Regionalna anestezija i blokada simpatikusa

master's thesis

• Title (english): Regional anesthesia and sympathetic blockade
• Author: Marko Moretti
• Mentor: Slobodan Mihaljević (mentor)
• Committee member: Mladen Perić (predsjednik povjerenstva)
• Committee member: DINKO TONKOVIĆ (član povjerenstva)
• Committee member: Slobodan Mihaljević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities); Zagreb
• Defense date and country: 2017-09-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Anesthesiology and Reanimatology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Intratekalna injekcija lokalnog anestetika, odnosno spinalna anestezija, je u uporabi više od stoljeća, a još ne postoji adekvatni režim korekcije i prevencije post-induktivne hipotenzije. Primarni cilj ovog istraživanja bio je pronaći korelaciju između pada sistoličkog krvnog tlaka 20 minuta nakon spinalnog bloka, volumena kristaloidnih otopina i korištenja efedrina intraoperativno za vrijeme carskog reza. Sekundarni cilj je bio izračunati incidenciju maternalne hipotenzije i predložiti adekvatnu terapiju za istu. Od inicijalno 59 pacijentica kod 28 su se bilježili podatci jer su ostale anestezirane bilo općom bilo epiduralnom anestezijom. Mjerio se sistolički krvni tlak, dijastolički krvni tlak i puls prije spinalnog bloka i 20 minuta nakon, volumen anestetika i doza fentanila intratekalno, godine pacijentica, doza efedrina, volumen intravenoznih otopina i promjena tlaka. Podatci su analizirani prikladnim statističkim testovima. Hipotenzija je registrirana u 27.6% slučajeva, između volumena kristaloidnih otopina i korištenja efedrina nalazimo negativnu korelaciju od -0.008, +0.155 između promjene sistoličkog krvnog tlaka i korištenog efedrina te +0.097 između volumena kristaloidnih otopina i korištenog efedrina. Nijedan rezultat nije statistički značajan. Ova tema zahtijeva daljnju obradu i diskusiju.

Abstract (english)

Injection of the local anesthetic intrathecally, or spinal anesthesia, has been in use for more than a century, and yet, there is still no adequate regime for the correction and prevention od post-inductive hypotension. Finding the correlation between the drop in the systolic blood pressure 20 minutes following the spinal block, the volume of crystalloid fluid given intravenously and the use of ephedrine intraoperatively during the caeseran section was the primary goal of this research. Secondary goal was to calculate the incidence of maternal hypotension and suggest the adequate therapy. 28 out of initial 59 patients undergoing cesarean section were included in the study. The rest were excluded because of different anesthesia method (general or epidural) . We measured the systolic blood pressure, diastolic blood pressure and pulse, before and 20 minutes following the block, volume of the local anesthetic, fentanyl dose, age of the patients, ephedrine dose, volume od the intravenously given fluids and the difference/drop in blood pressure. The data was analyzed by appropriate statistic tests. Hypotension occured in 27.6% of the cases, and the correlation of -0.008 was found between volume of the crystalloid infusion and the use of ephedrine, +0.155 between the change in systolic blood pressure and the use of ephedrine, while the correlation between the use of crystalloid infusion and the use of ephedrine was +0.097. None of the findings were statistically relevant. This topic demands further investigation and discussion.

• Keywords: hipotenzija; spinalna anestezija; carski rez
• Keywords (english): hypotension; spinal block; cesarean delivery
• Language: croatian
• URN:NBN: urn:nbn:hr:105:192239
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-03-15 12:06:55