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OBJECTIVE: Brain-derived neurotrophic factor (BDNF), a member of neurotrophins, plays a critical role in neuronal tissue. In this study, the effects of spinal or general anaesthesia on cord and maternal peripheral blood BDNF and malondialdehyde (MDA) levels were investigated in patients undergoing elective caesarean section. METHODS: Eighty patients with term pregnancy were included. General anaesthesia was induced with intravenous (IV) propofol 2 mg kg-1 in the general anaesthesia group (n=36). In the spinal anaesthesia group (n=35), hyperbaric bupivacaine 0.5%, 9 mg (1.8 mL) was injected intrathecally. Maternal blood samples were taken immediately after positioning the patient on the operating table (T1), before clamping the umbilical cord (T2) and 24 hours after the first sample was obtained (T3). Cord blood samples were drawn from the umbilical artery (T4). RESULTS: Maternal BDNF levels (pg mL-1) measured at T2 time point were higher in the general anaesthesia group compared to the spinal anaesthesia group (p<0.001). Cord blood BDNF levels were higher in the general anaesthesia group compared to the spinal anaesthesia group (p<0.001). In both groups, cord blood BDNF levels were significantly lower compared to the maternal blood samples collected at any time point (p<0.001, for all). There was a negative association between both maternal and cord blood BDNF levels with maternal MDA and cord blood MDA levels, respectively (r=-0.379, p<0.001; r=-0.375, p=0.001, respectively). CONCLUSION: The anaesthetic technique may have an influence on maternal peripheral and cord blood BDNF levels.
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OBJECTIVE: Pulmonary complications are important sepsis (such as ARDS, diffuse pneumonia). Acute respiratory distress syndrome (ARDS) is characterized by the extensive migration of neutrophils into alveoli of the lungs. Propofol and midazolam are the most widely used agents for sedation in intensive care units. Aimed to investigate the effects of anaesthesia with propofol and midazolam on measured hemodynamic variables and neutrophil migration induced by Escherichia Coli endotoxin (ECE) in pulmonary viscera. MATERIALS AND METHODS: Forty Sprague Dawley male rats were randomly assigned to four groups: Thiopental Sodium 30 mg/kg was administered intraperitoneally to anesthetize the rats. They were ventilated via tracheotomy. Femoral artery was cannulated for the measurement of continuous blood pressure and gases. Group C was the control. After the administration of 1 mL/kg 0.9% NaCL, infusion began at 1 mL/kg/h rate. In Group E 15 mg/kg lipopolysaccharide derived from ECE was administered iv. In Group PE, after a bolus dose of 10 mg/kg propofol and 15 mg/kg ECE, 10 mg/kg/h infusion was applied. In Group ME, after 0.1 mg/kg midazolam bolus dose and 15 mg/kg ECE administration, 0.1 mg/kg/h infusion was administered iv. Rats were sacrified by iv potassium chloride. The lungs were then removed, fixed in 10% buffered formalin for 3 days and embedded in paraffin. They were graded on a scale of 0-3 according to the aggregation of neutrophils. RESULTS: There was intense neutrophil migration in Group E (grade 2, 3). However, although mild neutrophil migration was obtained in 70% of the rat lungs in Group ME (grade 1, 2), it was recorded in only 30% of Group PE (grade 1). CONCLUSION: The sepsis model induced by ECE and compared with midazolam, propofol anaesthesia is associated with less neutrophil infiltration. In the light of the literature, propofol attenuate the free-radical-mediated lipid peroxidation and systemic inflammation in patients.
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This study investigated the association between fear of childbirth (FOC) and women's knowledge about painless childbirth methods. The study was performed on 900 multiparous women within the last month of pregnancy. Data was obtained through a questionnaire including the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) Turkish form A. FOC was defined as W-DEQ sum score ≥85. Women were questioned about their knowledge about painless childbirth and the most important source of this knowledge. Group 1 consists of participants with knowledge about painless childbirth. Group 2 consists of participants without knowledge about painless childbirth. Five hundred and twenty-four women (58.2%) had knowledge while 376 women (41.7%) had no knowledge about painless childbirth. Mean W-DEQ scores in group 1 (68.46 ± 12.53) were found to be lower than group 2 (71.35 ± 12.28) (P = 0.001). FOC was associated with increased maternal request for elective caesarean section (OR 4.22, 95% CI 2.91-6.11). Better informed pregnant women about painless childbirth methods may reduce the number of women with FOC and the rate of preferred elective caesarean section.
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OBJECTIVE: The technique of anaesthesia in caesarean sections is selected according to the patient's clinical presentation, experience of the anaesthesist and the patient's wishes. The purpose of this study was to evaluate the anaesthesia methods employed in our clinic in the last decade (2003-2012). METHODS: Records of caesarean operations performed between 2003-2012 in the Anaesthesia department of Atatürk University Medical Faculty and stored in the hospital computer system were examined. The annual distribution of methods of anaesthesia in operations was analysed. RESULTS: During 2003-2012, 9049 caesarean operations were performed in our clinic. General anaesthesia was used in 45% of operations and regional anaesthesia in 54%. Whereas the rate of regional anaesthesia in 2003 was 34%, this increased to 69% in 2012. The most commonly used method of regional anaesthesia was spinal anaesthesia (34%) in 2003, and spinal anaesthesia (41%) and combined spinal-epidural anaesthesia (27%) in 2012. CONCLUSION: The most commonly used anaesthesia technique for caesarean operations in our clinic between 2003-2012 was spinal anaesthesia. The most widely used regional anaesthetic method in our clinic was spinal anaesthesia. A significant increase in the use of the combined spinal-epidural anaesthetic technique occurred in the last two years of the study period.
