Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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Randomized Controlled Trial
Comparison of different end-tidal carbon dioxide levels in preventing postoperative nausea and vomiting in gynaecological patients undergoing laparoscopic surgery.
The aim of this study was to compare different end-tidal carbon dioxide (EtCO2) levels to prevent postoperative nausea and vomiting (PONV) caused by increased intracranial pressure due to pneumoperitoneum and Trendelenburg position in gynaecological laparoscopic surgery. A total of 60 female patients aged 25-50 years who would undergo laparoscopic gynaecological surgery under general anaesthesia were randomised into two groups: group A (EtCO2: 26 - 35 mmHg, n = 30) and group B (EtCO2: 36 - 45 mmHg, n = 30). In both groups, ONSD and EtCO2 of the patients were measured at baseline after anaesthesia induction (Tb), at 5 min after pneumoperitoneum (TPP5), and at 10 min intervals after Trendelenburg position (TPP10, TPP20, TPP30). ⋯ What the results of this study add? Postoperative nausea and vomiting caused by intracranial pressure (ICP) increase due to carbon dioxide pneumoperitoneum and Trendelenburg position in gynaecologic laparoscopic surgeries were decreased in the early postoperative period by low end-tidal carbon dioxide levels in the intraoperative period. It was shown that low end-tidal carbon dioxide levels have beneficial effects on ICP and PONV in laparoscopic gynaecologic operations. What the implications are of these findings for clinical practice and/or further research? This result indicates that low end-tidal carbon dioxide levels have beneficial effects on ICP and PONV in laparoscopic gynaecologic operations.
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Observational Study
Epidural analgesia during labour and stress markers in the newborn.
Labour and modes of delivery can influence the plasma levels of stress hormones and cytokines involved in pathophysiologic cascade, potentially damaging brain development of the newborn. This prospective observational, single-centre, case-control, non-profit study aimed to detect potential differences in foetal well-being such as stress neuroendocrine responses. Quantitative determinations of the stress markers interleukin (IL)-1β, IL-8, and β-endorphin were compared between the control group and the epidural analgesia group. ⋯ What do the results of this study add? This study found no significative differences in blood stress response markers between the epidural analgesia group and the control group. Under this study circumstances we found out that epidural analgesia does not significantly influence the newborn's well-being during labour and delivery. What are the implications of these findings for clinical practice and/or further research? These findings must be confirmed by further studies to verify whether epidural analgesia is safe for the newborn's development.