الفهرس | Only 14 pages are availabe for public view |
Abstract Respiratory depression is defined as the cessation of breathing for longer than 20 seconds, or a shorter duration in the presence of pallor, cyanosis, or bradycardia. A fetus makes breathing movements from early in pregnancy, although the purpose of fetal breathing is unknown. Breathing is intermittent in the fetus and becomes continuous after birth. The mechanisms that cause the transition from intermittent fetal breathing to continuous neonatal breathing remain unclear. The aim of this study was to find relation between respiratory depression in neonates and general and spinal anesthesia during cesarean section using Apgar score, Silverman Andrson retraction score and Downs’ score among singleton full term pregnant women. Two hundareds full term pregnant women who were admitted for elective cesarean delivery at Ain shams Maternity Hospital by using general or spinal anesthesia and the neonates which were suffered from respiratory depression were admitted to Ain shams Maternity Neonatal ICU. Patients were randomly allocated into two groups: General anesthesia group: 100 pregnant women received general anesthesia, we start induction of anesthesia by thiopentone 5mg/kg and succinylcholine 1-2mg/kg then intubation and maintenance by inhalational anesthesia (isoflurane 0.5%), after delivery of baby we give 100µg fentanyl., spinal anesthesia group:100 pregnant women received spinal anesthesia, we use heavy marcaine (heavy bupivacaine), 2-3 ml is injected via spinal needle gauge 22 in L3-4 or L4-5 without using of opioids. The current study showed that the general anesthesia group showed significantly higher percentage of respiratory depression than the spinal anesthesia group (P<0.05) as regards neonatal admission to neonatal ICU due to respiratory depression in neonates. On the other hand the current study showed that there is no statistically significant difference could be detected between the studied groups as regards Apgar score in 1min, Apgar score 5min, Silverman Andrson retraction and Downs’ score. |