The Effects of General and Epidural Anaesthesia in Maternal’s Stress Hormones and Blood Gases in Elective Cesarean Section

  • Meral EZBERCI
  • Beyazit ZENCIRCI
  • Hafize ÖKSÜZ
  • Melih Atahan GÜVEN

Turk J Obstet Gynecol 2005;2(3):181-187

OBJECTIVE: The aim of this study was to evaluate the effects of general and epidural anaesthesia in maternal’s stress hormones and blood gases in elective cesarean section. MATERIALS-METHODS: 50 patients in ASA II (American Society of Anesthesiology) class who would undergo elective cesarean section in University of Kahramanmaras Sutcuimam, Department of Anaesthesiology and Reanimation included in the study and randomized into two equal groups (General anaesthesia: Group G and Epidural anaesthesia: Group E). In both groups, maternal stress hormones (TSH, cortisol, and insulin) and blood gases were studied. All patients received famotidine and granisetron iv 30 min before operations in premedication room. In the general anaesthesia group; aritmal, propofol, and succinylcholine was used for induction and muscle relaxation. Following the induction, positive pressure ventilation of the lungs was started immediately using a 50% N2O + O2 mixture. After delivery of the baby, anaesthesia and muscle relaxation was maintained by 50% N2O +O2, 0,5-1% MAC isoflurane, and cisatracurium. In the epidural anaesthesia group; epidural anaesthesia was performed with 0,375 % bupivacaine. The epidural needle inserted through L2-3 or L3-4 interspace. After achieving T4-5 neural blockade, the operation was started. In general anaesthesia group; blood samples for maternal stres hormones were taken before induction and after delivery of the baby. In epidural anaesthesia group; blood samples for maternal stres hormones were taken catheter placement and after delivery of the baby. Blood samples for maternal blood gases were taken after the delivery of the baby. RESULTS: In both groups; there were statistically significant decrease in maternal TSH and insulin and there were no statistically significant changes in maternal cortisol. In maternal blood gases analyses, only PO2 and SO2 changes were statistically significant between two groups. CONCLUSION: With these results, we concluded that each of the general and epidural anaesthesia techniques have similar effects on maternal hemodynamics, blood gases and stress hormones and can be acceptable alternative for elective cesarean section.

Keywords: blood gases, cesarean section, epidural anaesthesia, general anaesthesia, stres hormones