Use of Sevoflurane During Elective Cesarean Birth

GRAMBLING, D. R.; Sharma, Sashi; White, P.F.; BEVEREN, T. VAN; Bala, Areeg; GOULDSON, R.

doi:10.1097/00132586-199606000-00030

Cited by 2 publications

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“…The blood gases, Apgar score, and NACS. [88] UV/MV ratio of nitrous oxide is 0.79 after 10-14 minutes of maternal administration. [78] The high inspired concentrations of 4.…”

Section: Nitrous Oxidementioning

confidence: 99%

Effects of Obstetric Analgesics and Anesthetics on the Neonate

2003

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Most anesthetic and analgesic agents in current use traverse the placental barrier in varying degrees, but are well tolerated by the fetus if judiciously administered. For labor analgesia, many options are available. Systemic administration of opioids and sedatives is one such option. Repeated maternal administration of opioids such as pethidine (meperidine) results in significant fetal exposure and neonatal respiratory depression. Patient-controlled analgesia with synthetic opioids such as fentanyl, alfentanil, and the new ultra-short-acting remifentanil may be used for labor analgesia in selected patients. Other options for labor analgesia include epidural and combined spinal-epidural techniques. With such techniques, neonatal exposure to opioids and sedatives can be minimized or totally avoided. While limiting the fetal exposure to the harmful effects of depressant drugs, epidural anesthesia and/or analgesia improves placental perfusion and oxygenation of the fetus, which is beneficial, especially in conditions such as pregnancy-induced hypertension. Regional blocks are also administered for the majority of cesarean deliveries because of the overwhelming and unequivocal evidence of maternal and fetal safety compared with general anesthesia for this indication. However, in some instances, administration of general anesthesia is unavoidable. Neonatal respiratory depression with low Apgar scores, and umbilical arterial and venous pH associated with general anesthesia, is often transient. A properly administered anesthetic, whether regional or general, has no significant adverse fetal or neonatal effects.

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“…The blood gases, Apgar score, and NACS. [88] UV/MV ratio of nitrous oxide is 0.79 after 10-14 minutes of maternal administration. [78] The high inspired concentrations of 4.…”

Section: Nitrous Oxidementioning

confidence: 99%

Effects of Obstetric Analgesics and Anesthetics on the Neonate

2003

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“…Sevoflurane is a volatile anesthetic agent used for the induction and maintenance of general anesthesia. It has several advantages in obstetrics: it has a low blood/gas partition coefficient in blood concentration, it is rapidly eliminated from the newborn after birth, and the patient quickly recovers from general anesthesia [6]. Puncturing of both vaginal skin and the ovarian capsule to aspirate oocytes causes discomfort similar to severe menstrual pain [7].…”

Section: Introductionmentioning

confidence: 99%

Effects of Propofol versus Sevoflurane on Postoperative Pain and Neuroendocrine Stress Response in Oocyte Pickup Patients

Orak

Tolun

Bakacak

et al. 2021

Pain Research and Management

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Background. Pain aggravates the autonomic response to stress and raises neuroendocrine stress hormone levels. We compared the effects of propofol and sevoflurane on postoperative pain and neuroendocrine stress hormones. A prospective, randomized, and controlled trial was conducted with 60 patients. Methods. We randomly allocated patients to groups P (remifentanil/propofol, n = 30) and S (remifentanil/sevoflurane, n = 30). Preoperative blood samples were taken to measure serum adrenocorticotropic hormone (ACTH), corticotropin-releasing hormone (CRH), glucagon, cortisol, aldosterone, and prostaglandin E2 (PGE2) levels. Intraoperatively and postoperatively, clinical parameters were monitored at different time points. The hormone levels were again measured in the follicular fluid and blood postoperatively. Result. Demographic data were similar. The preoperative serum aldosterone levels were significantly higher in group P ( p = 0.001 ). Preoperative and postoperative serum ACTH, glucagon, cortisol, and PGE2 levels were significantly different in group P ( p = 0.009 , p = 0.004 , p = 0.029 , and p = 0.002 ); serum ACTH, glucagon, and PGE2 levels increased while serum cortisol levels decreased postoperatively. In group S, serum CRH and aldosterone levels, both increased in the postoperative period compared to the preoperative ( p = 0.001 , p = 0.006 ). Postoperatively, glucagon and PGE2 levels were both higher in group P than group S ( p = 0.019 , p = 0.015 ). In postoperative follicular fluid, glucagon and PGE2 levels were higher in group P, while cortisol levels were higher in group S ( p = 0.001 , p = 0.007 , and p = 0.001 ). Conclusion. The effects of anesthetic agents were different. In group P, in the preoperative and postoperative evaluation, ACTH, glucagon, and PGE2 increased postoperatively, while cortisol decreased. In group S, aldosterone and CRH increased postoperatively. Glucagon and PG E2 were higher in group P than S, postoperatively.

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Use of Sevoflurane During Elective Cesarean Birth

Cited by 2 publications

References 0 publications

Effects of Obstetric Analgesics and Anesthetics on the Neonate

Effects of Obstetric Analgesics and Anesthetics on the Neonate

Effects of Propofol versus Sevoflurane on Postoperative Pain and Neuroendocrine Stress Response in Oocyte Pickup Patients

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