Journal of Mazandaran University of Medical Sciences
مجله دانشگاه علوم پزشکی مازندران
J Mazandaran Univ Med Sci
Medical Sciences
http://jmums.mazums.ac.ir
1
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1735-9260
1735-9279
fa
jalali
1401
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2022
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پیامدهای بیهوشی عمومی و بیحسی نخاعی در مادران مبتلا به کووید 19 تحت عمل سزارین در مراکز آموزشی درمانی دانشگاه علوم پزشکی مازندران در سال 1400
Outcomes of General and Spinal Anesthesia in Mothers with COVID-19 Undergoing Cesarean
زنان و زایمان و نازایی
Gynecology and Infertility
پژوهشي-کامل
Research(Original)
<strong> </strong><span style="font-size:12pt"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="FA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">سابقه</span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt"> و هدف:</span></span></span></span> <span lang="AR-SA" style="font-family:"B Zar""><span style="color:black">کروناویروس</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="AR-SA" style="font-family:"B Zar""><span style="color:black">ها نوعی از ویروس</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="AR-SA" style="font-family:"B Zar""><span style="color:black">ها هستند که می</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="AR-SA" style="font-family:"B Zar""><span style="color:black">توانند به علت پنومونی و مشکلات تنفسی موجب مرگ افراد شوند. زنان باردار خطر </span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">ابتلای بالاتری به کووید 19 دارند. کووید 19 چالش</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">هایی برای روش بیهوشی در این بیماران ایجاد کرده است. هدف مطالعه، بررسی پیامدهای بیهوشی عمومی و بیحسی نخاعی در مادران مبتلا به کووید 19 کاندید سزارین بود.</span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:#0e101a"></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">مواد و روش</span></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span></span> <span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt">این مطالعه توصیفی- تحلیلی بر روی </span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar"">80 مادر باردار مبتلا به کووید 19 </span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">کاندید</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""> سزارین در مراکز آموزشی درمانی ساری و قائمشهر در سال 1400 انجام گرفت. هر کدام از مادران تحت یک نوع روش بیهوشی عمومی یا <span style="letter-spacing:-.1pt">بیحسی نخاعی قرار گرفتند. چک لیست محقق ساخته در زمانهای قبل، حین و بعد از جراحی تکمیل شد. برای مقایسه دادهها</span> </span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">از آزمون</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">های مجذور کای، من ویتنی، </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">T-test</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">، آنالیز واریانس یکطرفه و </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">repeated measure ANOVA</span></span><span style="line-height:90%"><span style="font-family:"B Zar""> استفاده شد</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">.</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">یافته</span></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">ها:</span></span></span></span> <span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">بین دو گروه در مشخصات دموگرافیک تفاوت آماری معنی</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt"></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">داری وجود نداشت (0/05</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:90%"><span style="font-family:"B Zar""><</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">P</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">) ولی بین فوریت عمل جراحی و نوع بیهوشی، تفاوت معنی</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">دار بود (0/05 </span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:90%">></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">P</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">). تغییرات ضربان قلب و میانگین اشباع اکسیژن بین مادران دو گروه معنی</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">دار بود (به ترتیب 0/0001</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">=</span></span> <span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">P</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""> و 0/05</span></span><span lang="FA" style="font-size:10.0pt"><span style="line-height:90%">></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">P</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">). تهوع، استفراغ و لرز در مادران تحت بیحسی نخاعی بیش</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt"></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">تر بود <span style="letter-spacing:-.2pt">(0/007</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="letter-spacing:-.2pt">=</span></span></span> <span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="letter-spacing:-.2pt"> P</span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">و 0/002</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%"><span style="letter-spacing:-.2pt">P=</span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">). تغییرات فشارخون سیستولیک و دیاستولیک در مادران گروه بیحسی نخاعی نسبت به گروه بیهوشی</span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar""> عمومی بیش</span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt"></span></span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">تر بود (0/0001</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:90%">P=</span></span><span lang="FA" style="line-height:90%"><span style="font-family:"B Zar"">).<span style="color:black"></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:90%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">هر دو روش بیهوشی عمومی و بی</span></span></span><span lang="AR-SA" style="line-height:90%"><span style="font-family:"B Zar""><span style="color:black">حسی نخاعی در مادران مبتلا به کووید 19 اگر با برنامه</span><span style="letter-spacing:-.1pt"></span><span style="color:black">ریزی دقیق توسط متخصصین بیهوشی مجرب صورت بگیرد، می تواند برای مادر و نوزاد وی ایمن باشد.</span><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span></span></span></span></span></span></span></span><br>
