{"id":126,"date":"2023-07-29T19:56:56","date_gmt":"2023-07-29T19:56:56","guid":{"rendered":"https:\/\/painfreebirthing.com\/turk\/bilmek-istedikleriniz\/agrinin-giderilmesi-bebegi-nasil-etkiler\/"},"modified":"2023-07-29T19:56:56","modified_gmt":"2023-07-29T19:56:56","slug":"agrinin-giderilmesi-bebegi-nasil-etkiler","status":"publish","type":"page","link":"https:\/\/painfreebirthing.com\/turk\/bilmek-istedikleriniz\/agrinin-giderilmesi-bebegi-nasil-etkiler\/","title":{"rendered":"How Does Pain Relief Affect Baby?"},"content":{"rendered":"\n\n\n\n\n\n
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Hangi y\u00f6ntemin bebe\u011fe etkisi daha azd\u0131r? Epidural mi yoksa iv (intraven\u00f6z) metod mu?<\/b><\/b><\/font><\/p>\n<\/td>\n<\/tr>\n

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 Epidural <\/span><\/p>\n<\/td>\n<\/tr>\n

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Epidural anestezinin bebek \u00fczerine etkisi<\/font><\/b><\/span><\/b><\/font><\/p>\n\n\n\n\n
Genellikle etkili epidural analjezi i\u00e7in iki tip ila\u00e7 kullan\u0131lmaktad\u0131r: lokal anestezikler ve opioidler (narkotik). Epidural aral\u0131\u011fa verilen lokal anestezik ila\u00e7lar annenin dola\u015f\u0131m\u0131 yoluyla bebe\u011fe ula\u015fabilir. Ancak bebe\u011fe ula\u015fan miktar, bebe\u011fin kalp h\u0131z\u0131 veya do\u011fum sonras\u0131 genel uyan\u0131kl\u0131\u011f\u0131na etki etmeyecek kadar azd\u0131r. Benzer \u015fekilde epidural enjeksiyonlarda kullan\u0131lan opioidler de bebe\u011fe ula\u015fabilir. Yine, bebe\u011fe ula\u015fan miktar, annenin sistemik (iv=intraven\u00f6z) ald\u0131\u011f\u0131 ila\u00e7larla kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda olduk\u00e7a d\u00fc\u015f\u00fckt\u00fcr. Bunun nedeni iv metodla kullan\u0131lan opioidlerin miktar\u0131n\u0131n cok az bir miktar\u0131n\u0131n epidural enjeksiyonda kullan\u0131l\u0131yor olmas\u0131d\u0131r. Bazen, gebelerin %30\u2019unda epidural lokal anestezik veya opioid enjeksiyonundan 10- 15 dakika sonra fetal (bebek) kalp h\u0131z\u0131nda azalma gibi de\u011fi\u015fiklikler olabilir (1,2). Bu durum daha \u00e7ok a\u011fr\u0131n\u0131n giderilmesine kadar ki d\u00f6nemde bireylerin ciddi bir a\u011fr\u0131 ve stres ya\u015famalar\u0131na ba\u011fl\u0131 olabilir. Ancak bu kalp h\u0131z\u0131 de\u011fi\u015fiklikleri ge\u00e7icidir ve sadece 3-4 dakika s\u00fcrmektedir. Genelde yap\u0131ld\u0131\u011f\u0131 gibi bebe\u011fin kalp h\u0131z\u0131 devaml\u0131 olarak monitorize edildi\u011fi ve \u00f6nlemler al\u0131nd\u0131\u011f\u0131 s\u00fcrece bu ge\u00e7ici de\u011fi\u015fiklikler endi\u015felendirmemelidir. Epidural y\u00f6ntemle bazen meydana gelebilen bir yan etkisi de anne kan bas\u0131nc\u0131ndaki d\u00fc\u015fmedir. Bunun \u015fiddeti e\u011fer fazlaysa ve d\u00fczeltilmezse bebe\u011fi etkileyebilir. Epidural anestezi ba\u015flad\u0131ktan sonra ihtiya\u00e7 duyuldu\u011fu s\u0131kl\u0131kta kan bas\u0131nc\u0131 her zaman \u00f6l\u00e7\u00fcld\u00fc\u011f\u00fc i\u00e7in ve gerekti\u011finde d\u00fczeltici \u00f6nlemler al\u0131nd\u0131\u011f\u0131 i\u00e7in \u00f6nemli bir endi\u015fe kayna\u011f\u0131 de\u011fildir. A\u011fr\u0131s\u0131z do\u011fum i\u00e7in uygulanan \u00e7e\u015fitli y\u00f6ntemlerin yenido\u011fan\u0131n sinirsel davran\u0131\u015flar \u00fczerine etkisinin (yenido\u011fan\u0131n aktivitesinin de\u011ferlendirildi\u011fi testler) incelendi\u011fi testlerde \u00e7eli\u015fkili sonu\u00e7lar ortaya \u00e7\u0131km\u0131\u015ft\u0131r. Ancak son y\u0131llarda a\u011fr\u0131s\u0131z do\u011fum uygulamas\u0131nda epidural analjezide verilen lokal anestezik ve opioid dozlar\u0131nda azalma olmu\u015ftur ve g\u00fcn\u00fcm\u00fczde kullan\u0131lan doz s\u0131n\u0131rlar\u0131 i\u00e7inde, normal ko\u015fullarda lokal anesteziklerin bebe\u011fe \u00e7ok az etkisinin oldu\u011fu veya hi\u00e7 klinik \u00f6neminin olmad\u0131\u011f\u0131 konusunda g\u00f6r\u00fc\u015f birli\u011fi vard\u0131r. Baz\u0131 durumlarda epidural anestezi bebek i\u00e7in faydal\u0131 olabilmektedir. \u00d6rne\u011fin preeklampsisi olan gebe bir kad\u0131nda (y\u00fcksek kan bas\u0131nc\u0131, \u015fi\u015f ayaklar vb.) epidural analjezi travay ve do\u011fum s\u0131ras\u0131nda bebe\u011fe olan kan ak\u0131m\u0131n\u0131 d\u00fczeltebilir (3).<\/span> <\/p>\n

