The incidence of hypotension was higher in the levobupivacaine 10 mg group, even though this group presented more effective anesthesia and greater patient and surgeon satisfaction compared with the levobupivacaine 5 and 7.5 mg groups. As a result, we believe that levobupivacaine 7.5 mg combined with fentanyl 15 μg is suitable for combined spinal-epidural anesthesia in elective cesarean section.

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Amaç:Hastalar›n yo¤un bak›ma kabul edilmelerine veya yo¤un bak›m ünitelerinden baflka servislere ç›kart›lmalar›nda skorlama sistemlerinin kullan›lmas› önemlidir. Günümüze kadar bu amaçla çeflitli skorlama sistemleri kullan›lm›fl ve çeliflkili veya farkl› sonuçlar elde edilmifltir. Biz de bu çal›flmada dört farkl› skorlama sistemini mortalite tahmini aç›s›ndan birbirleriyle karfl›laflt›rmay› amaçlad›k Araflt›rmam›zda APACHE II, SAPS II, MPM0 II ve LODS skorlama sistemlerinin YBÜ'deki hastalar›n mortalite tahmininde performanslar›n›n karfl›laflt›r›lmas› amaçlanm›flt›r.

ÖZET Amaç

Introduction Spinal anesthesia is a safe, simple, rapid, effective, and easy-to-apply anesthetic technique for cesarean sections. Despite the advantages of spinal anesthesia, hypotension is a common complication with an incidence of 70%-85% in parturients (1-4). Many factors including the characteristics of the injected solution, patient position, age, height, weight, pregnancy, intraabdominal pressure (IAP), length of the vertebral column, and lumbosacral cerebrospinal fluid (CSF) volume determine the intrathecal spread of local anesthetics. In obstetric patients, physiological changes due to pregnancy, including changes in spinal curvature, venous pooling secondary to progesterone-induced decreases in vascular tone and aortocaval compression by the gravid uterus, contribute to hypotension during cesarean section under regional anesthesia (1-6). Many recent studies have addressed the effects of uterine size, abdominal girth, and IAP on sensory block level, ephedrine dose, and the incidence of hypotension in pregnant women. Large abdominal girth, big uterus, and increased IAP may be significant factors in greater cephalad spread of local anesthetics. The mechanisms explained in these studies are that the increased IAP secondary to the compression of the inferior vena cava due to the growing uterus leads to a reduction in CSF in the spinal canal (1,7-14). We hypothesized that there may be differences in the sensory block level and ephedrine requirements among pregnant women based on uterine size and the presence of abdominal obesity. The primary purpose of this study was to determine whether there is a relationship between uterine size and sensory block level and ephedrine dose in parturients receiving spinal anesthesia. Since Katulanda et al. (15) reported that the distance between the lower border of the xiphisternum and the center of the umbilicus could be used as an anthropometric measure to define abdominal obesity, we considered SPX to be a marker of both abdominal obesity and uterine size that contains abdominal obesity, easily identified anatomical landmarks Background/aim: Hypotension is a serious complication caused by spinal anesthesia that places both the mother and fetus at increased risk. We aimed to investigate the effects of uterine size with or without abdominal obesity on sensory block level of pregnant women receiving spinal anesthesia. Materials and methods: This study included 125 term parturients who underwent cesarean section. Motor and sensory block characteristics, the distance between the symphysis pubis and the fundus (SPF), the distance between the symphysis pubis and the xiphoid (SPX), newborn and placental weights, adverse effects, and doses of ephedrine were recorded. Results: Sensory block level and ephedrine dose were significantly correlated with the SPX and the combined newborn and placenta weights (P < 0.05). The incidence of hypotension was related to the SPX and the combined newborn and placenta weight (P < 0.05). There was no correlation between the SPF and sensory block leve...