerebral near-infrared spectroscopy (NIRS) for perioperative monitoring of brain oxygenation in children and adults. Cochrane Database of Systematic Reviews 2018; 1; CD010947.
- 15. Hirose N, Kondo Y, Maeda T ve ark. Relationship between regional cerebral blood volume and oxygenation and blood pressure during spinal anesthesia in women undergoing cesarean section. J Anesth. 2016; 30; 639-609.
- 16. Ito H, Ibaraki M, Kanno I ve ark. Changes in the arterial fraction of human cerebral blood volume during hypercapnia and hypocapnia measured by positron emission tomography. Journal of Cerebral Blood Flow & Metabolism. 2005; 25; 852-857.
- 17. Germon TJ, Evans PD, Barnett NJ ve ark. Cerebral near infrared spectroscopy: emitter-detector separation must be increased. Br J Anaesth. 1999; 82; 831-837.
- 18. Murkin JM, Arango M. Near-infrared spectroscopy as an index of brain and tissue oxygenation. Br J Anaesth. 2009; 103; 3-13.
- 19. Brawanski A, Faltermeier R, Rothoerl RD ve ark. Comparison of near-infrared spectroscopy and tissue p(O2) time series in patients after severe head injury and aneurysmal subarachnoid hemorrhage. J Cereb Blood Flow Metab. 2002; 22; 605-611.
- 20. Bakshı R, Laszlo L, Kamran Sv ve ark. MRI Finding in lumber puncture headache syndrome: abnormal dural-meningeal and Dural venous sinüs enhancement. Clinical İmaging. 1999; 23; 73-76.
- 21. Shahriari A, Sheikh M. Post-Spinal Headache: A New Possible Pathophysiology. Anesth Pain Med. 2017; 7; 1.
- 22. Ning Zhang, Liangliang He and Jia-Xiang Ni, Level of sensory block after spinal anesthesia as a predictor of hypotension in parturient. Medicine (Baltimore). 2017; 96; 7184.
- 23. Borgeat A, Ekatodramis G, Schenker CA. Postoperative Nausea and Vomiting in Regional Anesthesia. Anesthesiology 2003; 98; 530-547.
- 24. Tarhan O, Canbay O, Celebi N ve ark. Subhypnotic doses of midazolam prevent nausea and vomiting during spinal anesthesia for cesarean section. Minerva Anestesiol. 2007; 73: 629-633.
- 25. Magnia BJ, Dyer RA, van Dyk D ve ark. Incidence of intraoperative nausea and vomiting during spinal anaesthesia for Caesarean section in two Cape Town state hospitals. Southern African Journal of Anaesthesia and Analgesia 2016; 22; 131-134.
- 26. Bezov D, Lipton RB, Ashina S. Post-dural puncture headache: part I diagnosis, epidemiology, etiology, and pathophysiology. Headache. 2010; 50; 1144-1152.
- 27. Lavi R, Yarnitsky D, Rowe JM ve ark. Standard vs atraumatic Whitacre needle for diagnostic lumbar puncture: A randomized trial. Neurology. 2006; 67; 1492-1494.
- 28. Faure E, Moreno R, Thisted R. Incidence of postdural puncture headache in morbidly obese parturients. Reg anesth. 1994; 19; 361-363.
- 29. Van Oosterhout PJ, Van der Plas AA, Van Zwet EW ve ark. Postdural puncture headache in migraineurs and nonheadache subjects. Neurology. 2013; 5; 80; 941-948.
- 30. Song J, Breidenbach K, Lynn Penaco Duong A ve ark. Impact of migraine headaches and depression/anxiety on the incidence of post-dural puncture headache during postpartum course. in Australasian Medical Journal. 2018; 11; 3.
- 31. Georgieva Zhostova S, Todorov B, Trenova A ve ark. The impact of anxiety on post-dural pucture headache in routine neurology practice. International Journal of Surgery and Medicine. 2015; 1; 53-57.
- 32. Dodge HS, Ekhator NN, Jefferson-Wilson L ve ark. Cigarette smokers have reduced risk for post-dural puncture headache. Pain Physician. 2013;16; 25-30.
- 33. Abdullayev R, Küçükebe ÖB, Celik B ve ark. Smoking and postdural puncture headache. Anestezi Dergisi. 2015; 23; 152-155.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 6 Eylül 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 14 Sayı: 1 |
Kaynak Göster
-