A\u011fr\u0131s\u0131z do\u011fumda iv metodla kullan\u0131lan ila\u00e7lar\u0131n bebek \u00fczerine etkisi<\/span> <\/p>\n

Anneye iv yolla verilen t\u00fcm ila\u00e7lar plasentay\u0131 ge\u00e7erek bebe\u011fin dola\u015f\u0131m\u0131na girer. Bunun sonucu olarak bebekte de baz\u0131 etkiler g\u00f6r\u00fclebilir. Uterus i\u00e7inde bebe\u011fin kalp h\u0131z\u0131 biraz de\u011fi\u015febilir. Bu de\u011fi\u015fikli\u011fe ba\u011fl\u0131 ciddi etki g\u00f6r\u00fclmez. \u0130ntraven\u00f6z ila\u00e7larla ilgili en \u00f6nemli endi\u015fe yeni do\u011fanda depresyona neden olmas\u0131d\u0131r. Bu iv ila\u00e7lar\u0131n yenido\u011fana olan etkileri, ila\u00e7lar\u0131n cinsine ve dozuna, do\u011fum \u00f6ncesindeki zamanlamaya ba\u011fl\u0131d\u0131r. Bebe\u011fin do\u011fmadan \u00f6nce bu ila\u00e7lar\u0131 y\u0131kacak kadar zaman\u0131 varsa sadece az bir etki g\u00f6r\u00fcl\u00fcr. Bebek normal veya hafif uykulu olabilir. \u0130v opioidlerin kullan\u0131m\u0131n\u0131 takip eden birka\u00e7 g\u00fcn boyunca n\u00f6ro-davran\u0131\u015fsal skorlarda (yenido\u011fan aktivitesinin de\u011ferlendirildi\u011fi testler) ge\u00e7ici de\u011fi\u015fiklikler olabilir (4). Di\u011fer bir taraftan, bebekte b\u00fcy\u00fck miktarda bulunan ila\u00e7lar solunumunu ge\u00e7ici olarak deprese edebilece\u011fi i\u00e7in, pediatristin dikkatle takip etmesi gerekmektedir. \u0130la\u00e7lar\u0131n zamanlamas\u0131 ve dozlar\u0131, iv ila\u00e7lar\u0131n yenido\u011fandaki etkilerini en aza indirmek i\u00e7in ayarlanmaktad\u0131r.<\/span><\/p>\n

Kaynaklar:<\/span><\/p>\n

1. Cohen SE, Tan S, Albright GA, et al. Epidural fentanyl\/bupivacaine mixtures for obstetric analgesia. Anesthesiology 1987;67:403.<\/span><\/p>\n

2. Viscomi CM, Hood DD, Melone PJ, et al. Fetal heart rate variability after epidural fentanyl during labor. Aesthesia and Analgesia 1987;71:679.<\/span><\/p>\n

3. Jouppila P, Jouppila R, Hollman A, Koivula A. Lumbar epidural analgesia to improve intervillous blood flow during labor in severe preclampsia. Obstetrics and Gynecology 1982;59:158.<\/span><\/p>\n

4. Hodgkinson R, Bhatt M, Wang CN. Double blind comparison of the neurobehavior of neonate following the administration of different doses of meperidine to the mother. Can Anaesth Soc J 1978;25;405.<\/span> <\/p>\n

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Bir sonraki b\u00f6l\u00fcm i\u00e7in t\u0131klay\u0131n\u0131z<\/span><\/font><\/font>
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A\u011fr\u0131n\u0131n giderilmesi do\u011fumu nas\u0131l etkiler?<\/span><\/a><\/font><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n


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<\/p>\n","protected":false},"excerpt":{"rendered":"

Hangi y\u00f6ntemin bebe\u011fe etkisi daha azd\u0131r? Epidural mi yoksa iv (intraven\u00f6z) metod mu?  Epidural    Epidural anestezinin bebek \u00fczerine etkisi Genellikle etkili epidural analjezi i\u00e7in iki tip ila\u00e7 kullan\u0131lmaktad\u0131r: lokal anestezikler ve opioidler (narkotik). Epidural aral\u0131\u011fa verilen lokal anestezik ila\u00e7lar annenin dola\u015f\u0131m\u0131 yoluyla bebe\u011fe ula\u015fabilir. Ancak bebe\u011fe ula\u015fan miktar, bebe\u011fin kalp h\u0131z\u0131 veya do\u011fum sonras\u0131…<\/p>\n

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