EFFECTS OF PREOPERATIVE NALBUPHINE ON MATERNAL HEMODYNAMICS AND NEONATAL OUTCOMES DURING ELECTIVE CESAREAN SECTION UNDER GENERAL ANESTHESIA
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Keywords
Nalbuphine, Cesarean section, General anesthesia, Maternal hemodynamics, Neonatal outcomes
Abstract
Background: Cesarean section demands that anesthesia control consciousness, muscle function and pain together. Opioids are important for control of pain but may cause breathing problems for the new born and can enter the bloodstream of the baby through the mother’s placenta. Nalbuphine, an on-and-off opioid drug, may lower the risks to new borns.
Objective: This study looked at changes in maternal heart and the outcomes for the baby after nalbuphine was used just before the general anesthesia for elective cesarean section.
Methods: I gave 80 full-term pregnant women who were planning elective cesarean sections a study drug one minute ahead of anesthesia induction. Those in Group N were given nalbuphine diluted in normal saline and those in Group C were given normal saline only. Observation of both maternal heart rate and mean arterial pressure was started at the onset of labor, after intubation, throughout the operation and continued after the child was delivered. Researchers evaluated the outcomes at birth using the APGAR system at 1 and 5 minutes, the time for a infant to take its first breath and tests of the umbilical blood.
Conclusion: Stability in a mother’s heart rate and blood pressure was greater among those in the nalbuphine group than the controls whenever and after anesthesia induced (p < 0.05). After delivery, the scores for nalbuphine patients were below average at 1 minute but returned to normal at 5 minutes. In Group N, time to sustained respiration was greater, though patients had no serious clinical problems. Fetal oxygenation and balance of acids in the blood were preserved, since the umbilical cord blood gases were identical in both groups. Nalbuphine use pre-anesthesia in planned cesarean sections improves the mother’s blood pressure levels without jeopardizing the health of the baby. Because it floods the baby’s system quickly, its withdrawal is almost instant which is why it can be used safely in child birth.
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Dr. Seelam Bhagyavi
Assistant Professor, Department of Anaesthesia, Sri Lakshmi Narayana Institute of Medical Sciences & Hospital, Osudu, Puducherry - 605502