<em><span dir="LTR"></span></em>
<span style="font-size:12pt"><span style="line-height:135%"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:135%"><span style="font-family:"Arial","sans-serif""><span style="letter-spacing:-.2pt">Background and purpose:</span></span></span></span></b> <span style="font-size:10.0pt"><span style="line-height:135%">Coronaviruses are a type of virus that can cause death due to pneumonia and respiratory problems. Pregnant women are at higher risk for developing COVID-19 and the disease has posed challenges to anesthesia in these patients. The aim of this study was to evaluate the consequences of general anesthesia and spinal anesthesia in expectant mothers with COVID-19 candidates for cesarean section.</span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:135%"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:135%"><span style="font-family:"Arial","sans-serif"">Materials and methods:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:135%">This descriptive-analytical study was performed in 80 pregnant <span style="letter-spacing:-.2pt">women with COVID-19 candidates for cesarean delivery in Sari Imam Khomeini Hospital and Qaemshahr</span> Razi Hospital, 2021.</span></span> <span style="font-size:10.0pt"><span style="line-height:135%">The expectant mothers underwent general (n= 40) or spinal anesthesia (n= 40). A researcher-made checklist was completed before, during, and after the delivery. Data were analyzed <span style="letter-spacing:-.1pt">applying Chi-square, Mann-Whitney, T-test, One-way analysis of variance, and repeated measure ANOVA.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:135%"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:135%"><span style="font-family:"Arial","sans-serif"">Results:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:135%">No significant difference was found between the two groups in demographic characteristics (P> 0.05), but there was a significant difference between urgent surgery and the type of anesthesia (P <0.05). Significant differences were seen in heart rate and mean oxygen saturation between the two groups (P= 0.0001 and P< 0.05, respectively). Nausea and vomiting, and chills were observed to be more common during spinal anesthesia (P= 0.007 and P= 0.002). Changes in systolic and diastolic blood pressure occurred more in spinal anesthesia group than the general anesthesia group (P= 0.0001).</span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:135%"><span style="vertical-align:top"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:135%"><span style="font-family:"Arial","sans-serif"">Conclusion:</span></span></span></b><span style="font-size:10.0pt"><span style="line-height:135%"> Both g</span></span><span style="font-size:10.0pt"><span style="line-height:135%">eneral anesthesia and spinal anesthesia in mothers with COVID-19 can be safe for both the mother and baby if carefully planned and performed by experienced anesthesiologists.</span></span><i><span style="font-size:10.0pt"><span style="line-height:135%"></span></span></i></span></span></span></span><br>
بیهوشی عمومی, بیحسی نخاعی, کووید-19, سزارین
general anesthesia, spinal anesthesia, COVID-19, cesarean sections
93
103
http://jmums.mazums.ac.ir/browse.php?a_code=A-10-15267-1&slc_lang=fa&sid=1
Hooshang
Akbari
هوشنگ
اکبری
Hooshangakbari48@yahoo.com
1003194753284600144947
1003194753284600144947
No
Assistant Professor, Department of Anesthesiology and Operating Room, Faculty of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
استادیار، گروه بیهوشی و اتاق عمل، دانشکده پیراپزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران
Ebrahim
Nasiri
ابراهیم
نصیری
rezanf2002@yahoo.com
1003194753284600144948
1003194753284600144948
No
Assistant Professor , Department of Anesthesiology and Operating Room, Faculty of Allied Medical Sciences, Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
استادیار، گروه بیهوشی و اتاق عمل، مرکز تحقیقات طب سنتی و مکمل، موسسه ترک اعتیاد، دانشگاه علوم پزشکی مازندران، ساری، ایران
Mohammad
Khademloo
محمد
خادملو
comedicine.moh@gmail.com
1003194753284600144949
1003194753284600144949
No
Associate Professor , Department of Community Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
دانشیار، گروه پزشکی اجتماعی، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران
Saba
Chelengari
صبا
چلنگری
saba.chelengari@yahoo.com
1003194753284600144946
1003194753284600144946
Yes
MSc Student in Operating Room, Student Research Committee, Faculty of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
دانشجوی کارشناسی ارشد اتاق عمل، دانشکده پیراپزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران